Transcript Military Culture & Treatment

Military Culture & Treatment - 101
Ninety minute workshop to overview the
culture of the military and its families, issues
affecting treatment, and sources of support
Peter McCall, Exec Dir
www.CareForTheTroops.org
[email protected]
770-329-6156
1
Introduction and Ground Rules
• This is not a political forum
• Questions are encouraged for group discussion
• Be respectful of others
• If the discussions, material, or videos at any time
become too disturbing feel free to leave the room till
you feel comfortable enough to return
2
Sources of Materials
CareForTheTroops 2009/2010 Military Culture 101 Workshop
The Fraser Counseling Center Staff, Hinesville, GA
Dr Blaine Everson, Clinical Dir, Samaritan Counseling Center, Athens, GA
Major Chris Warner, Winn Army Community Hospital, Fort Stewart , GA
Spiritual Wounds of War material
•
Kent D. Drescher, Ph.D., National Center for PTSD – Menlo Park
•
LTC Peter E. Bauer, MS USAR, LMFT, currently at Ft Hood
•
Chaplain Bill Carr, D. Min., LMFT, VA Hospital, Atlanta, Ga
•
Alan Baroody, LMFT, Presbyterian Minister, Exec Dir Fraser Counseling Center
VA Website
2010 AAMFT Annual Conference Workshop 303
TriWest Healthcare Alliance “Help From Home” DVD
“Care For Returning Vets” presentation from the ELCA Bureau for Federal Chaplaincies
Other citations on charts and handouts
3
Presentation Goals
There are 4 goals of this presentation:
• Understand the basics of the
military culture and veteran
issues
• Review key issues that can
impact the mental health of a military family
• Provide an understanding of resources available and
how CFTT can help
• Ultimately, build more credibility for
working with military families
4
Agenda
Topics
Part 1
Opening
Veteran Issues
Discussion
Part 2
Military Culture
The Veteran Experience
Deployment Cycle
Military Couples
Children
Discussion
Part 3
Trauma Continuum
Spiritual Wounds of War
Resources
Discussion
Handout – A0 …..an Example
5
Opening Videos
These three movie trailers provide a
good backdrop to the Veterans Issues
we are about to discuss.
Please take notes as a discussion will
be conducted after the next section.
The run time is approximately 8
minutes.
6
Veteran Issues
•
Multiple deployments are common causing stress and family attachment issues.
–
–
As of Oct 2008, multiple deployment breakdown: 60% = 1x 36% >= 2x 4% >= 4x
“Typical Deployment Durations”
Army and Marine
1 year (Ex Aviation and Spec Forces 4-6 months)
Navy
6-9 months
Air Force
~6 months
•
An April ‘08 Rand Study reported 37% have either PTSD, TBI, or significant Mental Stress
(5% all 3). Some estimate >50% return with some form of mental distress
•
Other mental health, marriage, and family problems often occur with or leading up to PTSD
requiring attention so they don’t get worse
•
In 2009, military children and teens sought outpatient mental health care 2 million times, a 20%
increase from ‘08 and double from the start of the Iraq war (‘03)
–
43% of Service Members have children
–
Average number of children per military family is 1.97 (AAMFT 2010 Annual Conference)
–
42% rise in children’s visits in 2009 over 2004 per Tricare
–
84% of Regular Military Service Members’ children attend public school, not DoD base schools
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Veteran Issues (cont.)
•
Suicide, alcoholism, drug abuse, domestic abuse and violent crimes rates are rising. In 2010:
military suicides exceeded civilian suicides.
–
–
–
–
–
–
–
•
Army and Marine have higher suicide rates than Navy and Air Force
More are occurring Stateside and many go unreported for insurance reasons and are post-discharge
Female suicide rate triples when deployed (recent NIMH study), though still lower than male rate
In GA, per the CDC from 2006-2008, 500 suicides of people identified as current or former military . This
represents 19.4% of all suicides during those years. The Age breakdown is as follows:
20-29
8.4%
50-59
21.2%
30-39
10.8%
60-69
31.8%
40-49
16.3%
70+
55.8%
18 vet suicides out of 30 attempts per day; 5 are already being treated by the VA. Women try more with
less success than men …Army Times 04/2010
Illicit drug use in the military was 5% in 2005, but now nonmedical use of prescription drugs is the most
common form of drug abuse. SPICE is becoming very common.
24.8% reported binge drinking >1x per week in the past 30 days vs 17.4% for same-age civilians
Military Sexual Trauma (MST) is running at 16%-23%
–
–
–
–
–
Includes harassment and assault
Almost as significant among males as among females (Newsweek, April 2011)
Mostly enlisted personnel under 25 yrs old (DOD 2010 Annual Report)
Single strongest predictor of PTSD in women - as combat is for men (Natelson, 8/05/10).
80% of assault victims fail to report the offense. (Natelson, 8/05/10)
Handout – A1 A2 A3
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Veteran Issues (cont.)
•
DoD and VA facilities are stretched … the Aug 2009 VA claims backlog was 900,000; the April
2010 backlog was improved to 605,000
–
–
April 2010 back up to 756,000
450,00 claims are taking over 125 days (USA Today, Apr 2011)
•
The U.S. Bureau of Labor Statistics reports the unemployment rate among post 9/11 veterans as
15.2% in January 2011, well above the 9.6 percent rate for non-veterans.
•
The VA said in Dec 2010 that more than 9,000 OIF/OEF vets were homeless (UPI); women are the
fastest growing segment of this population.
•
Many more Reservists & Guard than previous wars (54% as of mid ‘08) and they and families are
more distant from DoD and VA support facilities. This may be one of the most significant
affecting the future mental health impact on our communities and our society
–
–
–
•
Current numbers are in the 48% range
By design, approximately 33% should be Guard and Reserve
A large number of civilian contractors are also part of the deployed forces
Rand Study (‘08) estimates that PTSD and depression among service members will cost the
nation up to $6.2 billion in the two years after deployment. Investing in proper treatment would
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actually save $2 billion within two years.
Fraser Center Experience
www.frasercenter.com
THE FRASER CENTER SETTING:
1.
2.
Clients include Veterans, Active Duty Soldiers, and Military Dependents
Clients primarily from FT Stewart (3rd Infantry Division) and Hunter Army Airfield
GENERAL OBSERVATIONS MADE BY FRASER CENTER THERAPISTS WHO WORK
WITH OIF/OEF VETERANS, ACTIVE DUTY SOLDIERS, AND MILITARY DEPENDENTS:
1.
2.
3.
4.
5.
The children of military families are often the first to be brought in for therapy – secondary trauma.
“Is daddy going to die?”
The length, number, and frequency of deployments decreases family resiliency upon redeployment (returning home from a deployment).
The number of engagements “outside the wire” increases the likelihood of Combat Stress
Symptoms (transient, acute, & PTSD).
Over time, the constant threat of incoming mortar rounds and IED incidents increases likelihood of
CSS and PTSD for those who remain primarily in “green zones.”
The primary concerns of combat troops are: Mission First, staying safe, keeping their buddies safe,
getting home, and what is happening at home with their spouse and families.
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Fraser Center Experience
www.frasercenter.com
GENERAL OBSERVATIONS (continued…):
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
While deployed, soldiers also fight on the homefront via internet and cell phone with their
spouses. Homefront stressors may be higher than combat stressors.
Viewing internet pornography and internet sex chat is becoming a norm for deployment and
effects marriages upon return.
Many soldiers maintain their unit bonds following re-deployment to the detriment of their family
bonds.
Returning soldiers rarely talk with spouses about combat experiences.
There is a high rate of infidelity among soldiers and spouses during deployments. This is not
necessarily the “deal breaker” that it might be in civilian life.
Illegal/prescription drugs and alcohol are prevalent and are used as common coping mechanism
by soldiers (deployed and at home) and by their spouses.
While deployed, many soldiers are constantly sleep deprived and share each others medications
(i.e. ambient, provigil). Hooked on Energy Drinks.
The suicide rate of re-deployed) soldiers and spouses is on the increase.
Most soldiers know of at least one other soldier in their unit who “ate his gun” or was blown up by
an IED.
There is a high incidence of rape and sexual molestation of deployed female soldiers.
Soldiers and spouses express a great deal of anger toward perceived incompetency in the chain
of command, or in procedures, which have a direct negative impact upon their lives.
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Fraser Center Experience
www.frasercenter.com
GENERAL OBSERVATIONS (continued…):
17. Home is no longer a safe place to live. Many now carry weapons when not on military
installations at home.
18. The vast majority of returning troops are filled with undifferentiated anger and a short fuse.
19. There is a statistically verifiable increase in domestic violence and child abuse among military
families. Child abuse increases as the stressors increase in the life of the non-deployed spouse.
20. A primary therapeutic issue is the soldier’s inability to re-connect emotionally with spouse and
children. (exacerbated by anger and lack of patience).
21. Chaplains are the mental and spiritual health “first responders” at home and in the combat arena.
22. Special attention needs to be given to National Guard and Reserve Chaplains. There is a high
incidence of their leaving the ministry.
23. Both spouse and soldier recognize that the soldier is “changed” by combat deployment.
24. Important family milestones and transitions have been missed.
25. Soldiers may pursue activities which replicate the adrenaline rush of combat and sometimes reenlist without spousal consultation in order to maintain the rush.
26. Spousal dissatisfaction and resentment: power control issues upon redeployment. “I didn’t sign
up for this.” The military spouse sacrifices education and career
27. With increased monetary incentives and a lowering of recruitment standards the quality of the
troops has been increasingly lowered: no GED necessary, accepting recruits with DSM-IV
diagnosable conditions and on meds, increase of gangs in the army.
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Fraser Center Experience
www.frasercenter.com
GENERAL OBSERVATIONS (continued…):
28. Due to young age, immaturity, and low educational levels, many soldiers and spouses have poor
life skills: money management, parenting, communication, etc.
29. Some soldiers return to empty bank accounts and houses.
30. The military has greatly increased mental health support resources at home and abroad. The
Army recognizes that it is still not adequate.
31. The military is going out of their way to encourage soldiers to seek out mental health treatment,
yet the stigma against seeking help continues to exist.
32. Spirituality is an important tool in the healing process as it is an important issue among those who
have been in combat. It may not be express in typical “religious” language.
13
The next few charts cover the Military Culture
and organizational background to help you
better understand the client, where he/she was
positioned, and to
better interpret the
information and
stories they might tell
during their therapy
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Military Culture
Sociologists define culture as …
• Language - nomenclature;
acronyms, abbr.
• Beliefs – defenders of Democracy
• Value Systems – leave no one behind
• Norms & Rules – formal & informal conduct
• Material Products – weapons systems
Culture is associated with a social system
and unique to a given system.
Handout – B1
15
Military Culture
Branches of the Military
Georgia’s Military presence is dominated by Marine and Army units, though Air Force
and Navy are well represented too.
Georgia’s National Guard also has a large number of transportation units subject to IEDs
on roads and highways. It was ill-prepared when first deployed in 2003.
Georgia is 6th largest National Guard State. With the current base closing plan (BRAC),
GA will be one of the 5 largest military states along with TX, CA, NC, VA
NOTE: Coast Guard is now under Homeland Security
Handout – B2
16
Military Culture
Military Branch Structures - Example: U.S. Army
Core Values
84%%
2%
14%
84%
2%
14%
Services – Army, Navy, Marines, AF, CG
Components - Active, Guard, Reserve
Handout – B3
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Military Culture
Language - Glossary of Military Terms / Acronyms
OEF
OIF
Operation Enduring Freedom – it is a multinational military operation aimed
at dismantling terrorist groups, mostly in Afghanistan. It officially commenced
on Oct. 7, 2001 in response to the September 11th terrorist attacks.
Operation Iraqi Freedom - also known as the Iraq War; began on 3/20/2003.
Operation New Dawn – post OIF operations
Army
Navy
Marine
Air Force
Soldier
Sailor
Marine
Airmen
USAR
USANG
United States Army Reserve (Federal)
United States Army National Guard (State)
E1-E9; O1-O10
SPC
First SGT
Gunnie
NCO
Enlisted Ranks; Officer Ranks
Specialist, rank of E4, often referred to a “Spec 4”
First Sergeant, rank of E7, lead enlisted person in a company. It and SSG,
Staff Sergeant are key leadership ranks with lots of job pressures
A Marine First Sergeant
Non-Commissioned Officer, ranks E6 through E9
IEDs
FOB
Sandbox
Down Range
Outside the Wire
Taking the Pack Off
Top Cover
Improvised Explosive Devices
Forward Operating Base
Iraq and Afghanistan
Deployed to anyplace where there is shooting.
Leave the safety of the “enclosed” military base (FOB)
Leaving mentally and physically from combat
Making sure the boss looks good
Handout – C1 C2 C3 C4 C5
www.rivervet.com/oif_glossary.htm
18
Military Culture
Belief and Value Systems; Norms and Rules
•
Beliefs:
Defenders of Democracy
Trust in the leadership
Role clarity
Distrust of civilians
•
Value Systems:
Leave no one behind
“The Group” practically becomes a “family system”
Top Cover-defend and support the boss
Violence: many have a history of violence which often plays a role
•
Norms & Rules:
Formal and informal conduct
Stigma of mental health and PTSD
Cover of the boss (Top Cover)
Back-logging trauma
19
Military Culture
Key ‘Descriptors’
•
•
•
•
•
•
Structured
Standardized
Authoritarian
Esprit de Corps
Focused on Mission
Disciplined
•
•
•
•
•
•
Service Before Self
Political
Mobile
Family Secondary
Technical
Education
20
Military Culture
Regular/Active Duty vs Reserve/Guard Units
Regular / Active
• Units are based at
major military
installations.
• Full-time soldiers who
expect to be deployed .
• Families are left at their post where a
variety of support is in place both onpost & in communities.
• Live on-post or nearby; other family
support
• Less need to relocate when deployed
• Access to a variety of health, welfare,
& educational services
• Support groups in-place through
soldier’s unit
Handout – D1
Reserve / Guard
• Units are small & based in local
communities.
• Part-time soldiers, often working with
local police, fire, and EMS.
• Families may be left in a town with
little or no support services.
• Mostly support units in Georgia
(transport, MP, etc)
• Likely to work within
local communities
• Can’t relocate easily
when activated
• Lack of military related health services
• Need to make use of family or local
supports (church, etc.) though FRG’s
are very helpful
21
…a closing thought
on the Military Culture
“The capacity of Soldiers for absorbing
punishment and enduring privations is
almost inexhaustible so long as they believe
they are getting a square deal, that their
commanders are looking out for them, and
that their own accomplishments are
understood and appreciated.”
GENERAL Dwight Eisenhower, 1944
22
The next few charts cover the Veteran
Experiences and Stressors that are part of the
military culture of OEF and OIF veterans’ families.
It applies in many
ways to other
veterans and
their families
also.
Handout – D2 D3 D4
23
The Veteran Experience
Why is this war different?
•
•
•
•
•
•
•
•
•
•
Volunteer vs. draft
Multiple deployments
Type of suicide bombings
Never any safety, no real recovery time
Use of civilians as shields and decoys by the enemy
Deliberately targeting our moral code
COMMUNICATION! Internet, cell phones, etc.
IEDs, RPGs (TBI, hearing loss, neuro-chemical effects)
Advancement in medical treatments
Nation-building activities and interactions
with local leaders
24
The Veteran Experience
Profile of Differences by Era
Vietnam
OIF / OEF
•
military cohorts
• relatively homogenous
• enlisted and drafted
• fewer Reservists/Guard
• fewer civilian contractors
•
•
•
•
•
•
average age 18-22
not married
no children
no career developed
adolescents— early stages of
development
one tour (12-13 mos) were typical
communications via phone, mail
wounded/killed ratio 3:1
•
•
•
•
•
•
•
•
•
•
•
not homogenous---heterogeneous
• Active duty
• Reservists/Guard• joined for variety of reasons
• likely did not expect to be deployed
• Large number of civilian contractors
wide age range: 18-60+
married
parenting/grand-parenting job/career
financial responsibilities (e.g. mortgage, family)
multiple deployments with unknown duration
are typical
instant communication
more indirect combat e.g. IEDs and suicide
bombers, constant threat
wounded/killed ratio 15:1
Korea and World War II ???
25
The Veteran Experience
With a Focus On “Negative Descriptors”
•
•
•
•
•
•
•
Fear of Death
Killing
Survivor Guilt
Unreality
Strong Bonds
About Face
Unfinished Business
•
•
•
•
•
•
•
Seared Memory
Multiple Losses
Teamwork
Survival Mindset
Cautious of People
Soul Searching
Lack of Understanding
The Veteran Experience
Realizing the bridge is down…
“Home—the place many think is the safe haven to
find relief from the stress of war—may initially be a
letdown. When a loved one asks, ‘What was it like?’
and you look into eyes that have not seen what yours
have, you suddenly realize that home is farther away
than you ever imagined.”
Down Range: From Iraq and Back, by Cantrell & Dean, 2005
Handout – E1
27
Video – Signs of Stress
Scenes from these movies depict the stress points that occur
between couples upon re-deployment . These are also intended
to set up the following charts that cover the deployment life
cycle and key points on the cycle’s timeline.
Again, please take notes as a discussion will be conducted
following these clips. Run time approximately 5 1/2 minutes.
28
Deployment Cycle
Chris Warner’s Sources of Stress
Number of Contacts
300
250
200
150
100
50
0
1
2
3
4
Combat Exposure
5
Peer/Unit
6
7
8
9
10
11
--->> Number of Months
Home Front Stressors
Warner CH, Breitbach JE, Appenzeller GN, et.al. “Division Mental Health: It’s Role in the New Brigade Combat Team Structure Part I:
Pre-Deployment and Deployment” Journal of Military Medicine 2007; 172: 907-11.
29
Deployment Cycle
• Pre-deployment - Period of training and
equipping prior to deployment (30-90 days).
• Deployment - Combat and Humanitarian
missions anywhere in the world (3-18
months).
• Redeployment - Return from operations to
home base (30 days). (For Reserve and National Guard
components this includes demobilization and return to civilian
life).
The Military Deployment Cycle
… or The Military Family Life Cycle
Pre-deployment
Conflict & Previous
Stressor pile-up
Family readjusts Consequences
for behavior
Revitalize
Relationships and
“honeymoon”
Pre-deployment
Stress – anxiety
and concern
Reunion and
homecoming –
joy and
anticipation
Soldier
Deployment
Separation
Stress –
Depression &
Anxiety
Family Adjustment w/o
Soldier in Home – Out-ofOrdinary Behaviors
Pre-reunion Stress
– anxiety and worry
about behavior
away
31
Military Family Life Cycle
(…Career View)
<May be 1st deployment for both partners>
-Courting
-Pregnant
Deploy
-Marriage
New
family
begins
in
absentia
<Missed 1st year of marriage>
Mid-tour
leave
Parental
adj &
young
children
Return
&
Reunion
Resume
normal
routines
<Divorce & remarriages w/ kids for previous relationships are common – complex stepfamily>
ETS or
Retire
Families
w/
teens &
possibly
steps
Relocation
Return
&
Reunion
Family
w/
school
agers
Redeploy
Transitions are often marked by crisis points in the family life cycle.
32
Deployment Cycle
Military Family At-Risk Factors
1. Frequent Relocation
3.3 years average
2. Previous Deployments
87%
3. Longer Separations
7.3 month average
4. Larger Families
42% ≥ 3 children
5. Younger Mothers
26.5 median age
6. Blended Families
31% step-parents
7. Education
21% w/o HS diploma
8. Working Outside Home
44%
9. Median Income
< $30,000 (34%)
Quality of Life Among U.S. Army Spouses During OIF, Dissertation, 2005, Dr. Blaine Everson
33
Military Couples
Deployment Related Stressors for Spouses
STRESSOR
POSITIVE RESPONSE
Feeling Lonely
90.0% (271)
Having Problems Communicating with my Spouse
61.2% (184)
Experiencing the Death of a Close Friend or Relative
33.2% (100)
Managing and Maintaining Family/Personal Finances
47.2% (142)
Personal/Family Health Issues
43.2% (130)
Being Pregnant during the Deployment
26.9% (81)
Raising a Young Child while my Spouse is not Present
63.2% (190)
Childcare
39.9% (120)
Managing and Maintaining the Upkeep of my Home
49.1% (148)
Having Reliable Transportation
19.9% (60)
Caring/Raising/Disciplining Children with my Spouse Absent
56.5% (170)
Balancing between Work and Family
Obligations/Responsibilities
53.4% (159)
The Safety of my Deployed Spouse
96.4% (290)
Warner CH, Appenzeller GN, Warner CM, Grieger T. “Psychological Effects of
Deployments on Military Families” Psychiatric Annals 2009; 14: 56-62.
34
Military Couples
Assessment and Treatment Issues
• Dangerousness to self / others
• Suicide / Homicide
• Domestic violence
• Child abuse
• Individual issues
• PTSD, TBI
• Medication abuse
• Alcohol and drug use
2010 AAMFT Annual Conference Workshop #303
35
Military Couples
Stressors Specific to the Couple Relationship
• Level of Commitment and Maturity
• Deployment Cycle / Adaptability
• Roles / Power issues
• Sexual Issues
• Infidelity
• Disabilities / Chronic illness
• Financial Issues
• Parenting
Additional for Reserve/Guard Families
• “Citizen Soldier”
• Mobilization and Deployment
• Separation from School, Jobs, etc
• Demobilization
2010 AAMFT Annual Conference Workshop #303
36
Children
What Impacts Are Seen
•
•
•
•
•
•
•
Disruption of Routines
Boundary Issues & Parental Roles
Fear for Safety of Military Parent
Mimicry of Parental Responses
Sleep Disturbances and Phobias
Increase in Number of Physical Ailments
Secondary and Vicarious Traumatization
Children
Developmental Issues
• Toddlers (3-5) - Separation Anxiety,
Self-Comforting Behavior, Regression,
Refusal to Eating and Sleep
• Elementary (5-10) - Anxiety, Withdrawal,
Regression, Fear, Uncontrolled Acting
Out, Behavioral Contagion
• Middle School (10-13) + Fighting, Isolation Behavior,
Emotional Contagion, Difficulties with Concentration
• Teenagers (13-18) + Rule Testing, Substance Use,
Assaults, Use of External Systems for Support
Children
Reserve and National Guard Family Concerns
• Families are not as experienced with deployment and
extended absences
• Family members are less familiar with military
support agencies
• Live in local communities with less
access to military support systems
• Face integration back into civilian job
or may need job assistance.
The next few charts cover Trauma, PTSD, TBI
and the Spiritual Wounds of War that are
related to the OEF
and OIF veteran.
40
The Trauma Continuum
“The past is never dead.
It is not even past.”
…William Faulkner
“Not everyone has PTSD.
It is not the only diagnosis.”
…me
ASR
COSR
PTSD
41
Trauma Continuum:
ASR to COSR to PTSD
• ASR (acute stress reaction)
produces biological, psychological, and behavioral
changes. ASD means it has become
disruptive and destructive.
• COSR(combat and operational stress)
is expected, common, and occurs throughout deployment to some
degree. Pretty much everyone comes home with some version of
combat and operational stress.
• PTSD(post traumatic stress disorder)
becomes classified if COSR symptoms are daily, interfere, and “last
longer than 1 month”
42
Trauma Continuum
Human Stress Response
43
Trauma Continuum
Signs / Symptoms Of (Combat) PTSD
• HYPER-AROUSAL:
Fight/Flight/Freeze, Angry, poor sleep, argumentative, impatient,
on alert, tense (hyper-vigilant), intense startle response, speeding
tickets (once home), and other risky behavior.
• NUMBING/AVOIDANCE:
Withdrawn, secretive, detached, controlling, removes all
reminders, avoids similar situations, ends relationships with
people associated with trauma, etc.
• RE-EXPERIENCING:
Nightmares, flashbacks, intrusive thoughts
Don’t Forget “Inter-Generational” PTSD
Handout – F1 F2 F3 F4 F5
44
Trauma Continuum
TBI: Traumatic Brain Injury
•
Signature Injury of OIF/OEF
•
Explosions account for 3 of 4 combat-related injuries
•
VA reports 61,285 OIF/OEF vets had preliminary
screen, 11,804 were positive (20%)
•
Improvements in war zone medical treatment has
decreased fatalities but may have impacted rise
in TBI
•
Prevalence is possibly still underestimated
•
Soldiers are returning home with “poly-trauma”
•
TBI may hinder or cause “good therapy” to be ineffective. A TBI
assessment may be appropriate.
•
Symptoms: headaches, tinnitus, dizziness, balance problems, sleep
problems, persistent fatigue, speech, hearing and vision impairment,
sensitivity to light and sounds, heightened or lessened senses,
impairments in attention and concentration, memory problems more like
dementia than amnesia, poor impulse and anger control
45
The Spiritual Wounds of War
Veteran Quotes of Spiritual Injuries
•
•
•
•
•
•
•
•
•
•
•
Handout – G1 G2
“I was totally alone”
“I was not myself”
“I saw myself dead”
“I lost my innocence, sanity and faith”
“Time stopped”
“Did I die there?”
“I became mean and cold”
“I was afraid”
“I never talked about it”
“I reject religion”
“Nothing prepared me”
46
Support Resources
The next few charts cover Support Resources
for veterans and those who come in contact
with a veteran in need of support
47
VA Hospital Contacts in Georgia
Handout – H1
48
www.CareForTheTroops.org
All the material used in this presentation (PPT and PDF), except for
the videos themselves, is available on the CareForTheTroops
website….Here is the link
http://www.careforthetroops.org/library_training.php
49
Approach
Military
Member
Person in
need of
support
Spouse
Siblings
Children
Parents
Grandparents
50
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-Program Guidebook
Clergy/Lay Leader Training
- Signs of Trauma and Spiritual Wounds
- Referral Source Information
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This is the top
of the Home
Page
Handout – H2
In Closing
Why it’s all worth learning
about how to work with
military families.
Run time is 4 minutes
Remember
www.JoiningForces.gov
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