Transcript Dallas /Chicago Regional

Grants Post Award Conference
St. Louis, MO
“The best thing about the future,
is that it comes only one day at
a time.”
A. Lincoln
BATTLEMIND
 Buddies/Cohesion vs. Withdrawal
 Accountability vs. Controlling
 Targeted Aggression vs. Inappropriate
Aggression
 Tactical Awareness vs. Hypervigilance
 Lethally Armed vs. “Locked and Loaded”
BATTLEMIND (cont.)
 Emotional Control vs. Anger /Detachment
 Mission Operational Security vs.
Secretiveness
 Individual Responsibility vs. Guilt
 Non-Defensive (combat) Driving vs.
Aggressive Driving
 Discipline and Ordering vs. Conflict
DISABILITIES
Two times the amputations of any
previous war
11-28 % identified with TBI
22% diagnosed with PTSD, could
reach 30%
 Many undiagnosed for many years
Post Traumatic Stress Disorder
 Exposure to an event that causes
intense horror, terror or fear of death.
After the event the person persistently
re-experiences the event, attempts to
avoid memory or images of the event
and suffers distress or impairment.
PTSD –Signs and symptoms
 Sleep problems
 Socially Disconnected
 Restlessness
 Emotionally numb
 Overly watchful
 Depressed/Anxious
 Hyper vigilant
 Memory/Attention Span
 Social withdrawal
 Follow through
 Headaches
 Poor frustration
 Anger Outbursts
tolerance
 Distrust of Authority
 Risk taking behavior
PTSD - FACTORS
 Do not want to be seen as “weak”
 Survivor Guilt
 Do not see own symptoms
 Major event will bring to the surface
 Whole body/mind disorder
Traumatic Brain Injury
 Both open head injury and closed head
injuries can vary greatly in degree and
resulting damage. A closed injury tends to
be more diffuse, from swelling and bleeding
and an open injury is more focal to one
specific area of the brain. The degree of
injury is normally judged by the intensity of
the blow.
TBI - Symptoms
 Physical: headaches,
dizziness, balance,
nausea, fatigue, sleep
disturbance, blurred
vision, sensitive to
light, hearing
difficulties or loss,
sensitivity to noise,
seizures, numbness,
tingling, loss of taste
 Weakness in one or
more limbs, facial
muscles, or one side of
body. Difficulty
finding words, or
understanding the
speech of others,
slurred or slow speech.
TBI – Symptoms (cont.)
Cognitive
 Attention span,
concentration,
memory, speed of
processing, judgment,
executive control
Behavioral/Emotional
 Depression, Anxiety,,
agitation, irritability,
impulsivity,
aggressiveness,
Nervous, difficulty
controlling urges,
(uninhibited),
inappropriate laughter.
TBI – Factors
 Majority are mild and gone in 3 months
 No two brain injuries are ever the same
 Effects are complex and vary from person to
person
 In combat TBI can be either from a direct blow to
the head or
 As a result of an IED
 A closed brain injury is often undetected until
later
TBI and PTSD
Possible Job accommodations
“Do what you can,
With what you have,
Where you are” T. Roosevelt
VA and Mayo Clinic
Suggestions
 Reduce distractions
 Provide private space
 Ensure adequate lighting
 Divide large assignments into smaller pieces
 Plan uninterrupted work time
 Provide disability awareness to co-workers
 Combine breaks into one long break
VA and Mayo Clinic
Suggestions
 Encourage employees to walk away
 Assign a mentor
 Provide the availability or closed door space
 Allows calls to counselors and doctors and the
time to make up the work
 Allow a place for relaxation techniques during
breaks
 Provide written as well as verbal instructions
Office of Disability
Employment Policy
 Table 10 – Employer concerns about hiring
 Costs More = 58.1%
 Lack skills and experience = 49.4%
 Not as Safe and Productive = 45.7&
 Supervisors/disciplinary action = 44.3%
 Supervisors/Evaluate = 40.7%
ODEP
 Table 12 – Helpful Hiring Strategies
 Employer tax credit and incentives = 69.2%
 Disability awareness training = 64.3%
 Visible top management commit = 64.2%
 Mentoring = 63.4%
 Assistive Technology = 61.1%
 A specialized Recruiting force = 60%
 Flexible work schedule = 60%
 Train Existing Staff = 57.9%
Offender Population
Success is not final,
Failure is not fatal: It is the courage
to continue that counts
W. Churchill
PTSD/ Incarceration
And Homelessness
 4/09 VHA states “1/5 of the veteran population was
homeless prior to incarceration
 National Center for PTSD….PTSD can indirectly lead to
criminal behavior, i.e. self medication and hyper
vigilance.
 Psychiatric services studied 129 veteran inmates and
50 tested positive for PTSD.
 2008 conference of Mayors committed to the idea of
veteran court systems and training of first responders.
Offender Mindset
 Self-concept
 Self-knowledge
 Self-efficacy
 Internal locus of control
 Negative beliefs or attitude
 Planning and decision making
Recidivism
 Bureau of Justice :

67.5% of prisoners are arrested for a new
offense within 3 years of release.
 Reasons for Recidivism:
Lack of Employment
Homeless
Effective Job Search Techniques
 Prepare a master application
 Have a social security number and card
 Have a permanent address
 Record an appropriate message on your
phone or answering machine
 Have resources for faxes and e-mails
Explaining a Criminal Record
Do Not Lie!
Letter of Explanation
Typical Offender Characteristics
 Immaturity
 Irresponsibleness
 Self-centeredness
 Little concern for others
 Lack of remorse
 Ability to “talk” themselves out of anything
 Model prisoner
Communicate
 Adults make mistakes
 Listen to Input
 Confront the Offender
Confronting Offenders
 Know your authority
 Do not threaten
 State clear consequences
 Be clear about observations and perceptions
 Monitor results for accountability
 Say no and follow through
Common Offender
Job Retention Barriers
 Substance Abuse 68%
 Transportation 63%
 Lack of understanding workplace
culture 34%
 Lack of meaningful support 29%
Organizational Barrier
Just the Facts
Criminal Background Checks
 In most cases needs permission in writing
 Arrests during last 7 years
 Convictions (no matter when it occurred)
 Do not have to report any records that have been
legally erased
Employers in 2001 44% always check and 18%
sometimes check. Some occupations are
required to check.
Case Management Overview
“Don’t let what you can’t do
Stop you from what you can do.”
J. Wooden
What is Case Management
Case management is the facilitation and
coordination of services at the
community level. The purpose of case
management is to provide individuals
with specific resources to take control
of his/her life. It requires the case
manager to focus on the long and short
term goals an individual has and
empower him/her to make educated
decisions about their future.
1. Case management is
comprehensive
and client centered
2. The case manager and the
client are partners
3.There is mutual respect between
clients and case managers
4. A client has only one IDP.
5. Case management relates client’s
actions to outcomes.
6. Case management involves
creative problem solving.
7. Case management relies on a
network of services and support.
8. The case manager and the
system are accountable.
9. Case management requires
partnership at the system level
EDUCATION
& TRAINING
TRANS FERAB LE
S KILLS
S OCIAL &
ECONOMIC
FACTORS
INTERES TS
Whole
Person
Concept
P ERS ONAL
TRAITS
P OTENTIAL
S KILLS
LEIS URE TIME
ACTIVITIES
P HYS ICAL
CAPACITIES
Four Step Goal Setting Process
Change the problem
statement into goal
statements
Brainstorm solutions
and options; Balance
options with reality
Four Step Goal Setting Process
Choose one or more
options
Sequence services and
options on the IDP and
establish responsibility
Criteria for Goals
Specific
Measurable
Attainable
Realistic
Trackable
~Date anything that is written
~Quote statements exactly as
stated
~Recognize pertinent
information
~Write in specific, observable
and measurable terms
~If something is an opinion, say
so
Reviewing IDPs
Summary of the assessment
information
Reviewing IDPs
State specific goals
In 2 weeks, I
will have…
Reviewing IDPs
State who is
Reviewing IDPs
Dates each step will be
accomplished
Reviewing IDPs
Client’s and case managers
Signature
Reviewing IDPs
Client should be given a copy
Reviewing IDPs
Reviewed and updated regularly
Reviewing IDPs
Can notes
be deciphered