Karen Kelly, Ph.D., LPC, NCC, MAC, CCS, CRPS,SAP,CAMF,CDD,CPS,CDC

1. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World Karen Kelly, Ph.D., LPC, NCC, MAC, CCS, CRPS,SAP,CAMF,CDD,CPS,CDC

2. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Overview: Active duty military life affects a person’s relationships, work, health and other parts of daily living. As individuals are leaving the military they are bringing their experiences into an unsuspecting community. As these individuals begin to show up in offices, programs and emergency rooms they may go undiagnosed or be improperly diagnosed. As providers of mental health and substance abuse services we need to be competent in at least the identification, assessment and referral of these individuals. This work shop will provide the audience with insight into some of the varied experiences into military life and the challenges faced upon discharge.

3. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Objectives: By the end of this presentation participants will… • Gain tools to assess who might be at risk for PTSD or other combat related stress reactions. • Explore various types of tools/therapies designed to assist these individuals. • Discuss additional community resources available • Discuss the impact of alcohol and drug use on PTSD and stress related disorders.

4. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Introductions:

5. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • What is Culture

6. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • ACTIVITY: • Identify Your Culture: • Discuss goals, values, visions, slogans, or pledges That are particular to your setting

7. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Identifying culture: • Why might these values, goals, slogans, etc. be important to an organization?

8. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Culture: • Culture can be defined as the knowledge, experience, values, ideas, attitudes, skills, taste, and techniques that are passed on from more experienced members of a group to new members. • Elements of culture include: symbols, signs, ceremony, rituals, ethics, health, gender, myths, gender roles, gestures, kinetics, presence, ownership,recreation,relationships,privilages and rewards.

9. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Understanding Military Culture?

10. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Training and Indoctrination: • Training as a way to accomplish the mission • Military training: Has been defined in previous years as “the inculcation of skills aimed at achieving maximum efficiency in the battlefield, hence Basic training. • Basic training: “The preparation of individuals from civilian life for the demands of military life.

11. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • This basic training requires fitness, discipline, and the ability to live, and work in a highly structure environment. • In addition emphasis is placed on rules, discipline, social conduct, physical conditioning, self-confidence, and pride in being a member of the military.

12. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Elements of Military Culture:

13. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Elements of Military Culture include by are not limited to: • Expectations • Terms • Chain of Command • Protocol • Customs • Transition

14. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Military culture is shaped by national culture as well as geographical and historical factors. • Because of the constant change in leadership, professional military education, technology, and the impact of war. • Members become weary, tired and disenfranchised to what is unknown. • The end result challenges and a breakdown in their mental and physical well being.

15. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Deployment and Reintegration Issues: • What is deployment? • What happens after deployment? • Adapting to normalcy after deployment . • Transitioning to home life after discharge.

16. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • The transitioning military member: • What to expect • Physical Health • Emotional Health • Taking care of self • Talking about the experiences • Identifying signs and symptoms • Resources

17. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Military training and stress reactions have one thing in common- survival • Military education exercises, training, drilling, discipline, focuses on building a cohesive unit and increased unit performance. • Certain circumstances, however, threatens both the physical and mental well being of military personnel. • The end result a breakdown in the physical and mental health of the individual

18. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Impacting physical and mental health concerns: • Injury • Developmental problems • Physical strains • Diseases of the brain • Viruses • Aging issues • Extreme grief • Prolonged stress

19. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Not all members were traumatized by Deployment and Combat. • Around 70% will experience Combat and Operational Stress Reactions • Research suggests that approximately 20% of returning Veteransmeet the criteria for Major Depression, Acute Anxiety orPTSD

20. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Identifying Post Traumatic Stress Disorder

21. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • What is Post Traumatic Stress Disorder • PTSD is an emotional and behavioral disturbance that may occur after exposure to an exceptionally stressful, threatening or catastrophic event. • Some events are: • Combat • Disaster • Life threatening events • Witnessing violent death • Sexual assault • Violent Crimes • Threats of serious injury or death • Diagnosis emerges in 5% men, 10% women some variance depending on specific sub-populations

22. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Symptoms: • Arousal symptoms, restlessness, sleeplessness, hyper alert, inability to relax or get comfortable • Intrusive symptoms, mental "replays” and dreams in which the person sees, hears, feels, smell, tastes aspects of the event • Avoidance, lack of emotion, avoiding others, reminders such as people, places, and conversations can set off a reaction • Symptoms typically last beyond a month and can occur long after the original traumatic event

23. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Challenges in managing PTSD • Multiple combat experiences • Combined military and personal traumatic events • Alcohol and Drug use/abuse • Grief • Emotional depression • Disability due to injury • Memory and thinking problems • Other mental and physical problems

24. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Treating PTSD: • Positive Motivation • Trained in the identification and treatment of PTSD • Behavioral therapy • Cognitive Behavior therapy • Pharmacotherapy • EMDR • Trauma Incident Reduction (TIR) • Thought Field Therapy (TFT) • Assisting family member in understanding PTSD

25. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Other factors effecting the returning military member: • Heavy alcohol use • Alcohol is used to cope with stress, boredom and loneliness • Easy accessibility • One fourth of military young adults reported heavy alcohol use compared to 17.4% of civilians • Drug use for 18-25 year olds is less than ½ civilians • Mental health of military kids are impacted • Increase in incarceration of veterans

26. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Major Transition challenges: • Re-connecting to a new city, community and area. • Difficulty in writing effective resumes for the job search • Family, medical, and spiritual support • How to succeed in the business/civilian world • Connecting and networking outside of the military • Difficulty in navigating through the resource network

27. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Assisting the reintegrating military veteran • Education • Arming yourself with knowledge around veterans and their military experiences • Understanding the distinction between Major Depression, Acute Anxiety andPTSD • Utilize appropriate treatment strategies • Reach out to assist family members and significant others associated with the veteran • Learn what available resources are in your community

28. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • Warriorswho are depressed or overwhelmed areat risk forsuicide! • Our negative emotions can create negative, hopeless thinking • Trained Mental Health Providers and Specialty Counselors are well-trained to assist “at risk” Soldiers and provideeffective counseling or referrals • Some Warriors require medication for stabilization and treatment • Other Warriors falsely believe they can not be helped. They can! WhereResiliency, Thriving and Post Traumatic Growth reside,Suicide is not an option!

29. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian WorldCLOSING REMARKS • As a man thinketh, so is he” Proverbs 23:7 • “The mind is its own place, and in itself, can make heaven of hell and a hell of heaven” John Milton-Author • “Its not stress that kills us, it is our reaction to it” Hans Selye- Scientist who coined the term “stress” • “If we know why (we suffer) we can endure any how” • “What doesn’t break my back makes me stronger” Nietzsche- German Philosopher • “…more than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope…” Romans 5:3

30. Identifying Issues/Challenges for Military Members & Families Transitioning into the Civilian World • RESOURCES: • Veterans Administration • Military One Source • Join Together • Alcohol Research & Health • International Society for Traumatic Stress • National Center for PTSD • PTSD Alliance • Substance Abuse and Mental Services Administration