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Another Kind of Valor:


Another Kind of Valor: A Day of Learning How to Better Serve Veterans and Their Families – PowerPoint PPT presentation

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Title: Another Kind of Valor:

Another Kind of Valor
  • A Day of Learning How to Better Serve Veterans
    and Their Families

  • and they shall beat their swords into
    plowshares, and their spears into pruning hooks
    nation shall not lift up sword against nation,
    neither shall they learn war any more. Is.24

  • What am I going to learn?
  • The effects of war on returning Veterans and
    their families
  • The effects of war and differences among those
    who served in all military branches, and in
    services available to Veterans and their families
  • How to engage, talk to, work with Veterans and
    their families
  • Resources for Veterans and their families

Todays Returning Veterans
  • Who are returning vets?
  • Over 1.6 million soldiers have been deployed to
    Iraq or Afghanistan.
  • Over 1/3 of those soldiers have been deployed
    multiple times.
  • Global War on Terror (GWOT) 799,791 veterans are
    currently separated from the military.
  • As of January 2008, there were 299,585 GWOT
    Veterans who have sought health care through the
  • Over 100,00 veterans have returned to California.

Alphabet Soup Veteran Key Terms
  • OEF Operation Enduring Freedom
  • OIF Operation Iraqi Freedom
  • GWOT Global War on Terror
  • DOD Department of Defense
  • VA Veterans Administration
  • VBA Veteran Benefits Administration
  • VHA Veteran Health Administration

Major Issues for Combat Veterans
  • Major Depression
  • Post-Traumatic Stress Disorder (PTSD)
  • Traumatic Brain Injury (TBI)
  • Military Sexual Trauma (MST)
  • Substance Abuse
  • Suicide
  • Job loss
  • Family dissolution
  • Homelessness
  • Violence towards self and others
  • Incarceration

Population Regular Forces
  • What are concerns for those who served in active
    duty in the Army, Navy, Air Force, Marines and
    Coast Guard as well as the National Guard
  • 46.6 of regular forces are under 25 years old.
  • Many entered as teenagers and left home for the
    first time.
  • They may return to an already unstable home
    environment with added stress from combat.

Population National Guard Reserves
  • What are the concerns among National Guard and
    Reservist Veterans?
  • The average age of Guard and Reservists is 35.8
    years old.
  • Many Guard and Reservists are forced to leave
    jobs at or near the peak of their career.
  • These volunteer soldier veterans are half as
    likely to file VA claims as their regular forces
    counterparts, and half as likely to have their
    claims approved.

Population Women Military in the Military
  • What are concerns among soldiers and Veterans who
    are women?
  • More women are engaging in combat roles in Iraq.
  • To date there are between 155,000- 180,000 women
    who have served in OIF/OEF.
  • Women are 2 to 4 times more likely than
    non-Veteran women to be homeless.
  • Preliminary research shows that women in war have
    much higher exposure to traumatic experiences
    than women in the community.

view interview
Population Veteran Families
  • What are some of the issues facing Veteran
  • PTSD frequently has a debilitating effect on
    Veterans ability to maintain employment and
    family relationships.
  • 50-60 of spouses of brain injured Veterans
    reported having depression.
  • A drastic increase in the rate of child abuse and
    neglect in military families has been reported
    since 2002.
  • Resources for Spouses and children of Guard and
    Reservists lose all benefits 90 days after their
    soldier returns from war

Meeting and Greeting Veterans Families
  • Be quick to listen and slow to speak.
  • When discussing combat experiences, ALWAYS avoid
    making character judgments.
  • Never say anything as stupid and insensitive as
  • So, did you kill anyone?
  • My mom told me not to date a vet.
  • Did your (son, daughter, spouse) come back crazy?
  • What do you think about the war?

Talking With Veterans Families
  • How should I talk to Veterans or their families
    about their experience?
  • With respect, compassion and patience. Talking
    about combat can be an awkward conversation.
  • Ask factual, logistical questions like
  • How long have you been home?
  • What did you do in the military?
  • How are you transitioning?
  • Be honest and direct in order to earn their trust
    and build rapport..
  • Welcome home. How can I help you? Thank you for
    your service.

Getting Help Support and Resources
  • Where can Veterans and their families go to get
  • Veterans Administration.
  • Vet Centers.
  • Community Organizations like
  • Coming Home Project
  • Swords to Plowshares
  • YOU.
  • What are helpful resources that you would

Resource Veterans Affairs (VA)
  • Cant all veterans go to the VA?
  • No. Generally, veterans must have an honorable
    discharge, have served 24 continuous months,
    demonstrate financial need, and/or have a service
    connected disability.
  • OIF/OEF Veterans who served in combat are
    eligible for 5 years of free health care and may
    be eligible for 90 days of dental care after
  • Veterans must apply separately to the VHA and the
  • Vet Centers are designed to serve combat
    veterans, their surviving family members and
    victims of military sexual trauma (MST).
  • Provide marital and family counseling with
    counselors who are a Veteran as a conduit for

Barriers to Assistance
  • I sent a veteran to the VA for help, so they
    should be okay, right?
  • Hopefully. Veterans do not always receive
    immediate assistance.
  • The backlog in Veteran benefit claims has risen
    to 600,000.
  • As of June 2007, there were 202,705 GWOT Veterans
    filing claims for the first time.
  • The AVERAGE WAIT TIME for an initial decision on
    a claim 183 days!
  • The time frame for a claim decision, including
    appeals, can exceed 10 years

What can I do to Help Veterans and Their Families?
  • Learn
  • About military culture, experiences of soldiers,
  • and the needs of military, Veterans and their
  • Give
  • Them some of your time and energy, your
    appreciation, and your resources.
  • Be an Advocate
  • For military, Veterans, and their families
  • Talk
  • To them with respect and honor, listening with
    compassion and patience.

Engagement Skills
  • Practicing empathy
  • Providing choice
  • Removing barriers
  • Providing feedback
  • Clarifying goals

PTSD Combat Stressors
  • Being in constant alert for an IED/Booby trap
    or other life threatening dangers.
  • Feeling responsible for the death of an enemy and
    fellow human.
  • Seeing or experiencing the death or injury of a
    friend or fellow soldier.
  • Being shot at or exposed to other dangers.
  • Sexual trauma.

Symptom Response
  • Acute stress reaction immediate
  • Acute stress disorder up to 1 month
  • Acute PTSD 1 to 3 months
  • Chronic PTSD 3 months and beyond

PTSD Diagnostic Criteria
  • Re-experiencing thoughts, nightmares,
    flashbacks, emotional reactions, physiological
  • Avoidance Avoid thoughts, reminders, amnesia
    detachment, numbing, anhedonia.
  • Arousal, sleep disturbance, concentration
    problems, anger, hypervigilance, hyper startle

PTSD Impact on Families
  • Intimate relationships
  • Directly effect the relationship Anger
    responses, withdrawal of affection, unpredictable
  • Indirect affect on relationship skills e.g.
    impaired communication skills, avoidance,
    numbing, etc.
  • Perception of the relationship satisfaction
    with relationship reduced

PTSD Impact on Families
  • Spouse/partner
  • Direct impact of PTSD symptoms
  • Indirect added stress, lack of intimacy
  • Domestic violence
  • Secondary trauma Contagious PTSD
  • Compassion fatigue
  • Caregiver burden

PTSD Impact on Children
  • Direct effects developmental milestones delayed,
    adjustment issues, frightened of parent
  • Indirect effects parenting skills/role changes,
    compromised e.g. hypervigilance,
    avoidance/withdrawal, anger/aggression
  • Child at risk increased risk taking, neglect,
    violence, substance abuse

Stages of Recovery and Treatment
Ohio Spaniol, Gagne, et al Prochaska DiClemente Stage of Treatment Treatment Focus
Dependent unaware Overwhelmed by disability Pre-contemplation Engagement outreach practical help crisis intervention relationship building
Dependent aware Struggling with disability Contemplation/preparation Persuasion psycho-education set goals build awareness
Independent aware Living with disability Action Active Treatment counseling skills training self-help groups
Inter-dependent aware Living beyond disability Maintenance Relapse Prevention prevention plan skills training expand recovery
Motivational Interviewing
  • asking open-ended questions
  • listening reflectively
  • affirming change-related participant statements
  • encouraging self-motivational statements
  • handling resistance without direct confrontation

What Helps
  • Cognitive Behavioral Therapy (CBT)
  • Eye Movement Desensitization and Reprocessing
  • Brainspotting
  • Support Groups
  • Assistance with daily living support as needed.
  • Spiritual and Social supports.
  • What have you found to be helpful in serving
    returning Veterans and their families?