The impact of deployment on service members and their families l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 51

The Impact of Deployment on Service Members and their Families PowerPoint PPT Presentation


  • 591 Views
  • Uploaded on
  • Presentation posted in: General

The Impact of Deployment on Service Members and their Families. Presented by: Jim Messina, Ph.D. Licensed Psychologist Lead Trainer: Florida ARC- Coping with Deployment PFA for Military Families Lead Disaster Mental Health Services Tampa Bay Chapter of American Red Cross

Download Presentation

The Impact of Deployment on Service Members and their Families

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


The impact of deployment on service members and their families l.jpg

The Impact of Deployment on Service Members and their Families

Presented by:

Jim Messina, Ph.D.

Licensed Psychologist

Lead Trainer: Florida ARC-

Coping with Deployment PFA for Military Families

Lead Disaster Mental Health Services

Tampa Bay Chapter of American Red Cross

Psychologist with: St. Joseph’s Hospital, Vericare, Argosy University

Presentation Available on: www.jamesjmessina.com


Most current statistics on make up of deployed military l.jpg

Most current statistics on make up of Deployed Military

  • Men = 90%

  • Women = 10%

  • Married = 53%

    • with children = 68%

    • without children = 32%

  • Single = 47%

    • with children = 13%

    • without children = 87%

  • CTS Deployment File Baseline Report, Defense Manpower Data Center, Aug 31, 2007


Major stressors for military families l.jpg

Major Stressors for Military Families

  • Frequent moves and separations

  • Individual augmentees

  • Risk of injury and death

  • Expectations

  • Long and unpredictable Foreign residence


Risk factors for military families l.jpg

Risk Factors for Military Families

  • Younger spouses

  • Younger children

  • Socially isolated and dependent families

  • Families undergoing major transitions

  • Families with multiple needs and problems before deployment

  • Children with school history of special education

  • How well children show coping skills prior to deployment


Risk factors for military families5 l.jpg

Risk Factors for Military Families

  • Family history of mental health issues

  • Families of junior enlisted

  • Single parents

  • Foreign-born spouses

  • Pregnant spouses

  • Prior deployments

  • Dual military

  • Newly married


Stressors in the deployment cycle l.jpg

Stressors in the Deployment Cycle


Pre deployment stressors l.jpg

Pre-Deployment Stressors

Preparedness – Practical preparation

  • Power of attorney/Will/Financial plan

  • Location of important papers

  • Emergency contact procedures

  • Child care arrangements

    Emotional preparation

  • Prepared to cope with unexpected problems

  • Trust service member will be protected

  • Support mission


Pre deployment stressors8 l.jpg

Pre-Deployment Stressors

  • Lack of Preparation Time

  • Unit Preparation vs. Family Preparation

  • Shifting expectations

  • Length of upcoming deployment

  • Open-ended deployments

  • Deployment date

  • Clarifying changes in family dynamics

  • Anticipation of threats to service member

  • Perception of mission purpose

  • Lack of information

  • Rumors


Deployment stressors on spouses l.jpg

PRE-DEPLOYMENT

Confusion

Denial

Resentment

Arguing

Worrying

Planning

DURING DEPLOYMENT

Busier than usual

Crying

Loss of sleep, appetite

Engrossed in war news

Self-growth

Independence

Decision maker

Less angry, but lonelier

Deployment Stressors on Spouses


Deployment stressors on children l.jpg

PRE-DEPLOYMENT

Confusion

Regression

Anger Outbursts

Sadness

Surprise

Guilt

Behavioral problems

DURING DEPLOYMENT

At higher risk for problems than the national norm.

Parenting stress during deployment is more than the national norm.

Boys and younger children may experience more symptoms than girls.

Internalizing symptoms may be more common than externalizing symptoms

Deployment Stressors on Children


Pre deployment stressors on adolescents l.jpg

Pre-Deployment Stressors on Adolescents

  • “I don’t care”

  • Fear of rejection

  • Denial of feelings

  • Anger

  • Higher value on friends


Children s reaction to deployment l.jpg

Children’s Reaction to Deployment


Stressors in the deployment cycle13 l.jpg

Stressors in the Deployment Cycle


Deployment stressors for service members l.jpg

Deployment Stressors for Service Members

  • Operational-heat, dehydration, lack of comforts, desert, noises, fumes

  • Cognitive-boredom, monotony, unclear role or mission, experiences that defy beliefs, info overload

  • Emotional-fear of failure, guilt, horror, fear, anxiety, feeling devalued

  • Social-separation from loved ones, lack of privacy, public opinion and media

  • Spiritual-change in faith, inability to forgive, loss of trust

  • Charles Figley and William Nash, Combat Stress Injury (2007)


Trauma descriptions offered by soldiers and marines l.jpg

Trauma descriptions offered by Soldiers and Marines

  • Friends burned to death, one killed in blast

  • A friend was liquefied in the driver’s position on a tank

  • A huge bomb blew my friends’ head off like 50 meters from me

  • Marines being buried alive

  • Seeing, smelling, touching, dead, blown-up people


Tough realities about combat l.jpg

Tough Realities about Combat

  • Fear in combat is ubiquitous

  • Unit members will be injured and killed

  • There will be communication breakdowns

  • Leadership failures will be perceived

  • Combat impacts every soldier mentally and emotionally

  • Combat has lasting mental health effects

  • Soldiers are afraid to admit that they have a mental health problem

  • Deployments place a tremendous strain upon families

  • Combat environment is harsh and demanding

  • Combat poses moral/ethical challenges

    • WRAIR Land Combat Study Team


Challenges of operation iraqi freedom oif operation enduring freedom oef l.jpg

Challenges of Operation Iraqi Freedom (OIF) & Operation Enduring Freedom (OEF)

  • No “front line”

  • Highly ambiguous environment

    • Complex and changing missions – combat, peacekeeping, humanitarian

  • Long deployments

  • Repeated deployments

  • Environment is very harsh – extreme heat

    • 24 hour operations

    • constant movement by ground or air

    • limited down time

    • crowded uncomfortable living conditions

    • difficult communications


Combat exposure in iraq l.jpg

Combat Exposure in Iraq


Common reactions to trauma l.jpg

Common Reactions to Trauma

  • Fear and anxiety

  • Intrusive thoughts about the trauma

  • Nightmares of the trauma

  • Sleep disturbance

  • Feeling jumpy and on guard

  • Concentration difficulties


Common reactions to trauma20 l.jpg

Common Reactions to Trauma

  • Avoiding trauma reminders

  • Feeling numb or detached

  • Feeling angry, guilty, or ashamed

  • Grief and depression

  • Negative image of self and world

    • The world is dangerous

    • I am incompetent

    • People can not be trusted


Battlemind training l.jpg

BATTLEMIND TRAINING

  • Battlemind skills helped you survive in combat, but may cause you problems if not adapted when you get home

  • Buddies (cohesion) vs. Withdrawal

  • Accountability vs. Controlling

  • Targeted Aggression vs. Inappropriate Aggression

  • Tactical Awareness vs. Hypervigilance

  • Lethally Armed vs. “Locked and Loaded” at Home

  • Emotional Control vs. Anger/Detachment

  • Mission OPSEC vs. Secretiveness

  • Individual Responsibility vs. Guilt

  • Non-Defensive Driving vs. Aggressive Driving

  • Discipline and Ordering vs. Conflict


Slide22 l.jpg

Social

Support

Initial

Reactions

Trauma

PTSD

Symptoms


The role of families l.jpg

The Role of Families

  • In general, families provide a primary source of social support.

  • Spouses and intimate partners are typically identified as the chief source of social support.

  • Approximately 50% of service members deployed to OEF/OIF are married at the time of deployment.


Background invisible wounds of war rand corporation 2008 l.jpg

Background Invisible Wounds of WarRand Corporation (2008)

  • Since October 2001, approximately 1.64 million U.S. troops were deployed to Operation Enduring Freedom (OEF; Afghanistan) and Operation Iraqi Freedom (OIF; Iraq).

  • Pace of deployments is unprecedented in the history of the all-volunteer force (Belasco, 2007; Bruner, 2006).

  • Higher proportion of armed forces are being deployed & deployments have been longer, redeployment to combat has been common, and breaks between deployments have been infrequent (Hosek, Kavanagh, and Miller, 2006).


Background invisible wounds of war rand corporation 200825 l.jpg

Background Invisible Wounds of WarRand Corporation (2008)

  • OEF & OIF have employed smaller forces & produced lower casualty rates of killed or wounded than Vietnam and Korea. More service members are surviving due to advances in medical technology & body armor (Regan, 2004; Warden, 2006).

  • However, casualties of a different kind have emerged—invisible wounds, such as mental health conditions and cognitive impairments

  • These deployment experiences may include multiple deployments per individual service member and exposure to difficult threats, such as improvised explosive devices (IEDs).


Invisible wounds of war rand corporation 2008 l.jpg

Invisible Wounds of War Rand Corporation (2008)

  • Data from phone survey of approximately 2000 OIF & OEF veterans

    • 14% PTSD

    • 14% depression

    • 19% TBI

    • 33% PTSD, depression or TBI

    • 5% symptoms of all 3


Invisible wounds of war rand corporation 200827 l.jpg

Invisible Wounds of War Rand Corporation (2008)

Top 3 barriers to mental health treatment

1. Treatment not confidential; could constrain future job assignments and military career advancement

2. Medications may have unpleasant side effects

3. Even good mental health care is not effective


Invisible wounds of war rand corporation 200828 l.jpg

Invisible Wounds of War Rand Corporation (2008)

Costs of PTSD, depression and TBI–Other psychiatric diagnoses

  • Risk of attempting suicide

  • Higher rates of unhealthy behaviors (smoking, overeating, unprotected sex)

  • Higher rates of physical health problems and mortality

  • Missed more days of work or less productivity

  • A relationship to being homeless


Invisible wounds of war rand corporation 200829 l.jpg

Invisible Wounds of War Rand Corporation (2008)

  • Service members not on active duty (Reserve Corps, discharged, retired)

  • Enlisted personnel

  • Females

  • Hispanics

  • More lengthy deployments

  • More extensive exposure to combat trauma


Summary of findings invisible wounds of war rand corporation 2008 l.jpg

Summary of FindingsInvisible Wounds of War Rand Corporation (2008)

  • About 10-15% of Soldiers develop PTSD after deployment

  • An additional 10-15% have significant symptoms of depression, anxiety, or PTSD

  • Alcohol misuse also increases post-deployment

  • Prevalence varies as a function of deployment experiences

  • MH problems associated with functional impairment, attrition, and physical health problems

  • One-third of Soldiers use MH services after deployment (includes screening and prevention services)

  • Perceptions of stigma may be improving. However, many Soldiers don’t seek help, due to stigma and other barrier


Financial stressors of deployment l.jpg

Financial Stressors of Deployment

  • Most do not experience serious financial difficulties – Potential loss of income offset by supplements

  • Substantial minority does face financial hardships– 18% of spouses report serious financial difficulties

    • 29% of spouses report trouble paying bills

    • 1/2 reporting difficulties are from junior enlisted grades

  • Increased expenses– Supplies for deployed service member

    • Shipping costs

    • Communication

    • Additional childcare costs


Stressors in the deployment cycle33 l.jpg

Stressors in the Deployment Cycle


Typical course of reintegration l.jpg

Typical Course of Reintegration

  • Family resilience is the rule, not the exception.

  • Usually, families return to the normal routine.

  • Common to incorporate changes without major disruption in family functioning.

  • HOWEVER…


Reunions can be stressful l.jpg

Reunions can be stressful

  • Changed roles/responsibilities

  • New independence of spouse

  • Lack of time

  • Tug on loyalties

  • Extended family

  • Health/Mental health problems

  • Unresolved marital issues haven’t vanished


Most frequently identified stressors following soldiers return l.jpg

Most frequently identified stressors following soldiers’ return

  • Readjustment to marital and family relationships

  • Lack of time for family reintegration

  • Couple jealousy and suspicions

  • Ongoing military stressors

  • Uncertainty about future retention

  • Teitelbaum (WRAIR,1992) conducted a study with the Army after ODS


Post deployment stressors of service members l.jpg

Post Deployment Stressors of Service Members

  • Physical: traffic, crowds, unarmed, access to alcohol

  • Cognitive: loyalty issues to family vs unit, secrecy vs disclosure, boredom, regrets, thoughts of losses

  • Emotional: grief, anger, feeling unsafe, guilt, withdrawal from war “rush,” numbness

  • Social: separated from buddies, overwhelmed or misunderstood by family, feelings of alienation

  • Spiritual: asking why buddies died, lack of purpose, changed faith, conflicting values

  • Charles Figley and William Nash, Combat Stress Injury (2007)


Service mindset when deployed l.jpg

Service Mindset when Deployed

  • Stay focused on mission /nothing else matters

  • Truly life or death / always on the edge

  • Constant adrenaline “rush”

  • Black or white / all or nothing

  • Sense of purpose, invincibility

  • Only trust battle buddies /others are threat

  • Need to control environment

  • Real problems and needs exist in Iraq

    • Adapted from briefing by COL Kevin Gerdes, May 2008


Mindset of returned service members at home l.jpg

Mindset of Returned Service Members at Home

  • Life is now unfocused and complex

  • No longer on the verge of life or death

  • What can replace the “high” of war?

  • Things aren’t clear cut

  • No sense of purpose, nothing matters

  • Can’t trust anybody

  • Can’t be in control of surroundings

  • Problems at home pale in comparison to those in Iraq

    • Adapted from briefing by COL Kevin Gerdes, May 2008


Reserve components stress after deployment l.jpg

Reserve Components Stress after Deployment

  • Return to civilian life

  • Job may no longer be available

  • May experience a reduction in income

  • Transition of health care or loss of health coverage

  • Loss of unit/military support system for the family

  • Lack of follow up/observation by unit commanders to assess needs


Changes in family faced by returning service members l.jpg

Changes in Family faced by returning Service Members

  • FAMILY HAS

    • New routines

    • New responsibilities

    • More independence and confidence

    • Made many sacrifices

    • Worried, felt lonely

    • Gone through milestones that were missed

      • Adapted from briefing by COL Kevin Gerdes, May 2008


Impact of returning home l.jpg

Impact of Returning Home

  • VETERAN’S RETURN CAN

    • Interrupt routine

    • Disrupt space

    • Throw off decision making

    • Cause family to walk on tip toes

    • Not make everything perfect

    • Not replace the sacrifices and missed milestones

    • Adapted from briefing by COL Kevin Gerdes, May 2008


Post deployment stressors for spouses l.jpg

Post Deployment Stressors for Spouses


Post deployment stressors for children l.jpg

Post Deployment Stressors for Children

  • Afraid of returning parent /Avoiding

    • Wants attention

    • Clingy

    • Anger

    • Needs reassurance

    • Attempts to split parents

    • Desires recognition

    • Joy

    • Excitement

      • Briefing by Doug Lehman, May 2008


Post deployment stressors of adolescents l.jpg

Spending more time with friends

School problems

Behavioral problems

Relief

Defiance

Resentment

Avoidance

Withdrawal

Briefing by Doug Lehman, May 2008

Post-Deployment Stressors of Adolescents


Tips for both spouses during reintegration l.jpg

Tips for both spouses during reintegration

  • Recognize that readjustment stress is common

  • Listen to each other’s stories and be curious

  • Recognize that experiences have changed both partners

  • Discover new family strengths

  • Negotiate a new balance, roles, and routine

  • Make sure each spouse has space


Tips for both spouses during reintegration47 l.jpg

Tips for both spouses during reintegration

  • Don’t play “one-up” games about deployment

  • Build common interests again

  • Go slow

  • Don’t drill the other if there are concerns regarding an affair

  • Don’t plan sudden romantic getaways

  • Both spouses may feel unneeded, unwanted - discuss changes and gradually develop solutions


Tips for both spouses during reintegration48 l.jpg

Tips for both spouses during reintegration

  • Expect children to test limits

  • Be flexible and patient

  • Communicate respect

  • Plan for future together

  • Compliment each other more

  • Be willing to apologize

  • Take time outs when things feel out of control


Tips for both parents during reintegration l.jpg

Tips for Both Parents during Reintegration

  • Spend one-on-one time with each child

  • Be giving of time and energy

  • Allow child to also have space

  • Listen and accept child’s feelings

  • Be realistic and flexible

  • Avoid excess gift giving

  • Don’t get upset if child has reactions to you

  • Don’t give into demands of guilt


Tips for both parents during reintegration50 l.jpg

Tips for Both Parents during Reintegration

  • Express specific concerns and offer to help but don’t push

  • Become an expert in available resources

  • Have honest discussion about financial situation

  • Use connections made during deployment to develop strategies to help transition

  • Give your child a chance to talk about war experiences

  • Have a battle buddy talk to your child

    • Armstrong, K., Best, S., & Domenici, P. (2006), Courage After Fire


References l.jpg

References

  • The Center for Deployment Psychologyhttp://www.deploymentpsych.org/

  • Mission of CDP: To train military and civilian psychologists and other mental health professionals to provide high quality deployment-related behavioral health services to military personnel and their families.

  • CDP's Course Resources:http://www.deploymentpsych.org/courseres.html

    • Introduction to the CDP (powerpoint)  

    • PTSD and Domestic Violence (powerpoint)  

    • Families in the Wake of Trauma (powerpoint)

  • CDP's Links : http://www.deploymentpsych.org/links.html


  • Login