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Military Culture & Treatment - 101 AAPC – SE Region Kanuga Conference Date 10/24/2009. workshop to overview the culture of military families, effective treatments, and sources of support . Peter McCall email@example.com 770-329-6156. Presentation Goals.
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workshop to overview the culture of military families, effective treatments, and sources of support
I, (NAME) DO SOLEMNLY SWEAR…THATI WILL SUPPORT AND DEFEND THE CONSTITUTION OF THE UNITED STATES… AGAINST ALL ENEMIES, FOREIGN AND DOMESTIC;… THAT I WILL BEAR TRUE FAITH AND ALLEGIANCE TO THE SAME;… AND THAT I WILL OBEY THE ORDERS OF THE PRESIDENT OF THE UNITED STATES… AND THE ORDERS OF THE OFFICERS APPOINTED OVER ME,… ACCORDING TO REGULATIONS AND THE UNIFORM CODE OF MILITARY JUSTICE,… SO HELP ME GOD.
NOTE: 3 dots … = represents a repetition break
Speaking these words has far more emotional power than these words on paper could ever convey. Anyone who has done this for real knows, in that moment, that they are agreeing to defend a principle with their very lives. It is a moment they never forget.
501c3 status has already been approved by the IRS
Current Board of Directors:
President Rev Robert Certain, Rector, Episcopal Church of St Peter and St Paul (USAF)
Exec Director Peter McCall (USArmy)
Member Bill Harrison, Partner, Mozley, Finlayson & Loggins LLP (USAF)
Member William Matson, Exec Director, Pathways Community Network, Atlanta, GA
Member Alan Baroody, Exec Director, Fraser Counseling Center, Hinesville, GA
Member Joseph Krygiel, CEO of Catholic Charities, Archdiocese of Atlanta (US Navy)
The Georgia Association for Marriage and Family Therapy (GAMFT)
The EMDR Network of Clinicians in Georgia
Pathways Community Network, Inc
Fraser Counseling Center, Hinesville, Georgia (nearby Fort Stewart)
Episcopal Diocese of Atlanta
Presbytery of Atlanta and the Presbyterian Women of Atlanta
Catholic Charities and the Archdiocese of Atlanta
Multiple deployments are common causing stress and family attachment issues
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
Suicide, alcoholism, domestic abuse and violent crimes rates are rising. Suicide is 33% higher in ‘07 over ’06, 50% higher in ‘08, and almost equal to ‘08 by May of ’09
Military Sexual Trauma (MST) is running at 16%-23%
In 2008, 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)
DoD and VA facilities are stretched … the Aug 2009 VA claims backlog is 900,000
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
Other mental health, marriage, and family problems often occur with or leading up to PTSD requiring attention so they don’t get worse
Rand Study estimates that PTSD and depression among service members will cost the nation up to $6.2 billion in the two years after deployment. The study concludes that investing in proper treatment would actually save $2 billion within two years
Extended Family Members
Person in need of support
RAND study says over 33% of returning military have some form of mental distress
CareForTheTroops Operations Overview
CFTT will improve the overall mental health infrastructure to better support military families
How can families know where trained support is available
How do we expect to overcome the stigma of mental health help
Private Sector MH providers have limited military experience
How can CFTT assure that word of mouth spread all over the GA
How to help referral sources know better when & where to refer
Use congregations to create a grassroots info distribution channel
Target info for friends & family “surrounding” the military member
CFTT website shows info usable by therapists & referrals
CFTT website lists therapists trained in the military culture
CFTT will provide training opportunities, including remote areas
54% of those deployed are R/NG. GA is 6th largest R/NG
Improve support even in remote areas of the state
The next set of charts provide a simulation of using the www.CareForTheTroops.org website with pastoral counselors in mind
The drop-down menu for Mental Health Professional is opened up.
In this case, selecting the Enroll with CFTT page
Note the other options available
The info asked is completely voluntary. We do not ask you to volunteer time and any financial info is left between you and the client.
We are looking for people with background, training, and experience.
The menu for Congregation Leaders is opened up.
In this case, selecting the About Congregation Programs page
Click on the picture and this presentation is available
Moving down the same page gets you to the Guide Book info we have introduced in this presentation. It also shows the TOC and the Intro Letter in the document
Clicking on the picture of the book will let you download it.
A key piece of the web site is the Resource Library with the 4 selections shown. This material is updated periodically. The reference material is weekly.
Another key section is the gathered in the “Stuff” You Should Know Section.
Our goal here is to provide plenty of info on these topics and also refer you to the top 3-5 sites on these topics.
Finally, an important aspect of our mission is to connect you to others that can help.
The Find a Therapist menu item discusses how one might choose a therapist and then allows you to search many ways.
This is intended for use by congregation sources, clinicians, and people in need searching for a therapist who wants to work with military families.
This shows the training events we are aware of. Both from CFTT and from other organizations.
Please visit it periodically and also let us know of training you hear about to share with others.
Weekend 1 (Part I)
January 15-17, 2010
Weekend 2 (Part II) - TBA
HAP Participant Requirements
EMDR PART I AND PART II are available for licensed mental health clinicians at the masters degree level or above, or for masters level clinicians on a licensure track, with permission of their licensed clinical supervisor. In keeping with its mission, HAP normally trains only clinicians working 30 or more hours per week in community based, non-profit settings. Exceptions have been made for private practice clinicians who have made a substantial commitment to pro bono service in the community.
CareForTheTroops(CFTT) Scholarship Criteria
It is the intent of CFTT to incent attendance of both EMDR Training Weekends (Part I and Part II) in order to increase the number of fully qualified EMDR Therapists to treat trauma in Georgia. Participants must:
Practice in Georgia
Attend and successfully complete both Part I and Part II EMDR training by HAP
Enroll in the CareForTheTroops Therapist Database at the completion of Weekend 1 and stay enrolled at least 2 years. More Info about this is available at www.careforthetroops.org/clinician_cftt_enroll.php
Be willing to work with military clients and their extended family members
Pay the HAP Training Fee for Part I. CareForTheTroops will pay the HAP Training Fee for Part II which means you must attend a Part II by HAP
Attend and complete Part II within 12 months of completing Part I
Be responsible for all other costs, fees, and expenses associated with the training weekends.
NOTE: Check with your local GAMFT Chapter and also with the www.CareForTheTroops.org web site for changes and updates.
Sociologists define culture as …
Culture is associated with a social system and unique to a given system.
OEF 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.
OIF Operation Iraqi Freedom - also known as the Iraq War; began on 3/20/2003.
USAR United States Army Reserve
USANG United States Army National Guard
E1-E9; O1-O10 Enlisted Ranks; Officer Ranks
SPC Specialist, rank of E4, often referred to a “Spec 4”
First SGT 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
NCO Non-Commissioned Officer, ranks E6 through E9
IEDs Improvised Explosive Devices
Sandbox Iraq and Afghanistan
Down Range Deployed to anyplace where there is shooting.
Outside the Wire Leave the safety of the “enclosed” military base (FOB)
Taking the Pack Off Leaving mentally and physically from combat
Top Cover Making sure the boss looks good
Defenders of Democracy
Trust in the leadership
Distrust of civilians
Formal and informal conduct Stigma of mental health and PTSD Cover of the boss (Top Cover) Back-logging trauma
Reserve / Guard
The next few charts provide some background of this war that might help you better understand your client or congregation member and their presenting story and issues
According to a new American Journal of Public Health study on veterans' mental health diagnoses
A recent (July, 2009) US government accountability office report found that nearly 20% of women veterans suffer from PTSD (ref: http://www.gao.gov/new.items/d09899t.pdf )
The next several charts will cover life within the military family and clinical treatment considerations
The Military Deployment Cycle … or
The Military Family Life Cycle
Pre-deployment Conflict & Previous
Revitalize Relationships and “honeymoon”
Pre-deployment Stress – anxiety and concern
Reunion and homecoming – joy and anticipation
Pre-reunion Stress – anxiety and worry about behavior away
Separation Stress – Depression & Anxiety
Family Adjustment w/o Soldier in Home – Out-of-Ordinary Behaviors
Frequent Relocation 3.3 years average
Previous Deployments 87%
Longer Separations 7.3 month average
Larger Families 42% ≥ 3 children
Younger Mothers 26.5 median age
Blended Families 31% step-parents
Education 21% w/o HS diploma
Working Outside Home 44%
Median Income < $30,000 (34%)
Warner CH, Appenzeller GN, Warner CM, Grieger T. “Psychological Effects of Deployments on Military Families” Psychiatric Annals 2009; 14: 56-62.
“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
Source: Military Family Research Institute at Purdue University.(2005). 2005 demographics report. Arlington, VA: Office of the Deputy Under Secretary of Defense, Military Community and Family Policy. Retrieved January 7, 2009, from
Women represent approximately 15% of the military force.
Representation of women is slightly lower for Senior Enlisted and General Officers.
RED = Civilian
BLUE = Total DOD
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 thoughtsSIGNS / SYMPTOMS OF (COMBAT) PTSD
Generally individually oriented
and systemically focused – “One
size does not fit all”
VA Opinion of PTSD Interventions
“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