Military Families Deploy Reunion6011

The Military Family and Addictions: Understanding and Counseling within the Context of the Military Culture Mark A Mortier, NCC, LPC, MAC Beacon Counseling/ Genesis Counseling Centers: Williamsburg, Hampton Jan M Brown, Executive Director Spiritworks Foundation, Williamsburg

Military Culture Language Code of Conduct Customs and Traditions Dress Lifestyle Sanctions

Living in a Military Family Now Additional stresses of Deployment, TDY, Training, Demanding Work Marriage Relationship and Relationship with Parent(s) who are affected by military life Living on a Military installation, “bubble” Transitions/Challenges and Change: Moves, Life Disruption, Broken Connections with Friends, community, schools

Cultural Aspects of Military Life Hard to answer: “Where’s Home You lived overseas, feel connected to another culture, You lived overseas in an “American Bubble” ? Your Parents represent different cultures? Consider/don’t consider self a “military brat” ? Do you want a “Global Nomad” lifestyle ? Hard to find acceptance “back home” Rules, expectations, humor is different

Are You a Military Brat ? Residence in Foreign Countries Residence in Foreign Countries

Trends in The Military High Operations Tempo Ongoing Deployments Transformation: High Level of Change High Rates of Marriage/ Divorce Entitlement Mentality of New Members Single Parents - Growing Population Dual Working Parents

Participants Profession Practice Settings Contact with Military Members, Families Questions You Want Answered Today

Resources For Military Members and Families Alcohol/ Substance Abuse Behavioral Health and Support Off-Post Services

Army Substance Abuse Program Serves: Military, DOD Civilians and Retirees -Alcohol and Drug Control Officer (ADCO) -Employee Assistance Program Coord. -Installation Biochemical Test Coordinator -Risk Reduction Program -Prevention Coordinator OCONUS/Overseas: ASACS for Adolescents Medical Command: Counseling Programs CONFIDENTIAL ALCOHOL TREATMENT AND EDUCATION PILOT (CATEP) PROJECT.

The Air Force Alcohol and Drug Abuse Prevention and Treatment (ADAPT) and Demand Reduction (DR) programs Include substance abuse (SA) prevention, education, treatment, and urinalysis testing. SA prevention and treatment policies and programs. Our members are held to the highest standards of discipline and behavior, both on and off duty. Individuals who experience problems related to SA will receive counseling and treatment as needed; however, all Air Force members are held accountable for unacceptable behavior.

Navy Alcohol and Drug Abuse Prevention (NADAP), Substance Abuse and Rehabilitation (SARP) DRUG AND ALCOHOL PROGRAM ADVISOR.—The DAPAs are responsible for advising commanding officers on all NADSAP matters. Provide command education, prevention, screening, and counseling programs. DAPAs also provide aftercare, probationary supervision, motivational training, and referral services. ALCOHOL TREATMENT FACILITIES.— ATFs provide help to fleet and shore commands by counseling personnel involved with drugs and alcohol. Individuals not requiring inpatient treatment may receive help in these nonresident-counseling programs. Naval Medical Center Portsmouth: Residential short-term treatment (30 days or less) Outpatient Partial hospitalization/day treatment

National Guard Family Programs Welcome Programs Pre-Deployment, Post-Deployment Training and Support Emotional Support, Counseling: MFLC Financial Programs Children and Youth Programs Use Active Duty Programs

Substance Abuse among the Military, Veterans, and their Families A Research Update from the National Institute on Drug Abuse April 2011 Backdrop: The ongoing operations in Iraq (Operation Iraqi Freedom) and Afghanistan (Operation Enduring Freedom) continue to strain military personnel, returning veterans, and their families. Some have experienced long and multiple deployments, combat exposure, and physical injuries, as well as post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI).

Substance Abuse among the Military, Veterans, and their Families A Research Update from the National Institute on Drug Abuse April 2011 Alcohol abuse is the most prevalent problem and one which poses a significant health risk. A study of Army soldiers screened 3 to 4 months after returning from deployment to Iraq showed that 27 percent met criteria for alcohol abuse and were at increased risk for related harmful behaviors (e.g., drinking and driving, using illicit drugs). And although soldiers frequently report alcohol concerns, few are referred to alcohol treatment.

Substance Abuse among the Military, Veterans, and their Families A Research Update from the National Institute on Drug Abuse April 2011 Substance abuse is also a key concern. While the 2008 Department of Defense Health Behavior Survey reveals general reductions over time in tobacco use and illicit drug use, it reported increases in other areas, such as prescription drug abuse and heavy alcohol use. In fact, prescription drug abuse doubled among U.S. military personnel from 2002 to 2005 and almost tripled between 2005 and 2008.

Substance Abuse among the Military, Veterans, and their Families A Research Update from the National Institute on Drug Abuse April 2011 Mental illness among military personnel is also a major concern. In another study of returning soldiers, clinicians identified 20 percent of active and 42 percent of reserve component soldiers as requiring mental health treatment. Drug or alcohol use frequently accompanies mental health problems and was involved in 30 percent of the Army's suicide deaths from 2003 to 2009 and in more than 45 percent of non-fatal suicide attempts from 2005 to 2009.

ALL Service Branches Behavioral Health/ Mental Health programs at clinics/Hospitals. Family Members seen on space available basis Family support services: assistance with transitions, money, marriage, parenting, abuse prevention, job hunting, etc. Family Life Chaplains have MFT training and often see children.

Off-Post Services Service member needs referral, expected to use on-post services first Higher ranking service members may seek services as private pay. Family members can access Tri-care easily, still need referral for LPC’s Spouses often seek help for marriage, child concerns, other issues emerge Military One Source, 12 sessions EAP

Military Brat 101 How does growing up in a military family affect Kids today and in the future. Book: Military Brats and other global nomads: Growing up in organizational families Editor, Morten Ender, 2002

How do you define “Military Brat” Origin ?: British Regiment Attached Traveler= B.R.A.T. Now means: “kid growing up in a U.S. military family and identifying himself/herself as a Brat” Not every kid growing up in a military community identifies themselves as a “Military Brat”

Factors: How Long you have “served” with your parents Number of moves Overseas Assignments Lived on – post or off-post Learned a language other than English Attended American or International Schools Attachment to the military lifestyle

Living Overseas Connected with the culture: lived “on the economy”, learned the language, made foreign friends, developed a connection with the host country. - OR- Overseas, but primarily in American Culture: Didn’t learn language, Stayed in the American “Bubble” or “Little America”, no strong foreign relationships.

Terms for Kids who have lived Internationally Global Nomads Third Culture Kids (TCK’s) Missionary Kids (MK’s) Internationally Mobile Military Brats Average of 8 major changes before age 18

Third Culture Kid American Culture Foreign Culture Military Culture

Advantages to Being a Military Brat/ Third Culture Kid Flexible, can Adjust to Change Open to Other Cultures, New Experiences Confident when Facing Challenges Observe and Comment International Worldview International Careers

Military Brat’s: Risk and Assets/ Protective Factors Military Kids Tend to Have More Life Experience and Assets Than their Civilian Counterparts Military Families have Fewer Social Supports Nearby After each Transition Many Assets have to be Re-established Each Transition Exposes Military Kids to Potential Risk Factors Until they are Re-connected to: Family Community School Peers (positive influence)

Range of Differences in Military Parent’s Involved Stable Communicate Follow Through Many Parenting Tools Manage Issues Coping Well Uninvolved Unstable, Volatile Distanced Talk, No Action Overuse a few Tools Avoid Issues, Blame Overwhelmed

Military Brat’s: Differences in Student’s Advanced in Studies, High Achievers High Motivation Self-Disciplined Adapt Well to Change Involved in Activities Successful Behind, Learning Difficulties & Gaps Low Motivation Erratic Effort Struggle with Change Disconnected High Risk for Trouble

Effect of being a Brat on your future Most Brats do well in college/ training for a career Many join the military of find other ways to live overseas Many end up serving their country or others in service fields or government Tend to seek out other Brats (this is helpful in marriage) May seek stability or a global nomad lifestyle.

Challenges of Mobility Rootlessnes: Where’s home? Who will I keep in touch with? (quick release of friends) Isolate, keep distance from others, superficial relationships Distrust of Adults, used to decisions made by authorities Challenges of planning ahead Internal values vs. going along with others.

Everyone is Handles Change Differently

Three Responses to Change 1 . Better Normal 2 . Return to Life “New Normal” DISRUPTION 3 . Worse

What Makes Things Worse For Kids Poor relationships in the family, conflicts Not included in Decision making, listened to. Not valuing your parents work Emotional flatness (past pain not addressed) Poor Preparation for Change Misinformation, Worry Lack of Community Connection Trouble Making Friends Isolation, Inactivity, depression

The Military Family and Deployment/ Reunion Mark Mortier, LPC, MAC Genesis Counseling Centers

Deployment and Family Stability Constant Adaptation and Change: Pre-Deployment, R & R, Through Reunion Increase in Conflicts and Irritability Responsibilities Shift, usually increase Hard to Communicate Feelings, to Reason Coping Skills are Stretched to the Limit What Helps: Communication, Patience, Family Plan, Friend/Family Support, Activities

Deployment Factors Number of Deployments, Timing Degree of Change Experienced Active Coping with Feelings, Situation Family Stability: Adapting to Roles & Responsibilities that Maintain Relationships Kids can Cope with Difficult Situations if they feel Safe, Loved and Supported

What Kids Dislike/Like about Deployment Dislike Parent is Missed Worry about Safety Change in Activities Parent Overwhelmed More Responsibilities Caretaking Younger Kids Missed Holidays, Events Mid-Term Leave Waiting for Reunion Source: Army Affiliated Students, 2005-2007, Compiled By Mark Mortier, Ft. Richardson ASACS Counselor Like Freedom, Relaxed Rules Eat out More Family Stay’s Active Relative May help Out Easier Chores Different Role, “Needed” Travel to See Family Mid-Term Leave

Deployment and Loss Ambiguous Loss: Vague, Unclear, Indescribable: “they know they are missing something”, “ They Know Things Feel Different” “ The premise is that ambiguity coupled with loss creates a powerful barrier to coping and grieving, and leads to symptoms such as depression and relational conflict that erode human relationships.” Boss ( 2006) Cited in: Parental Deployment and Youth in Military Families: Exploring Uncertainty and Ambiguous Loss , Huebner et All, Family Relations, 56 (April 2007), pgs. 112-122.

Active Coping with Feelings Broad Range (relief, worry, grief/loss) Ambiguous/ Confusing/ Complex More touchy/ Irritable, easily angered Teens tend to avoid, cover-up, withdraw Anxiety, depression, acting out, increased conflicts, AOD Use are serious responses. What Helps : Sharing Feelings openly, Adults/Peers who understand, Daily Routine, Skills, Support Groups, Counseling as needed

Battle Stress Parents coming back from deployment in a conflict zone, there is every chance that your parent has had experiences that are life changing. War is not a pretty sight and existing in or near a battle zone can expose them and their comrades to some very unpleasant happenings.

What is Post Combat Stress? Post Combat Stress Long term reactions to combat and operational exposure Can impact quality of life Can result in a diagnosis of Post Traumatic Stress Disorder

What to Look For? Physical Behavioral Emotional Fatigue Chest Pain Weakness * Sleep Problems Nightmares Breathing Difficulty Muscle Tremors Profuse Sweating Pounding Heart *Headaches *Withdrawal Restlessness *Emotional Outbursts Suspicion Paranoia Loss of Interest *Alcohol Consumption *Substance Abuse *Anxiety or Panic Guilt Fear Denial *Irritability *Depression *Intense Anger *Agitation Apprehension

Mixed Feelings Kids and parents alike say that a homecoming can be the best and the worst time of a deployment. A survey of military teens found some common thoughts at reunion time: Like / Don’t Like

What Kids Like/ Dislike about Reunion Like Getting to see Parent Special Meals/ Trip Parent Involved in Their Life Together for Holiday or Event Less Caretaking Less/ Different Chores Roles Change Balanced Parenting Anticipation/ Excitement Source: Army Affiliated Students, 2005-2007, Compiled By Mark Mortier, Ft. Richardson ASACS Counselor Dislike Parent Tries to “Fix” Everything Expected to be Perfect Extra House Cleaning Their Changes not Acknowledged “ Catching Up” on Discipline Roles Change Rules Stricter Person Seems Different Expectations Not Met

Teen Thoughts About Reunion I made it. Will you be proud of me? Will you notice I have been helping out? I’ve missed you a lot, did you miss me? Have you changed? I’ve Changed I’m scared you won’t like me the way I am Great. But don’t change anything - we’re doing fine. Ugh? More hassles now.

It’s okay to have concerning thoughts about your parent’s return, it is not disloyal. Reunions can be as hard as separations. While your parent/caregiver was gone, you have all changed.

Most Families Adjust Well When you get back together again everyone needs to adjust to changes. It takes time, patience, effort and a sense of humor.

Tips for a Successful Reunion: Remember, your family will be different but, with the right attitude, it can be better or at least you can cope. Be patient - the longer your parent/caregiver was gone, the more time it takes for you and your family to adjust. Go slow - watch out for overload! Too much activity can cause stress and conflict.

Reunion: Alcohol / Drug Problems It’s Back! If it was a problem before it is likely to return or be compounded. Issues can emerge in military member, spouse or adolescent Denial and frustration can go on for along time, or a crisis can spotlight it. Prescription Drug abuse is harder to ID

Reunion: Alcohol / Drug Problems A military member getting treatment is often seen as a sign of weakness, especially for leaders. Enabling exists. Kids don’t understand it, may have liked the freedom they had with a parent using, may seek to sabotage treatment Variable spouse support, especially if there is conflict, deep relationship issues.

Elmendorf general dies of gunshot on base By JULIA O'MALLEY | jo'malley@adn.com Published: July 28th, 2008 05:03 PM The commander of the 3rd Wing at Elmendorf Air Force Base died of what is being described as a self-inflicted gunshot wound to the chest at his on-base home Sunday night, the Air Force said this afternoon.

What makes treatment more difficult Culture of Drinking in the Military “ You should be able to Control it” message Tendency to overlook until it is really bad “ Band of Brothers” More rigid roles in families Going away to treatment can affect career. Expectation that culture is understand

“ An alarming statistic shows an estimated 18 service members kill themselves everyday due to Post Traumatic Stress Disorder.” WJFW News (Wisconsin) June 7, 2011

Recovery Factors for Service Members Despite a century and a half of experience dealing with addiction in soldiers and veterans, the United States military continues to struggle with an epidemic of addiction to this day. In our country’s current wars in Iraq and Afghanistan, the unpredictability of counterinsurgency tactics has led to a very high occurrence of post traumatic stress disorder (PTSD) among troops and veterans. Many of these veterans have high rates of co-occurrence with PTSD and substance abuse. Among many discouraging statistics about veteran wellness, a recently released report by the Army found an increase in high-risk behaviors, including substance abuse, in Iraq and Afghanistan veterans. These high-risk behaviors have ultimately led to higher mortality among veterans at home than among active-duty soldiers stationed overseas.

Resources for Individuals, Families & Professionals: BrainLine.org is a WETA website funded by the Defense and Veterans Brain Injury Center through a contract with the Henry M. Jackson Foundation. Government funding support is not an endorsement of WETA or any of its products, including this website.

24 Life-Changing iPhone and iPad Apps for People with Brain Injury, http://www.brainline.org/content/2011/05/23-lifechanging-iphone-ipad-apps-for-people-with-brain-injury.html Military & Veterans, http://www.brainline.org/landing_pages/categories/military.html Post Traumatic Stress Disorder (PTSD), http://www.brainline.org/landing_pages/categories/ptsd.html

Once a Warrior, Always a Warrior http://www.brainline.org/content/2011/06/once-a-warrior-always-a-warrior.html Traumatic Brain Injury: What Military Families Need to Know http://www.brainline.org/content/2011/05/traumatic-brain-injury-tbi-what-military-families-need-to-know.html

Resources for Individuals, Families & Professionals: Defense and Veterans Brain Injury Center (DVBIC) assists the DoD and VA in optimizing care of service members and veterans who have sustained a traumatic brain injury (TBI), at home and in the deployed setting, through state-of- the-art clinical care, innovative research, care coordination, and educational tools and resources. http://www.dvbic.org

24/7 SUPPORT CRISIS INTERVENTION (24/7) US Department of Veterans Affairs (VA) Suicide Prevention Hotline 1.800.237.8255 Military OneSource 1.800.342.9647 Help for active duty military and their dependents, including 12 free non-medical counseling appointments.

INFORMATION & REFERRAL (24/7) Defense Centers of Excellence (DCoE) Outreach Call Center 1.866.966.1020 Information and education on behavioral health and traumatic brain injury (TBI). Download pdf information sheet . Navy Safe Harbor 1.877.746.8563 US Marine Corps Wounded Warrior Regiment 1.877.487.6299 Wounded Warrior Resource Call Center 1.800.342.9647 Help with questions about care of our wounded ill and injured.

INFORMATION & REFERRAL (BUSINESS HOURS) Air Force Wounded Warrior Program (AFW2) 1.800.581.9437 7:00 AM - 4:00 PM (CST), M-F Defense and Veterans Brain Injury Center (DVBIC) 1.800.870.9244 8:00 AM - 5:00 PM (EST), M-F US Army Wounded Warrior Program (AW2) 1.800.237.1336 8:00 AM - 7:00 PM (EST), M-F

For additional information and resources for Military Members, Family Members & Providers please contact: Jan M. Brown SpiritWorks Foundation www.spiritworksfoundation.org [email_address] (757) 564-0001

Military Families Deploy Reunion6011

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