Evaluation of a Third-Location Decompression Program for Canadian Forces Members Returning From Afghanistan
|
|
- Bertram Gilbert
- 5 years ago
- Views:
Transcription
1 MILITARY MEDICINE, 177, 4:397, 2012 Evaluation of a Third-Location Decompression Program for Canadian Forces Members Returning From Afghanistan Bryan G. Garber, MD, MSc; Mark A. Zamorski, MD, MHSA ABSTRACT Background: Service members returning from combat can experience difficulty adapting to home life. To help ease this transition, the Canadian Forces provides a Third-location Decompression (TLD) program in Cyprus to members returning from deployment to Afghanistan. Methods: The 5-day program consists of individual free time, structured recreational activities, and educational programming. Its perceived value and impact were measured immediately afterward and 4 to 6 months later. Results: Respondents overwhelmingly supported the TLD concept, with 95% agreeing that some form of TLD is a good idea. Eighty-one percent of participants found the program valuable, and 83% recommended it for future deployments to Afghanistan. Perceived value persisted 4 to 6 months after return, and 74% felt that it helped to make reintegration easier for them. Conclusion: Canadian Forces members saw value in the TLD program, and most members believed that the program had its intended effect of making the reintegration process easier for them. INTRODUCTION Service members returning from a difficult deployment experience drastic changes in their physical and social environment. To successfully negotiate this transition, they must adapt psychologically, physically, and socially. 1 Although there is an extensive literature on the outcomes of this transition (i.e., psychological and social well-being 2 7 ), research on the process of adaptation itself is surprisingly limited. What is known is that although service members are generally happy to be home, some find at least parts of this transition process to be difficult. 1 We also know that although most will transition successfully, an important minority will have longstanding psychosocial difficulties. 2 7 Decompression refers to a particular phase of this transition, specifically the early period during which service members move quickly from the high-pressure deployed environment to the low-pressure home environment. 8 This phase has attracted particular attention for several reasons: First, it is obviously the most acute phase of the transition process, during which the differences between the home environment and the deployed environment are most stark. Second, modern air travel makes this transition occur more abruptly relative to historical times when service members came home slowly by ship. 8,9 Finally, research on Vietnam veterans, in particular, has demonstrated that difficult homecoming experiences are strongly correlated with long-term psychopathology Deployment Health Section, Canadian Forces Health Services Group Headquarters, 1745 Alta Vista Dr., Ottawa, ON K1A 0K6, Canada. This research was previously presented at the Third Location Decompression Workshop sponsored by the Military Operational Medicine Research Program of the UA Army Medical Research and Materiel Command in Portsmouth, United Kingdom, May 11 13, Parts of this research were also presented at the International Society for Traumatic Stress Studies Annual Meeting, Montreal, QC, Canada, November Parts of this research were also presented at the Canadian Psychological Association Annual Convention, Ottawa, ON, Canada, June Much has been made of this last observation: Some authors have suggested that making the homecoming process easier will prevent later psychopathology. 15 These authors must believe that difficult homecoming experiences cause (or contribute heavily to) mental disorders such as posttraumatic stress disorder (PTSD). Others point out that the research demonstrating this correlation is nearly entirely cross-sectional, done many years after the events of interest. 1 Even without considering the possibility of recall and other biases inherent in this kind of research, it is also plausible that the difficult homecoming experiences (or the perception thereof) were the consequence of psychopathology rather than the cause of it. Irrespective of whether parts of the early phases of transition are permanently toxic or merely temporarily unpleasant, military organizations have taken an avid interest in developing tools to make the transition process easier for service members and their families. Decompression programs are one such tool designed to allow service members to adapt to the home environment in a more gradual way. 8 Third-Location Decompression (TLD) programs take place in a location that is neither the operational theater nor the home, thereby allowing the early phases of transition to occur in a neutral environment before reunification with family and friends. TLD has been used intermittently by a number of Armed Forces over the years including those of The Netherlands, United Kingdom, and Australia. 8 More recently, the United States has offered decompression to at least some personnel in the Air Force (USAF Deployment Transition Center 16 ), the Naval Special Warfare Command, 17 and the Marine Corps. 9 Since August 2006, the Canadian Forces (CF) has implemented a TLD for members returning from deployment on its combat and peace support mission in Kandahar Province, Afghanistan. The intent of the program is to ease transition by giving service members some time to achieve a sense of closure and prepare for their return home. MILITARY MEDICINE, Vol. 177, April
2 Despite its common sense appeal and widespread use, published data on the perceived value and impact of TLD are scarce. The purpose of this article is (1) to describe the TLD program currently in use by the CF in Cyprus and (2) to report the results of the surveys conducted on participants immediately after TLD and 4 to 6 months after their return home. METHODS Program Description The participants were CF members completing a tour of duty of 6 months or more in Kandahar Province, Afghanistan, from August 2006 through March The mission has been a demanding one, and more than 150 CF members have been killed on it since late The island nation of Cyprus was selected as the site for the program after consideration of various programmatic and logistical factors. The facility employed is a four- to five-star civilian resort hotel, with two participants lodged in each room. The 5-day program consisted of mandatory educational briefings and both structured and unstructured recreational activities. Up to 300 personnel who had largely worked together while deployed were on the ground at any given point in time. To mitigate the risk of alcohol-related misconduct and physical injuries, a variety of command and control measures were put into place (e.g., making certain problem-prone drinking establishments offlimits). TLD participants were subject to the Service Code of Discipline while on TLD. At least during the study period reflected in this report, consumption of alcohol in quantities that increase the risk of injuries and adverse social consequences was nevertheless common. However, alcohol-related incidents occurred only in a distinct minority of participants, and most such incidents had no lasting consequences. To decrease the risk of serious accidents, operating a motor vehicle or a motorbike was prohibited. Educational Program The purpose of the educational programming is (1) to minimize the distress associated with transition by normalizing it and by providing guidance on how to manage common transition problems and (2) to facilitate care seeking for mental health and transition problems by reviewing their signs and symptoms, identifying potential sources of care, and refuting common misconceptions about mental health care. Thus, all TLD participants received a video version 18 of the US Army s Post-deployment BATTLEMIND training (US Army Medical Department 19 ). The video consists of 4 vignettes of soldiers experiencing transition problems or mental health problems. Facilitators played each vignette and the accompanying commentary and then led some brief group discussion. This program was selected because of evidence that it improves mental health and well-being in soldiers returning from combat. 20 The video was intended to be used 3 to 6 months after return from deployment, but it was used on TLD because of its engaging nature. A central message of the BATTLEMIND program is that there is nothing wrong with seeking help for mental health problems. 20 This core program was complimented by a variety of 1-hour elective sessions. Between four and eight different electives were offered per TLD. Participants were required to attend two sessions but could select whichever suits their needs and preferences. The most popular topics included Coping with Stress and Anger, Healthy Relationships, and Post-deployment Reintegration from the Veteran s Perspective. The latter offering was presented by Peer Support Coordinators from the CF/Veterans Affairs Canada Operational Stress Injury Social Support Program. This program uses trained veterans with a history of service-related mental health problems as a source of peer support for those with similar problems. All training was delivered by one or two facilitators to groups of approximately 15 to 25 participants in English or French; a professionally dubbed French language version of the BATTLEMIND video was used. The delivery team consisted of approximately six military or civilian clinicians (social workers, mental health nurses, or psychologists), two Peer Support Coordinators, and a chaplain with pastoral counseling qualifications. Team members also provided both informal and formal mental health consultation/peer support for members requesting it. Questionnaire Methodology A 68-item, voluntary, anonymous survey was administered as participants were leaving Cyprus. The survey covered sociodemographic and military characteristics (including combat exposure), support for the general concept of TLD, the perceived value of the TLD program as delivered, and the satisfaction with various aspects of the program such as the location and the educational program. This was framed as a routine user satisfaction evaluation of a new educational and personnel welfare program, and as such, review by a Research Ethics Board was not required under Canadian guidelines. 21 A subset of participants was also anonymously surveyed approximately 4 to 6 months after returning home as part of the CF s Human Dimensions of Operations (HDO) survey that is routinely administered at that time. This survey was administered en masse to personnel identified from the CF Tasking Data Base as having been deployed at the main mounting base by Personnel Selection Officers. Nine items touching on the support for the TLD concept and the perceived value of the program were included, along with nine items on the precise ways in which the participants felt the TLD helped. These were adapted from a validated scale of postdeployment transition (Defence Research and Development Canada 22 ). Although the HDO survey content is largely standardized, several sociodemographic and military variables (e.g., age) were dropped from the survey in The HDO survey protocol was approved by a CF Research Ethics Board. 398 MILITARY MEDICINE, Vol. 177, April 2012
3 Primary and Secondary Outcome Variables The primary outcome was the perceived value of the TLD as a whole ( Overall, I think this TLD was a valuable experience for me ), both at the end of TLD (hereafter termed immediate ) and 4 to 6 months afterward (hereafter termed postdeployment ). Secondary outcomes include both immediate and postdeployment satisfaction with different aspects of the program and the ways in which the program was perceived to have helped ease the transition process. Statistical Analysis Descriptive data analysis was carried out using SPSS, version Significance testing on contingency table data was conducted using the c 2 statistic. A four-point, forcedchoice Likert scale was used for responses to all questions, but for ease of presentation and interpretation, most data were analyzed by collapsing the agree and strongly agree categories into a single category and the disagree and strongly disagree into a single category. RESULTS Between August 2006 and September 2008, 10,598 CF members serving in Kandahar participated in TLD. However, TABLE I. 4- to 6-month follow-up was only completed for the first two rotations. Therefore, data provided will only be for surveys administered to the 3,473 CF members from those rotations. A total of 3332 CF members completed the immediate satisfaction surveys (96% completion) and 1846 completed the postdeployment survey (53% completion). Sociodemographic and Military Characteristics of Respondents As shown in Table I, sociodemographic and military characteristics of respondents were mostly similar between the two surveys. They were largely male (92% in both immediate and postdeployment samples), young adults (30% and 31% in immediate and postdeployment samples, respectively, were 26 years old or younger), anglophone (88% and 87%, respectively), and over half (58% and 59%, respectively) were married or living with a partner. They were largely junior, noncommissioned members (70% and 71%, respectively), and most had spent more than 6 years in military service. Key differences between the two survey respondents were a higher proportion of combat arms personnel in the postdeployment survey compared with the immediate survey (66% vs. 56% respectively, p < ) and a smaller proportion Sociodemographics and Military Characteristics of Survey Respondents Immediately After TLD and 4 to 6 Months Later Timing of Questionnaire Immediately After TLD (Overall N = 3332) 4 6 Months Postdeployment (Overall N = 1846) N % N % Age (Years) , ³ Sex Male 2, , Female First Language English 2, , French Marital Status Married or Living With Partner 1, , Not Married (Single, Widowed, 1, Divorced, or Separated) Rank Junior Noncommissioned Member 2, , Senior Noncommissioned Member Officer Component a Regular 2, , Reserves Military Occupation b Combat Arms 1, Support Staff 1, Administrative Staff Years of Military Service < , ³ a c 2 = , 1 df; p < b c 2 = , 2 df; p < MILITARY MEDICINE, Vol. 177, April
4 of Reservists in the postdeployment respondents compared to the immediate survey respondents (6.4% vs. 12.6%, respectively, p < ). The most frequent combat exposures reported by participants were as follows: being subject to shelling at least once (88%), seeing serious injuries (69%), seeing widespread destruction (69%), dangerous traffic conditions/incidents (67%), and being fired at (67%). Immediate Questionnaire Results Participants overwhelmingly supported the concept of TLD: 95% agreed that some form of TLD is a good idea, 90% agreed that letting off steam before going home is a good idea, 81% of respondents felt the TLD was a valuable experience for them, 91% felt that it was a valuable experience for others, and 83% would recommend the TLD for future rotations to Afghanistan (see Fig. 1). Delayed Questionnaire Results The perceived value of TLD still remained strong postdeployment with 81% indicating that it was a valuable experience for me, 89% responding that it was valuable for others, 84% recommending the TLD for future rotations coming out of Afghanistan, and 94% responded that some form of TLD was a good idea (see Fig. 1). There were small but statistically significant decreases in those who thought that the TLD was valuable for others (89% vs. 91%: immediate vs. postdeployment, p = 0.009) and a small but statistically significant increase in those who felt it was a good idea to let off steam before going home (93% vs. 90%: immediate vs. postdeployment, p < ). There was a greater and statistically significant decrease in the satisfaction with educational component postdeployment compared to the immediate survey (74% vs. 85%, p < ). Analysis of the native response categories showed divergent results: There was a 6% increase in those strongly dissatisfied with the educational program (4% vs. 10%), but there was also a 13% increase in those who were strongly satisfied with the educational program (14% vs. 27%). The most frequently identified benefits of TLD were as follows: 75% felt that it made them realize there is nothing wrong with seeking help, 74% believed that it made reintegration easier for them, 65% felt that it helped them to focus on things other than the tour, 60% felt that it made reintegration easier for their family, and 58% felt that it helped them to readjust to the Canadian way of life (see Table II). DISCUSSION Key Findings The results of these surveys demonstrate strong support for both the concept of TLD and the way the CF implemented it in Cyprus. Satisfaction with the concept and the program remained strong at least over the first 4 to 6 months after return, and most participants believed that the program made the reintegration process easier for them and for their families. They also believed that the program favorably changed their attitudes toward seeking help this was a central message of the educational component of the program. Comparison With Other Literature Other nations have also reported strong support for their TLD programs 24,25 and high immediate 24 and long-term satisfaction FIGURE 1. Satisfaction with TLD program: immediate vs. 4 to 6 months postdeployment. 400 MILITARY MEDICINE, Vol. 177, April 2012
5 TABLE II. Perception on How TLD Helped Their Transition on the Subset of Participants Surveyed 4 to 6 Months Later (Overall N = 1,846) Agree + Strongly Agree N % The TLD has helped me realize there is nothing wrong with seeking help 1, The TLD made the reintegration process easier for me 1, The TLD has helped me focus on things other than the tour 1, The TLD made the reintegration process easier for my family 1, The TLD has helped me readjust to the Canadian way of life 1, The TLD has helped me realize how important my family and friends are to me 1, The TLD has helped me put the events of the tour behind me 1, The TLD has helped me deal with real life situations 1, The TLD has helped me get back into sync with family life 1, The TLD has helped me become more involved in my family relationships 1, The TLD has helped me become more responsive to my family s needs 1, (Geerligs E: Adapatie te Cyprus. Report No.: GW , The Hague, Netherlands Ministry of Defence, 2005; Field C: Ration packs to the Sunday roast: an analysis of the Australian Defence Forces experience with postdeployment reintegration. Unpublished thesis for Postgraduate Diploma of Psychology, Monash University, 2005). Some have also found that spouses were supportive of the program (Geerligs E: Adapatie te Cyprus. Report No.: GW , The Hague: Netherlands Ministry of Defence, 2005). Consistent support and satisfaction are seen even though the specifics of the TLD program vary with respect to duration, setting (military base vs. hotel), access to alcohol, educational content, logistics, location, etc. For example, the U.K. program lasts only 36 hours, the participants are confined to a military base for the entirety of the program, and access to alcohol is tightly controlled. What these programs do have in common is as follows: (1) use after more difficult deployments; (2) having those who worked together go through decompression together; (3) brevity (less than 5 days); (4) use of a safe location in-between the theater of operations and home; (5) delivery of limited educational content on the transition process; (6) a mixture of individual free time and group recreational activities; (7) at least some access to alcohol; and (8) a focus on rest and recreation. This consistent support for TLD and satisfaction with varied TLD programs used in different nations suggest that the TLD concept is robust and does not depend heavily on the particulars of the program. Alternatively, each nation may have been highly effective at tailoring their TLD programs to the unique needs of their personnel. Limitations This study does have a number of limitations. The use of cross-sectional survey data capturing participants perceptions of the value of TLD does not prove that it had a true impact on their reintegration experience. However, we can say that participants supported the idea of TLD, that they found it valuable, that the perceived value persisted over time, and that they perceived it to have made reintegration easier for them and for their families. Whether it actually did so is another question. In addition, although participants believed that the program helped to make reintegration easier for their families, we did not directly assess this from the families perspective. The TLD experience was a pleasant one, and participants appeared to genuinely appreciate the attention and effort made on their behalf. As such, the favorable satisfaction and perceived impact ratings are more likely to be overestimates than underestimates of the true underlying effects. 26 We used questionnaires with face validity rather than going through a rigorous process of questionnaire development and validation. Nevertheless, we did draw on research on decompression and transition/reintegration in the design of our questionnaire. 22 Only a subset of participants had the opportunity to complete the delayed evaluation 4 to 6 months after return, and the response rate for this survey was low enough that selection bias may have distorted the results. The survey strategy likely targeted those in more forward roles while deployed, and those in the combat arms were overrepresented among respondents while reservists were underrepresented. The satisfaction of these individuals and the perceived impact of the program may have been lower in those in less forward roles. Even if participants perceptions of the favorable effect of the TLD on their transition experience are accurate, we don t know the magnitude of this effect. That is, did it help a little or a lot? We also can t say whether the same or better results might have been achieved with a less expensive, less logistically complex, and perhaps even less risky approach. In particular, our methods don t allow us to tease out the unique effects of the educational content from the R & R aspects of the program. This is important because the same educational content might be more (or less) effective if presented in some other context. 9 Indeed, engaging and retaining the attention of service members fresh out of a combat zone was a constant challenge. Finally, because of the way we structured the offering of elective educational sessions, it is not possible to attribute the perceived impact MILITARY MEDICINE, Vol. 177, April
6 on attitudes about mental health care to any particular educational module. Notwithstanding these limitations, this study provides evidence that a good majority of CF members support the TLD concept and perceive our TLD program to be of value following their rotation to Afghanistan. It is unclear how the program would have been received by personnel returning from a very different type of deployment (e.g., a humanitarian mission after a natural disaster). Jones et al 24 recently noted that decompression was counterintuitively less favorably evaluated by those with heavier combat exposure. Implications for Policy and Research Any program should be evaluated against its intended objectives. In the case of TLD in the CF, the objective is to make the transition process easier for members and their families. These surveys of attitudes and perceptions provide supportive evidence that the program achieved that objective. Others 8,9 have looked for evidence that TLD or similar programs influence long-term distress or psychopathology such as PTSD. We chose not to do so because we did not believe that the decompression aspect of the program was likely to achieve this end. As we discussed in the introduction, we are skeptical that assuring a nicer homecoming or easing transition will prevent PTSD in those who will go on to develop it. In other words, we think our program is helpful, not life transforming. We think it likely that its benefits are largely limited to making the first weeks to months a bit easier on our members, and we unapologetically judge this to be a humane and sensible thing to do for those who have already sacrificed so much. Although we downplay the potential for TLD to prevent long-term mental disorders, we believe that the complex relationship between the transition/reintegration experience and psychopathology does merit further research. Longitudinal research at multiple points of the deployment cycle will provide insight as to which problem comes first and the extent to which transition problems are mediated by mental disorders. If the goal of TLD is indeed to ease transition, then studying it presents further challenges. Transition is a remarkably complex and poorly understood phenomenon. For example, it is clear that there are a number of dimensions to it, including physical, social, and emotional dimensions. 1 Each of these has subdimensions (e.g., the social dimension includes family, workplace, and community reintegration). Each seems to have both negative and positive aspects, 1,22 and each may follow a different time course. Furthermore, there is much interindividual variation in how this all plays out. It is believed that deployment experiences influence transition, but in what precise ways is unclear. Finally, tools to study this complex process are only just being developed and validated. 1,22 A richer understanding of transition and reintegration will facilitate the evaluation of how TLD and other interventions might influence these. Such research would facilitate exploration of questions such as: What sorts of deployment circumstances make TLD more or less valuable? Are there certain kinds of education that are more (or less) effective on TLD as opposed to elsewhere in the deployment cycle? What are the fundamentals of an ideal TLD program, and how does this vary from deployment to deployment and from nation to nation? Specifically, is the third location essential, or could the same results be seen with a similar program in theater or in garrison? Is there a role for some sort of decompression program for those who return home on mid-tour leave? Program evaluation should also be driven by consideration of the cost of the program and its potential risks. Although the cost of TLD is substantial in absolute terms, it is small relative to the overall cost of the mission. The risk for alcoholrelated problems is harder to dismiss out of hand: Wherever high-risk drinking occurs (whether on TLD or elsewhere), the potential for serious injury exists, and control measures will never eliminate this entirely. Legal or disciplinary problems can also have life-altering implications. However, these risks need to be weighed against the risks personnel face while decompressing on their own at home, where access to alcohol is virtually uncontrolled, where peer and military supervision is more limited, and where operating a motor vehicle cannot be restricted. In any case, as our TLD program has matured, we have added additional controls (e.g., curfews, military police patrols) to decrease the risk of alcohol-related harm and to minimize the impact of alcohol on the educational program. CONCLUSION Everyone ultimately transitions from the deployed environment to the home environment: The fundamental question is whether this goes more smoothly with TLD than without it. Rigorously answering this would require a randomized controlled trial (RCT). Other study designs are unlikely to be strong enough to convincingly control for the many confounding factors that are likely to contribute to variation in the relevant outcomes. If one views TLD as a medical intervention like a medication, an RCT makes sense. Viewed as a human resources wellness tool, an RCT seems less urgent. Each military organization will have to decide whether evidence of the sort we present is strong enough to sustain its TLD program. ACKNOWLEDGMENTS The authors would like to thank MAJ Marie Norris, LTC Lisa Noonan, and Dr. Don McCreary for their assistance in the planning and execution of the 4- to 8-month postdeployment survey. This research was funded by the Department of National Defence (Canada). REFERENCES 1. Adler AB, Zamorski MA, Britt TW: The psychology of transition: adapting to home after deployment. In: Deployment Psychology: Evidence-Based Strategies to Promote Mental Health in the Military, 402 MILITARY MEDICINE, Vol. 177, April 2012
7 pp Edited by Adler AB, Bliese PD, Castro CA. Washington, DC, American Psychological Association, Wells TS, Miller SC, Adler AB, Engel CC, Smith TC, Fairbank JA: Mental health impact of the Iraq and Afghanistan conflicts: a review of US research, service provision, and programmatic responses. Int Rev Psychiatry 2011; 23: Creamer M, Wade D, Fletcher S, Forbes D: PTSD among military personnel. Int Rev Psychiatry 2011; 23: Sundin J, Forbes H, Fear NT, Dandeker C, Wessely S: The impact of the conflicts of Iraq and Afghanistan: a UK perspective. Int Rev Psychiatry 2011; 23: Stimpson NJ, Thomas HV, Weightman AL, Dunstan F, Lewis G: Psychiatric disorder in veterans of the Persian Gulf War of Systematic review. Br J Psychiatry 2003; 182: Kulka RA, Schlenger WE, Fairbank JA, Hough RL, Jordan BK, Marmar CR, et al: Trauma and the Vietnam War Generation. New York, Brunner/Mazel, Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL: Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 2004; 351: Hacker Hughes JG, Earnshaw NM, Greenberg N, Eldridge R, Fear NT, French C, et al: Use of psychological decompression in military operational environments. Mil Med 2008; 173: Johnston SL, Dipp RD: Support of marines and sailors returning from combat: a comparison of two different mental health models. Mil Med 2009; 174: Bolton EE, Litz BT, Glenn DM, Orsillo S, Roemer L: The impact of homecoming reception on the adaptation of peacekeepers following deployment. Mil Psychol 2002; 14: Fontana A, Rosenheck R, Horvath T: Social support and psychopathology in the war zone. J Nerv Ment Dis 1997; 185: King LA, King DW, Fairbank JA, Keane TM, Adams GA: Resiliencerecovery factors in post-traumatic stress disorder among female and male Vietnam veterans: hardiness, postwar social support, and additional stressful life events. J Pers Soc Psychol 1998; 74: Koenen KC, Stellman JM, Stellman SD, Sommer JF Jr: Risk factors for course of posttraumatic stress disorder among Vietnam veterans: a 14-year follow-up of American Legionnaires. J Consult Clin Psychol 2003; 71: Borus JF: Reentry. I. Adjustment issues facing the Vietnam returnee. Arch Gen Psychiatry 1973; 28: Shay J: Odysseus in America. New York, Scribner, United States Air Force. Deployment Transition Center. Available at Ramstein Air Base Web site transitioncenter.asp; accessed October 18, Lasco D: Going from the war zone to the home front. Ethos (Magazine of the Naval Special Warfare Command) 2010: Walter Reed Army Institute for Research. Battlemind Training Video. Washington, DC, Department of Defense (US), US Army Medical Department. Resilience Training, Formerly Known as Battlemind Training. Available at US Army Medical Department Web site accessed October 18, Adler AB, Bliese PD, McGurk D, Hoge CW, Castro CA: Battlemind debriefing and battlemind training as early interventions with soldiers returning from Iraq: Randomization by platoon. J Consult Clin Psychol 2009; 77: Interagency Advisory Panel on Research Ethics. Tri-council Policy Statement: Ethical Conduct of Research Involving Humans. Canada, Medical Research Council of Canada, Blais AR, Thompson MM, McCreary DR: Post-deployment reintegration measure: psychometric replication and preliminary validation results. Defence R & D Canada Toronto Technical Report. Available at cradpdf.drdc.gc.ca/pdfs/unc48/p pdf; accessed October 18, SPSS for Windows, Version 15.0 [computer program]. Chicago: SPSS, Jones N, Burdett H, Wessely S, Greenberg N: The subjective utility of early psychosocial interventions following combat deployment. Occup Med (Lond) 2011; 61: Burdett H, Jones N, Fear NT, Wessely S, Greenberg N: Early psychosocial intervention following operational deployment: analysis of a free text questionnaire response. Mil Med 2011; 176: Lester PB, McBride S, Bliese PD, Adler AB: Bringing science to bear: an empirical assessment of the Comprehensive Soldier Fitness program. Am Psychol 2011; 66: MILITARY MEDICINE, Vol. 177, April
Beyond Battlemind: Evaluation of a New Mental Health Training Program for Canadian Forces Personnel Participating in Third-Location Decompression
MILITARY MEDICINE, 177, 11:1245, 2012 Beyond Battlemind: Evaluation of a New Mental Health Training Program for Canadian Forces Personnel Participating in Third-Location Decompression Mark A. Zamorski,
More informationExcellence in USAMRU-EUROPE Research
Excellence in USAMRU-EUROPE Research A Bibliometric Evaluation Prepared by the Gorgas Memorial Library May 2011 Walter Reed Army Institute of Research/Naval Medical Research Center Silver Spring, MD 20910
More informationTITLE: Critical Incident Stress Debriefing for First Responders: A Review of the Clinical Benefit and Harm
TITLE: Critical Incident Stress Debriefing for First Responders: A Review of the Clinical Benefit and Harm DATE: 12 February 2010 CONTEXT AND POLICY ISSUES: Critical incident stress debriefing (CISD) is
More informationDeployment Stressors, Coping, and. Psychological Well-Being Among Peacekeepers. Luigi Pastò, Ph.D., Don McCreary, Ph.D., Megan Thompson, Ph.D.
Deployment Stressors, Coping, and Psychological Well-Being Among Peacekeepers Luigi Pastò, Ph.D., Don McCreary, Ph.D., Megan Thompson, Ph.D. Defence Research and Development Toronto 1133 Sheppard Avenue
More informationb. Potentially harmful alcohol misuse remains a common behavioural problem, but has declined steadily from 16% in 2004/6 to 10% in 2014/16.
THE MENTAL HEALTH OF THE UK ARMED FORCES (September 2018 version) This briefing note provides an outline of the current evidence on UK military mental health, including prevalence rates of mental health
More informationDoes trauma risk management reduce psychological distress in deployed troops?
Occupational Medicine 2010;60:645 650 Advance Access publication on 1 October 2010 doi:10.1093/occmed/kqq149 Does trauma risk management reduce psychological distress in deployed troops? W. Frappell-Cooke
More informationThe Stigma of Mental Health Problems in the Military
MILITARY MEDICINE, 172, 2:157, 2007 The Stigma of Mental Health Problems in the Military Guarantor: Thomas W. Britt, PhD Contributors: Tiffany M. Greene-Shortridge, MS, Thomas W. Britt, PhD; LTC Carl Andrew
More informationScreening for Traumatic Stress among Re-deploying Soldiers
R E S E A R C H R E P O R T # 2 0 0 4-0 0 1 US Army Medical Research Unit - Europe Walter Reed Army Institute of Research MAJ Paul Bliese (paul.bliese@us.army.mil) Dr. Kathleen Wright (kathleen.wright@us.army.mil)
More informationPerceived Stigma and Barriers to Mental Health Care Utilization Among OEF-OIF Veterans
Brief Reports Perceived Stigma and Barriers to Mental Health Care Utilization Among OEF-OIF Veterans Robert H. Pietrzak, Ph.D., M.P.H. Douglas C. Johnson, Ph.D. Marc B. Goldstein, Ph.D. James C. Malley,
More informationHealth Care Utilization by Veterans with Posttraumatic Stress Disorder: A Spouse/Intimate Partner Perspective By: Cassandra Buchanan, Nursing
1 Health Care Utilization by Veterans with Posttraumatic Stress Disorder: A Spouse/Intimate Partner Perspective By: Cassandra Buchanan, Nursing 2 Introduction With Operation Iraqi Freedom (OIF) and Operation
More informationDo stigma and other perceived barriers to mental health care differ across Armed Forces?
RESEARCH Do stigma and other perceived barriers to mental health care differ across Armed Forces? Matthew Gould 1 + Amy Adler 2 + Mark Zamorski 3 + Carl Castro 4 + Natalie Hanily 5 + Nicole Steele 6 +
More informationTrauma and Occupational Therapy: Perspectives of an Occupational Therapy Student. Laura Bulk
Main Article Health Professional Student Journal 2015 2(1) Trauma and Occupational Therapy: Perspectives of an Occupational Therapy Student Laura Bulk Abstract: Health professionals, including Occupational
More informationFOR: JONATHAN WOODSON, M.D., ASSISTANT SECRETARY OF DEFENSE (HEALTH AFFAIRS)
DEFENSE HEALTH BOARD FIVE SKYLINE PLACE, SUITE 810 5111 LEESBURG PIKE FALLS CHURCH, VA 22041-3206 FOR: JONATHAN WOODSON, M.D., ASSISTANT SECRETARY OF DEFENSE (HEALTH AFFAIRS) SUBJECT: Interim Report: Department
More informationTraumatic Events and Suicide Attempts
Traumatic Events and Suicide Attempts Findings from a large representative sample of Canadian military personnel Presenter: Shay-Lee Belik Co-Authors: Brian J Cox Gordon JG Asmundson Murray B Stein Jitender
More informationReliability of the Deployment Resiliency Assessment
BRIEF REPORTS MILITARY MEDICINE, 181, 7:638, 2016 Reliability of the Deployment Resiliency Assessment Samuel E. Simon, PhD*; Kate Stewart, PhD*; Michelle Kloc, PhD ; Thomas V. Williams, PhD ; MG Margaret
More informationPOST-DEPLOYMENT MENTAL HEALTH SCREENING INSTRUMENTS: HOW GOOD ARE THEY?
POST-DEPLOYMENT MENTAL HEALTH SCREENING INSTRUMENTS: HOW GOOD ARE THEY? MAJ (P) Paul D. Bliese, Ph.D., Kathleen M. Wright, Ph.D., CPT Jeffrey L. Thomas*, Ph.D., Amy B. Adler, Ph.D. United States Army Medical
More informationWar & Post-Traumatic Stress Disorder. Abigail B. Calkin Calkin Consulting Center, Gustavus, Alaska Association Behavior Analysis Int l, May 2015
War & Post-Traumatic Stress Disorder Abigail B. Calkin Calkin Consulting Center, Gustavus, Alaska Association Behavior Analysis Int l, May 2015 Few things are as painful as an invisible wound. Nelson Mandela
More informationNews Release Landstuhl Regional Medical Center Public Affairs Office Phone: DSN /8144 Civilian: /8144 Fax:
News Release Landstuhl Regional Medical Center Public Affairs Office Phone: DSN 486-7181/8144 Civilian: 06371-86-7181/8144 Fax: 486-8829 Release No. 7 July 1, 2009 New PTSD program answers need for comprehensive
More informationThe CAF Recruit Health Questionnaire: Longitudinal Studies of Resilience in CAF Recruits
The CAF Recruit Health Questionnaire: Longitudinal Studies of Resilience in CAF Recruits Jennifer E.C. Lee, Ph.D. Defence Scientist Personnel and Family Support Research Team May 3, 2016 CFPC CoI Templates:
More informationThe Canadian Armed Forces Suicide Prevention Program. Preventing Military Suicides Tallinn, Estonia June 17, 2013
The Canadian Armed Forces Suicide Prevention Program Preventing Military Suicides Tallinn, Estonia June 17, 2013 LCdr Kenneth J. Cooper CD BA, MD, MBA, MHSc, FRCPC Psychiatrist and Clinical Leader Mental
More informationIn 2004 the U.S. Preventive Services
Screening for Alcohol Misuse and Alcohol- Related Behaviors Among Combat Veterans Patcho N. Santiago, M.D., M.P.H. Joshua E. Wilk, Ph.D. Charles S. Milliken, M.D. Carl A. Castro, Ph.D. Charles C. Engel,
More informationTHE AUSTRIAN MILITARY PSYCHOLOGY DOCTRINE
THE AUSTRIAN MILITARY PSYCHOLOGY DOCTRINE Ernst Frise, Christian E. Lohwasser Military Psychology Service, Federal Ministry of Defence, Austria ABSTRACT During the year 1999 the Austrian Military Psychology
More informationDoes anonymity increase the reporting of mental health symptoms?
BMC Public Health This Provisional PDF corresponds to the article as it appeared upon acceptance. Fully formatted PDF and full text (HTML) versions will be made available soon. Does anonymity increase
More informationLong-Term Effects of Military Service on Mental Health among Veterans of the Vietnam War Era
MILITARY MEDICINE, 173, 6:570, 2008 Long-Term Effects of Military Service on Mental Health among Veterans of the Vietnam War Era Matthew S. Brooks, PhD*; Sarah B. Laditka, PhD ; James N. Laditka, DA PhD
More informationDo military peacekeepers want to talk about their experiences? Perceived psychological support of UK military peacekeepers on return from deployment
(T&F) CJMH120603 Journal of Mental Health (December 2003) 12, 6, 561 569 Do military peacekeepers want to talk about their experiences? Perceived psychological support of UK military peacekeepers on return
More informationREINTEGRATION PARTNERSHIP PROJECT
Reintegration Partnership Project: A Summary of Major Findings REINTEGRATION PARTNERSHIP PROJECT Summary of Findings & Key Recommendations Authored by: Sara Kintzle, Sherrie Wilcox, Anthony Hassan & Kathleen
More informationThe Contribution of Prior Psychological Symptoms and Combat Exposure to Post Iraq Deployment Mental Health in the UK Military
Journal of Traumatic Stress, Vol. 22, No. 1, February 2009, pp. 11 19 ( C 2009) The Contribution of Prior Psychological Symptoms and Combat Exposure to Post Iraq Deployment Mental Health in the UK Military
More informationDeployment, Readjustment & Restoration: The PTSD Family Workshop. Stratton VA Medical Center, Albany, NY
Deployment, Readjustment & Restoration: The PTSD Family Workshop Stratton VA Medical Center, Albany, NY Homecoming With deployment comes change, knowing what to expect and how to deal with changes will
More informationStructured Clinical Interview Guide for Postdeployment Psychological Screening Programs
VOLUME 173 MAY 2008 NUMBER 5 ORIGINAL ARTICLES Authors alone are responsible for opinions expressed in the contribution and for its clearance through their federal health agency, if required. MILITARY
More informationDiagnosis of PTSD by Army Behavioral Health Clinicians: Are Diagnoses Recorded in Electronic Health Records?
ARTICLES Diagnosis of PTSD by Army Behavioral Health Clinicians: Are Diagnoses Recorded in Electronic Health Records? Joshua E. Wilk, Ph.D., Richard K. Herrell, Ph.D., Abby L. Carr, Joyce C. West, Ph.D.,
More informationLeadership in Action. Strategies for Distress Prevention and Management
Leadership in Action Strategies for Distress Prevention and Management I. The Nature of Distress Sources of Distress Stressful events can motivate and challenge an individual. However, they can also have
More informationManual Supplement. Posttraumatic Stress Disorder Checklist (PCL)
Manual Supplement V OLUME 1, I SSUE 1 N OVEMBER 18, 2014 Posttraumatic Stress Disorder Checklist (PCL) The Posttraumatic Stress Disorder Checklist (PCL) is one of the most frequently used standardized
More informationKing s Research Portal
King s Research Portal DOI: 10.1177/2054270417692729 Document Version Publisher's PDF, also known as Version of record Link to publication record in King's Research Portal Citation for published version
More informationThe Impact of Reported Direct and Indirect Killing on Mental Health Symptoms in Iraq War Veterans
Journal of Traumatic Stress, Vol. 23, No. 1, February 2010, pp. 86 90 ( C 2010) The Impact of Reported Direct and Indirect Killing on Mental Health Symptoms in Iraq War Veterans Shira Maguen San Francisco
More informationHelping Military Veterans and Their Families Recover from the Losses of War: Emerging Perspectives and Complementary Approaches
Helping Military Veterans and Their Families Recover from the Losses of War: Emerging Perspectives and Complementary Approaches April 17 th 2015 Conference Evaluation Report Office of Research Sonia Suri,
More informationMilitary Operational Medicine Research Program
Mission Military Operational Medicine Research Program The mission of the Military Operational Medicine Research Program (MOMRP) is to develop effective countermeasures against stressors and to maximize
More informationSleep and Fatigue Issues in Continuous Operations: A Survey of U.S. Army Officers
Sleep and Fatigue Issues in Continuous Operations: A Survey of U.S. Army Officers Abstract A group of 49 US Army Officers recently returned from combat and attending the Infantry Officers Advanced Course
More informationAn Overview of PTSD and Treatment Perspectives Among Native American Veterans. Greg Urquhart, B.A. Washington State University
An Overview of PTSD and Treatment Perspectives Among Native American Veterans Greg Urquhart, B.A. Washington State University History of PTSD and Native American Veterans What is PTSD History of PTSD A
More informationRETURNING FROM THE WAR ZONE
RETURNING FROM THE WAR ZONE Produced by the National Center for PTSD November 2005 A Guide for Military Personnel ON BEHALF OF A GRATEFUL NATION WELCOME HOME! This pamphlet is provided to assist military
More informationRESEARCH AND PRACTICE. Karen H. Seal, MD, MPH, Daniel Bertenthal, MPH, Shira Maguen, PhD, Kristian Gima, BA, Ann Chu, MS, and Charles R.
Getting Beyond Don t Ask; Don t Tell : an Evaluation of US Veterans Administration Postdeployment Mental Health Screening of Veterans Returning From Iraq and Afghanistan Karen H. Seal, MD, MPH, Daniel
More informationThe Consistency of Combat Exposure Reporting and Course of PTSD in Vietnam War Veterans
Journal of Traumatic Stress, Vol. 20, No. 1, February 2007, pp. 3 13 ( C 2007) The Consistency of Combat Exposure Reporting and Course of PTSD in Vietnam War Veterans K. C. Koenen Departments of Society,
More informationBACKGROUND METHODS. (c) 2018 University of Newcastle upon Tyne and University of Teesside. MOD Crown copyright 2016
BACKGROUND Research around transition to civilian life indicates that for a small number of people, leaving the Armed Forces may be a challenge to well-being [Ahern et al 2015; Cooper et al 2016]. It is
More informationAre We Winning the War against Posttraumatic Stress Disorder?
Are We Winning the War against Posttraumatic Stress Disorder? The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation McNally,
More informationUNDERSTANDING CAPACITY & DECISION-MAKING VIDEO TRANSCRIPT
I m Paul Bourque, President and CEO of the Investment Funds Institute of Canada. IFIC is preparing materials to assist advisors and firms in managing effective and productive relationships with their aging
More informationPOSTTRAUMATIC GROWTH AND REDUCED PTSD FOR VETERANS THROUGH RECREATION
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 POSTTRAUMATIC GROWTH AND REDUCED PTSD FOR VETERANS THROUGH RECREATION Jessie
More informationEvaluating the Merits of Using Brief Measures of PTSD or General Mental Health Measures in Two-Stage PTSD Screening
MILITARY MEDICINE, 179, 12:1497, 2014 Evaluating the Merits of Using Brief Measures of PTSD or General Mental Health Measures in Two-Stage PTSD Screening Nicole M. Steele, BSc (Hons)*; Helen P. Benassi,
More informationTitle registration for a review proposal: Deployment of military personnel to military missions
Title registration for a review proposal: Deployment of military personnel to military missions Joannes Jacobsen, Julie Heidemann, Krystyna Kowalski & Anne- Marie Klint Jørgensen Title registration approval
More informationTimothy Heeren Department of Biostatistics, Boston University School of Public Health, Boston, MA
Journal of Traumatic Stress, Vol. 23, No. 1, February 2010, pp. 41 51 ( C 2010) PTSD Symptom Increases in Iraq-Deployed Soldiers: Comparison With Nondeployed Soldiers and Associations With Baseline Symptoms,
More informationA guide to peer support programs on post-secondary campuses
A guide to peer support programs on post-secondary campuses Ideas and considerations Contents Introduction... 1 What is peer support?... 2 History of peer support in Canada... 2 Peer support in BC... 3
More informationPost-Traumatic Stress Disorder (PTSD) in the military and veterans
Post-Traumatic Stress Disorder (PTSD) in the military and veterans When people think of mental illness in the military it is unsurprising that many of them think of Post-Traumatic Stress Disorder (PTSD),
More informationamong U.S. military members,
Mental Disorders and Mental Health Problems, Active Component, U.S. Armed Forces, 2-211 Mental disorders account for significant morbidity, health care utilization, disability, and attrition from military
More informationCRITICALLY APPRAISED PAPER (CAP)
CRITICALLY APPRAISED PAPER (CAP) Biggs, Q. M., Fullerton, C. S., McCarroll, J. E., Liu, X., Wang, L., Dacuyan, N. M.,... Ursano, R. J. (2016). Early intervention for post-traumatic stress disorder, depression,
More informationCopyright 2012 The Guilford Press
This is a chapter excerpt from Guilford Publications. Couple-Based Interventions for Military and Veteran Families: A Practitioner's Guide. Edited by Douglas K. Snyder and Candice M. Monson. Purchase this
More informationMark A. ZAMORSKI Canadian Forces Health Services Group HQ 1745 Alta Vista Dr. Ottawa, ON K1A 0K6 CANADA
to Mental Health Care in Military Organizations: Recent Research Findings from the Canadian Forces Mark A. ZAMORSKI Canadian Forces Health Services Group HQ 1745 Alta Vista Dr. Ottawa, ON K1A 0K6 CANADA
More informationStigma and Barriers to Mental Health Care in Deployed Canadian Forces Personnel
MILITARY PSYCHOLOGY, 24:414 431, 2012 Copyright Crown copyright ISSN: 0899-5605 print / 1532-7876 online DOI: 10.1080/08995605.2012.697368 Stigma and Barriers to Mental Health Care in Deployed Canadian
More informationPost Traumatic Stress Disorder With Respect to Combat Exposure: A Study on Army Veterans
Post Traumatic Stress Disorder With Respect to Combat Exposure: A Study on Army Veterans Pallavi Sachdeva 1, Rahul Sharma 2 & Sonia Sharma Badyal 3 1. Assistant Professor, Department of Life Long Learning,
More informationUnderstanding the role of Acute Stress Disorder in trauma
Understanding the role of Acute Stress Disorder in trauma Dr. Trina Hall Police Psychologist Dallas Police Department Lessons Learned: Unfolding the story of PTSD NAMI 2014 Fall Conference Trauma and
More informationRelationships Among PTSD Symptoms, Social Support, and Support Source in Veterans With Chronic PTSD
Journal of Traumatic Stress,Vol.21,No.4,August2008,pp.394 401 (C 2008) Relationships Among PTSD Symptoms, Social Support, and Support Source in Veterans With Chronic PTSD Charlene Laffaye VA HSR&D Center
More informationLes McFarling a, Michael D'Angelo a, Marsha Drain a, Deborah A. Gibbs b & Kristine L. Rae Olmsted b a U.S. Army Center for Substance Abuse Programs,
This article was downloaded by: [Florida State University] On: 10 November 2011, At: 13:53 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office:
More informationPsychological Support Pre-During and Post-Deployment. Introduction
Maj. Liesbeth Horstman, MSc Ministry of Defence The Netherlands PO Box 3003, 3800 DA Amersfoort THE NETHERLANDS Tel.+31-334661400 Fax.+31-334661407 aih@army.dnet.mindef.nl ABSTRACT From the early nineties
More informationPeer-group risk assessment: a post-traumatic management strategy for hierarchical organizations
Occupational Medicine 2003;53:469 475 DOI: 10.1093/occmed/kqg093 Peer-group risk assessment: a post-traumatic management strategy for hierarchical organizations N. Jones 1, P. Roberts 2 and N. Greenberg
More informationMood Disorders Society of Canada Mental Health Care System Study Summary Report
Mood Disorders Society of Canada Mental Health Care System Study Summary Report July 2015 Prepared for the Mood Disorders Society of Canada by: Objectives and Methodology 2 The primary objective of the
More informationMILD TRAUMATIC BRAIN INJURY (mtbi) is
J Head Trauma Rehabil Vol. 27, No. 1, pp. 75 82 Copyright c 2012 Wolters Kluwer Health Lippincott Williams & Wilkins Frequency of Mild Traumatic Brain Injury in Iraq and Afghanistan: Are We Measuring Incidence
More informationTogether for Mental Health Delivery Plan Royal British Legion Consultation Response. 1.0 About us
Together for Mental Health Delivery Plan 2016-2019 Royal British Legion Consultation Response 1.0 About us 1.1 The Royal British Legion was created as a unifying force for the military charity sector at
More informationPsycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: a review
Psychological Medicine, Page 1 of 14. f Cambridge University Press 2010 doi:10.1017/s003329171000125x REVIEW ARTICLE Psycho-educational interventions designed to prevent deployment-related psychological
More informationAccording to a recent report (1),
Predeployment and In-Theater Diagnoses of American Military Personnel Serving in Iraq Gerald E. Larson, Ph.D. Paul S. Hammer, M.D., U.S.N. Terry L. Conway, Ph.D. Emily A. Schmied, M.P.H. Michael R. Galarneau,
More informationEagala s Military Services Designation raises the bar for equine assisted psychotherapy for active military, reserves, veterans and their families.
Serving those who serve with the global standard in equine assisted psychotherapy Eagala s Military Services Designation raises the bar for equine assisted psychotherapy for active military, reserves,
More informationIN MEMORY OF MARINE TRAVIS MACKIN
IN MEMORY OF MARINE TRAVIS MACKIN IN MEMORY OF MARINE TRAVIS MACKIN CORBIN MACKIN Interview by Katy Regan Corbin, from Plymouth, lost his brother, Travis Mackin, 22, who was serving in 45 Commando, the
More informationTSgt Kyle Blair Psychological Health Center of Excellence (PHCoE) 5 DEC Medically Ready Force Ready Medical Force
TSgt Kyle Blair Psychological Health Center of Excellence (PHCoE) 5 DEC 2018 Medically Ready Force Ready Medical Force Disclosure The views expressed in this presentation are those of the presenter and
More informationEffect of Center-Based Counseling for Veterans and Veterans Families on Long-Term Mental Health Outcomes
MILITARY MEDICINE, 178, 12:1328, 2013 Effect of Center-Based Counseling for Veterans and Veterans Families on Long-Term Mental Health Outcomes Meaghan O Donnell, PhD*; Tracey Varker, PhD*; Desmond Perry,
More informationThe effect of job demands and social support on peacekeepers stress and sense of coherence after deployment
Finnish Defence Research Agency The effect of job demands and social support on peacekeepers stress and sense of coherence after deployment ISMS Annual Conference 2015, Finnish National Defence University
More informationWirral JSNA: Survey of AMMO veterans
Wirral JSNA: Survey of AMMO veterans Summary Report May 2015 John Highton Wirral JSNA Programme Lead Wirral Joint Strategic Needs Assessment Survey of members of AMMO (Ex-service personnel and military
More informationTRAUMA SCENE: INITIATION OF THE PROCESS OF POSITIVE RESOLUTION OF TRAUMATIC EXPERIENCES IN GROUPS AND INDIVIDUALS
TRAUMA SCENE: INITIATION OF THE PROCESS OF POSITIVE RESOLUTION OF TRAUMATIC EXPERIENCES IN GROUPS AND Mladen Trlek Ministry of Defence of the Republic of Croatia ABSTRACT The author presents his experience
More informationResponding to large-scale traumatic events and acts of terrorism
Responding to large-scale traumatic events and acts of terrorism Position Statement PS03/16 August 2016 London Approved by Policy and Public Affairs Committee: July 2016 Disclaimer This guidance (as updated
More informationTHE ASSIST ANT SECRETARY OF DEFENSE 1200 DEFENSE PENTAGON WASHINGTON, DC
THE ASSIST ANT SECRETARY OF DEFENSE 1200 DEFENSE PENTAGON WASHINGTON, DC 20301-1200 HEALTH AFFAIRS SEP 09 2013 MEMORANDUM FOR ASSISTANT SECRETARY OF THE ARMY (MANPOWER AND RESERVE AFFAIRS) ASSISTANT SECRETARY
More informationResilience and Early Interventions: A Military Occupational-Health Perspective
Resilience and Early Interventions: A Military Occupational-Health Perspective Amy B. Adler, Ph.D. Center for Military Psychiatry and Neuroscience Walter Reed Army Institute of Research Warrior Care 21
More informationAPNA 30th Annual Conference Session 3037: October 21, 2016
Erica Mumm, DNP, MSN, RN American Psychiatric Nurses Association 30 th Annual Conference October 19 th 22 nd, 2016 Disclosure This presenter has no conflict of interest to disclose. 2 OEF & OIF: A Different
More informationWhat explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?
Psychological Medicine, Page 1 of 10. f Cambridge University Press 2012 doi:10.1017/s0033291712002619 What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something
More informationHelping People to Deal with the Traumatic Effects of Organizational. Downsizing and Change
Helping People to Deal with the Traumatic Effects of Organizational Downsizing and Change Kerry Bernes, Ph.D., C.Psych. Associate Professor of Educational and Counselling Psychology University of Lethbridge
More informationVietnam: The Gift of Recovery, 2013 Sharing our experience, strength and hope for recovery By David J. Powell, Ph.D. Allen Berger, Ph.D.
Introduction Vietnam: The Gift of Recovery, 2013 Sharing our experience, strength and hope for recovery By David J. Powell, Ph.D. Allen Berger, Ph.D. Vietnam for most Americans remains an enigma. Millions
More informationNew Criteria for Posttraumatic Stress Disorder in DSM-5: Implications for Causality
New Criteria for Posttraumatic Stress Disorder in DSM-5: Implications for Causality Paul A. Arbisi, Ph.D. ABAP, ABPP. Staff Psychologist Minneapolis VA Medical Center Professor Departments of Psychiatry
More informationDefense Health Board
Defense Health Board Psychotropic Medication and Complementary and Alternative Medicine Interim Report Charles J. Fogelman, Ph.D. Psychological Health External Advisory Subcommittee Chair Michael D. Parkinson,
More informationnicola.sorfleet@combatstress.org.uk 01372 587016 1 2 Focusing on Veterans Our work 5,954 We are: Accessible through our 24-hour Helpline, We Provide: Evidence-based, recovery focused interventions including;
More informationMilitary Hardiness as a Buffer of Psychological Health on Return from Deployment
VOLUME 171 FEBRUARY 2006 NUMBER 2 ORIGINAL ARTICLES Authors alone are responsible for opinions expressed in the contribution and for its clearance through their federal health agency, if required. MILITARY
More informationEVALUATION OF EXISTING PEER PARENTING PROGRAMS
EVALUATION OF EXISTING PEER PARENTING PROGRAMS MARCH 2016 Carl Asuncion* and Carly Fraser* *CESI Research Shop Intern Citation: Asuncion, C. and C. Fraser (2016). Evaluation of Existing Peer Parenting
More informationEffects of PTSD with Family Members of Veterans. Dr. Barbara Anderson, DSW, MSW, BCD, MAC, LICSW
Effects of PTSD with Family Members of Veterans Dr. Barbara Anderson, DSW, MSW, BCD, MAC, LICSW Learning Objectives: 1) Increased knowledge about Post-Traumatic Stress Disorder and the effects of Post-Traumatic
More informationImproving clinicians' attitudes toward providing feedback on routine outcome assessments
University of Wollongong Research Online Faculty of Health and Behavioural Sciences - Papers (Archive) Faculty of Science, Medicine and Health 2009 Improving clinicians' attitudes toward providing feedback
More informationAbstinence - The practice of refraining from the consumption or use of alcohol and other intoxicating substances.
Terms Abstinence - The practice of refraining from the consumption or use of alcohol and other intoxicating substances. Air Force Personnel - Active duty, Air National Guard, Air Force Reserve personnel,
More informationPTSD and Other Invisible Wounds affecting our Service Members and Veterans. Alan Peterson, PhD, ABPP
PTSD and Other Invisible Wounds affecting our Service Members and Veterans Alan Peterson, PhD, ABPP 1 Alan Peterson, PhD, ABPP Retired USAF Lt Col Clinical Health Psychologist Former Chair, Department
More informationAward Number: MIPR 3GD3DN3081. TITLE: Outcomes of Telehealth Group Psychosocial Interventions for Breast Cancer Patients and Their Partners
AD Award Number: MIPR 3GD3DN3081 TITLE: Outcomes of Telehealth Group Psychosocial Interventions for Breast Cancer Patients and Their Partners PRINCIPAL INVESTIGATOR: LTC Debra L. Dunivin CONTRACTING ORGANIZATION:
More informationPosttraumatic Stress, Family Adjustment, and Treatment Preferences Among National Guard Soldiers Deployed to OEF/OIF
ORIGINAL ARTICLES Authors alone are responsible for opinions expressed in the contribution and for its clearance through their federal health agency, if required. MILITARY MEDICINE, 176, 2:126, 2011 Posttraumatic
More informationMoral Injury and Stress Response Patterns in United States Military Veterans
Modern Psychological Studies Volume 23 Number 1 2017 Moral Injury and Stress Response Patterns in United States Military Veterans Emily L. Ferrell Bowling Green State University, emilylf@bgsu.edu John
More informationChristopher R. Erbes, PhD Melissa A. Polusny, PhD Minneapolis VA Medical Center and University of Minnesota Medical School
Christopher R. Erbes, PhD Melissa A. Polusny, PhD Minneapolis VA Medical Center and University of Minnesota Medical School This research is funded by grants from the Department of Defense, the Military
More informationFlightfax R Online newsletter of Army aircraft mishap prevention information
Number 32 December 2013 Flightfax R Online newsletter of Army aircraft mishap prevention information In this month s issue of Flightfax, we are focusing on individual and aircrew situational awareness
More informationBACKGROUND + GENERAL COMMENTS
Response on behalf of Sobi (Swedish Orphan Biovitrum AB) to the European Commission s Public Consultation on a Commission Notice on the Application of Articles 3, 5 and 7 of Regulation (EC) No. 141/2000
More informationClients perception of HIV/AIDS voluntary counseling and Testing (VCT) services in Nairobi, Kenya
Clients perception of HIV/AIDS voluntary counseling and Testing (VCT) services in Nairobi, Kenya Tom M. Olewe 1*, John O. Wanyungu 2 and Anthony M. Makau 3 1 Vision Integrity & Passion to Serve (VIPS)
More informationThe Effects of Mental Health Symptoms and Organizational Climate on Intent to Leave the Military Among Combat Veterans
MILITARY MEDICINE, 177, 7:773, 2012 The Effects of Mental Health Symptoms and Organizational Climate on Intent to Leave the Military Among Combat Veterans CPT Paul J. Wright, MS USA; Paul Y. Kim, MA; Joshua
More information} 1989: Began offering free counselling services to survivors of political violence under apartheid
Dominique Dix-Peek ISS Conference: August 2014 } 1989: Began offering free counselling services to survivors of political violence under apartheid } Post-1994: Saw an increase in criminal violence } Early
More informationPREVALENCE AND DETERMINANTS OF ANTIDEPRESSANT USE AMONG CANADIAN FORCES MEMBERS EXPERIENCING MAJOR DEPRESSIVE EPISODES
PREVALENCE AND DETERMINANTS OF ANTIDEPRESSANT USE AMONG CANADIAN FORCES MEMBERS EXPERIENCING MAJOR DEPRESSIVE EPISODES Chiranjeev Sanyal 1, Mark Asbridge 1, Steve Kisely 2, Ingrid Sketris 1, Pantelis Andreou
More informationJournal of Mestizo and Indigenous Voices
NATIVE AMERICAN VETERAN TREATMENT PREFERENCES 1 Journal of Mestizo and Indigenous Voices Volume (1) Issue (1) Article (3) October 2015 Native American Veteran Treatment Preferences: results from an ongoing
More information