Thursday, January 18, 2018
Monday, June 9, 2014
Wednesday, November 20, 2013
Hello everyone I apologize for not being as pro-active in keeping up my blog. Well a lot has happened since my last post. I am now in my final two semesters of graduate school (graduate Aug 2014) I also have run into a few bumps in the road that have helped re-evaluate some actions and think about how poor choices can adversely effect the goals you place for yourself. But more about that later! As for now I want to post a few things I have written concerning suicide and the impact that Post Traumatic Stress Disorders plays in increasing the propensity for completed suicide as well as increased attempts. Although this is a dark subject it is something that needs to be addressed.
After the initial assessment takes place suicide risk reduction and safety plan refinement is an ongoing process. The clinician is encouraged to take the lead in facilitating a coordinated treatment plan, with each provider identifying their role in a collaborative process to reduce suicide risk. There are many ways other treatment providers can provide critical support in the reduction of suicidal risk. During this phase the veteran is encouraged to identify specific emotional states that frequently cue suicidal thoughts
Cognitive Behavioral Techniques Used in PTSD Treatment
Prolonged Exposure Therapy (PE)
Disconnecting the overwhelming sense of fear from trauma
Relearning thoughts and beliefs generated from the traumatic event, which impede current coping skills.
Cognitive Processing Therapy (CPT)
Understanding both emotional and cognitive consequences of trauma exposure
Stress Inoculation Training (SIT)
Anxiety Management to increase coping skills for current situations.
Exposure and cognitive restructuring through a protocol-driven CBT treatment accessed via the internet.
Imagery Rehearsal Therapy
Changing disturbing traumatic nightmares by rehearsing "new dreams"
Biofeedback and Relaxation Training
Anxiety management to help patients master overwhelming anxiety feelings and physiological reactions elicited by a trauma reminder.
Dialectical Behavior Therapy (DBT)
Treating borderline personality disorder, a syndrome of associated with PTSD and complex PTSD.
Barriers To Mental Health Care in General Population and Among Former Deployed Military Personnel
In General Population (Kessler, Berglund, et al., 2001)
Among Formerly Deployed Military Personnel (Schell and Marshall, 2008)
Lack of perceived need
Negative career repercussions
Unsure about where to go for help
Inability to receive a security clearance
Cost (too expensive)
Concerns about confidentiality
Perceived lack of effectiveness
Concerns about side effects of medications
Reliance on self (desire to solve problems on one's own or thoughts that the problem will get better)
Preferred reliance on family and friends
Perceived lack of effectiveness
Written by Gene Hicks 2013
Wednesday, August 8, 2012
As a graduate student working towards my Masters Degree in Social Work degree I can honestly say that I truely want to help Veterans and their families. I also believe that it is important that a Vet help a Vet because there is a common bond between the two "SERVICE". I am reminded of a saying that "For those who fought for it, freedom has a taste the protected will never
|1SG Gene Hicks Helmand, Afghanistan|
(CNN) -- Things probably should have turned out differently for Samantha Schilling. The stories she tells have dark beginnings and could have had, under different circumstances, dark endings -- as so many stories for those in the military do. Schilling, now 31, served in the U.S. Navy from 1999 to 2003. She was never deployed but worked as an information systems technician at Naval Station Norfolk in Virginia.
"I'm determined to be able to be helpful to others," she said. "Helping others helps me. ... I think therapy can help people adapt to civilian life again instead of maladapt. People who have PTSD and other (issues) can maladapt and cause trouble in the civilian world."
But some former active-duty service members aren't waiting for help to arrive. Veterans have turned to psychology to become mental health professionals, and they're filling in gaps in veteran care that government and civilian efforts have left open. And while they are still rare, programs to train them are slowly emerging at universities and nonprofit organizations around the United States.
"It's just going to increase and increase"
Although he still carries burdens from his deployment, since his return, he hasn't forgotten about his military family. Some, he knows personally; others, he's only met through that beeping laptop. He has dedicated his life to helping veterans connect to one another and improve their mental health.
Kyle works as a peer coach at Vets Prevail, a free online forum and multistep mental health program. It was founded in 2009 by a small group of professionals, almost all of them veterans.
"They haven't experienced it"
Monday, July 16, 2012
In this week’s TIME cover story, “One a Day” (available to subscribers here), journalists Mark Thompson and Nancy Gibbs explore why suicides among the U.S. military have reached crisis levels. Every day, one active-duty service member dies by his own hand, the authors note: “The U.S. military seldom meets an enemy it cannot target, cannot crush, cannot put a fence around or drive a tank across. But it has not been ale to defeat or contain the epidemic of suicides among its troops.”
The specific triggers for suicide are unique to each soldier. Each person deals differently with the stresses of war, frequent deployments, separation from family, death of comrades. Many contend with depression and post-traumatic stress upon returning home. There are several programs and support lines for these soldiers, but it also helps for their immediate families to remain vigilant and to monitor their behavior. Even still, many service members fall through the cracks.
Below is what we hope is helpful advice for military spouses, who want to know what warning signs to look for in their service member and how best to handle severe situations. One immediate sign, say experts, is a pervasive sense of uselessness, a feeling that they no longer belong. “What we learn from our families [who lost service family members to suicide] and what they saw in their loved ones, is behavior [in which they] pulled back and felt they were not able to be a useful part of unit that relied on them,” says Bonnie Carroll, founder and chairman of the Tragedy Assistance Program for Survivors, or TAPS, a non-profit that supports those who have lost a loved one in the military. “These men and women need to know they are still a part of a unit at home and overseas.”
Here, experts offer more answers to common questions that military families face when a loved one shows signs of trouble:
What are the signs of suicide risk to look out for?
There are many signs of suicide, says Kim Ruocco, director of the suicide prevention programs at TAPS. Some key warning signs to look out for:
- Hopelessness and saying things like “This will never get better”
- Helplessness and saying things like “I can’t do anything about this”
- No longer finding joy in things they once enjoyed
- Angry outbursts and increased agitation
- Sleeplessness or oversleeping
- Lack of appetite or increased appetite
- Withdrawal from friends and family, or suggestions that family would be better off without them
- History of suicide attempt and history of depression
- Post-traumatic injury
Warning signs of suicide that call for immediate attention:
- Talking about or making plans to take his or her own life
- Putting personal affairs in order
- Giving away personal possessions
- Obsessing about death
- Abusing drugs or alcohol
- Acquiring or obtaining access to lethal means (prescription drugs, weapons, etc.)
- Engaging in out-of-the-ordinary or risky behaviors
“You should always ask someone if they are thinking of killing themselves and if they are, do not leave them alone, escort them to help, take them to a doctor at primary care, behavioral health or the emergency room,” says Ruocco. “Sometimes a person will deny thinking of suicide despite warning signs. These people should also be considered high risk and be taken for immediate evaluation.”
Whom should I contact if I’m concerned about my loved one?
The first person to speak with is your loved one. Ask your he or she is feeling, says Eileen M. Lainez, a spokeswoman for the U.S. Department of Defense. For example: Do you feel as if you could harm yourself? How often are you having those kinds of thoughts? Do you have a plan to harm yourself?
“Keep track of all conversations with a service member who expresses any indication that he or she could harm him or herself, or is experiencing unique or intense stressors,” says Lainez.
There are several 24/7 service lines open to family members who have immediate concerns:
- Military Crisis Line: Dial 800-273-8255 (press 1 for military) or visit the crisis line online, which provides a chat and text service for veterans (see below) and active duty members
- Veterans Crisis Line: Visit Veterans Live Chat or call 800-273-TALK to talk with a crisis counselor
- DCoE Outreach Center: Visit Real Warriors Live Chat or call 866-966-1020 to talk with a health resource consultant
- Military OneSource: Call 800-342-9647 for one-on-one counseling or visit online
- Do not hesitate to call 911 in an emergency
Should I alert the military if my loved one is showing signs of suicide at home?
Anyone concerned about a service member for any reason should not hesitate to contact that service member’s supervisor, commander, any health-care provider or a chaplain. “If the family member is looking for behavioral health support, information or resources, they should contact [these individuals]. The earlier an adjustment or behavioral health issue is identified and addressed, the more likely a positive outcome will result,” says Lainez.
Is there anything I shouldn’t do?
Don’t be afraid to be proactive: Ask your loved one questions about suicidal thoughts or plans, and do not hesitate to get help. “Suicidal thoughts can be a medical emergency. Someone who has been thinking about suicide over time can lose the ability to control the impulse. Put aside fears of betraying your loved one or ruining his [or her] career and chose to save his [or her] life,” says Ruocco.
Should I be more concerned if my loved one has been overseas for several tours, or less concerned if he or she hasn’t?
There are many factors associated with suicide, which make it difficult to point to any one factor as a root cause. Currently, there is no evidence directly linking the number of deployments to an increased risk of suicide. Any warning signs of suicide should be taken seriously, regardless of the number of times the service member has been deployed overseas.
“Combat exposure can increase risk for suicide, especially if the service member was exposed to trauma or suffered a concussive injury,” says Ruocco. “However, about half of our service members who die by suicide have never deployed, so the fact that they have not deployed should not be a reason to not seek treatment.” The 2010 Department of Defense Suicide Event Report found that indeed half of all service members who died by suicide during 2010 had never been deployed to Iraq or Afghanistan.
What can I do to support my soldier and help prevent suicide risk?
Real Warriors, a campaign started by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) to promote recovery and resilience among returning service members, suggests that you encourage and help your loved one do the following:
- Cut back on obligations when possible and set reasonable schedules for goals
- Consider keeping a journal to express pain, anger, fear or other emotions
- Avoid isolation — get together with buddies, commanding officers, family, friends or other members of the community regularly
- Stay physically fit by eating healthy foods and getting enough sleep
- Stay motivated by keeping personal and career goals in mind
- Use relaxation techniques to help manage stress
- Stay organized by keeping a daily schedule of tasks and activities
There are plenty of mental-health resources out there, but here are a few we highly recommended for service members and their families:
- U.S. National Suicide & Crisis Hotlines: http://suicidehotlines.com/national.html
- U.S. Army Suicide Prevention: http://www.armyg1.army.mil/hr/suicide/
- Real Warriors suicide prevention: http://www.realwarriors.net/family/support/preventsuicide.php
- U.S. Department of Veterans Affairs suicide prevention: http://www.mentalhealth.va.gov/suicide_prevention/
- Tragedy Assistance Program for Survivors, for families who have lost a loved one in uniform to suicide: http://www.taps.org/survivors/survivor.aspx?id=6320
Read the full TIME cover story, available to subscribers here.
Tuesday, July 10, 2012
I am currently attending a program that will certify me to conduct the Wellness Recovery Action Plan (WRAP) for veterans I serve.
If you are on active duty, in the reserves, or have been in the military, you may be having a hard time coping with the hardship, trauma, and loss related to military service and being involved in war-related activities. You may have feelings and experiences that are extremely upsetting, feelings that keep you from being the way you want to be and doing the things you want to do. In addition, things may be happening in your life that are difficult to deal with. Family members and friends, who don’t understand what you are experiencing and why you are behaving the way you are, may not know how to respond or how to help. Some may try to help and others may turn away. You may feel like the situation is hopeless - that you will never feel well and enjoy life again.
The Wellness Recovery Action Plan can help you in the process of recovery, of getting well and staying well, and of assisting you in becoming who you want to be and making your life the way you want it. It will also be helpful to you in adapting to any challenges you have in your life like chronic illness, serious disability, being on active duty, or dealing with extreme loss or grief.
This online version of the Wellness Recovery Action Plan (WRAP) is specifically oriented for people who are in the military or have been in the military. There are video clips with Mary Ellen Copeland talking to veterans as they are developing their WRAPs. This WRAP is private and can be accessed at any time. You can make changes to it whenever you want and e-mail it to anyone you choose. WRAP can help with coordinating daily living as well as larger issued like depression and PTSD. This version of WRAP is very convenient for military personnel and is friendly, easy, and empowering. https://wrap.essentiallearning.com/Default.aspx?ReturnUrl=%2f
After my certification I hope to begin providing classes specifically for veterans in Idaho that will help them develop a personal WRAP as well help them start down the road of recovery.
Call me at Riverside Rehab, Inc. (208) 853-8536 and I will help you with your WRAP in my veteran services department.
Did you know that:
- More than 42 million American men and women have served in a time of war
- Current Projected U.S. Veterans Population: 23,442,000
- There are between 529,000 and 840,000 veterans who are homeless at some time during the year, that’s 23% of the homeless population
- 89% of homeless veterans received Honorable Discharges
- 33% of homeless veterans served in a war zone
- Each year between 375,000 – 600,000 homeless veterans receive no assistance
- 6 million veterans are living with a disability
- 45% of veterans need help finding a job
- 37% of veterans need help finding housing
- Number of Veterans with for Post Traumatic Stress Disorder (as of 09/30/08): 342,624
Tuesday, February 7, 2012
"For those who are like me, there is help. Seek it out. You were strong enough to make it this far, don’t give up. Dig a little deeper and make that final push. If you do not know where to go or have fallen astray, contact me. I will help. We are all brothers and sisters in this battle that will rage invariably for eternity and the one constant is that we have each other."
By RU Rob
I have PTSD. We all know what it is, Post Traumatic Stress Disorder. I am one of millions who are affected by it each and every day. Millions of men and women who have varying symptoms yet manage to maintain a normal lifestyle. I, along with my cohorts, have been classified as a potential powder keg just waiting on that spark to set us off into a murderous explosion of ire. This is not the case as I am just as normal as you.
At the end of every day I lay my head down in an attempt to sleep. That in itself is no different than you. But when my eyes close and I should be drifting off into a peaceful bliss, my mind takes over and I am tormented in my dreams with a vivid and exaggerated version of every combat encounter witnessed. There has been nary a night that I do not have this, and have not had an uninterrupted night of sleep for years. Yet in the morning, I rise with the consistency of the sun, roll out of my sweat soaked bed, and shake off the remnants of the nightly battles and start my day…just like you.
I am functional in society, but I am a little more vigilant than you, always on the look-out for danger, avoiding large crowds and loud places. But somehow, I can still manage to go out to eat, shop for my clothes and drive my car. I pay close attention to those around me, see the drug deal that just took place on my right and notice the people who just don’t belong in a certain situation. You may not have evil intentions, but I will notice nonetheless.
I have guns. As a matter of fact I just about always have one on me. You see, even though I have PTSD, I am still a Sheepdog watching out for my flock. I don’t brandish my weapon and most of the time you won’t even know I have it on my body, but it is there. I also carry a large knife in my pocket, one that could cause serious injury or death if used improperly. I have never used any of my weapons in a malicious manner and never will, but in my duties as a Sheepdog I will not hesitate to draw down on you should the circumstance warrant it. I am armed, but I am not dangerous.
There are times that I am medicated. My PTSD comes in cycles and when things get bad I need that extra chemical push to regulate me. I accept this and because of it I do not drink. I have other physical problems that could easily warrant an addiction to pain killers, but just like most of us with PTSD, I avoid it.
I have never committed violence in the workplace, just like the vast majority of those who suffer with me. My co-workers know I spent time in the military but they do not know of my daily struggles, and they won’t. I can still communicate with my subordinates and supervisors in a clear manner. I have never physically assaulted anyone out of anger or rage.
It pains me when I listen to the news and every time a veteran commits a crime (or commits suicide); it is automatically linked to and blamed on PTSD. Yes, there are some who cannot control their actions due to this imbalance in our heads, but don’t put a label on us that we are all incorrigible. Very few of us are bad. There are more of us out there that are trying harder to do good than the lesser alternative.
Do not pity me. I know who I am and recognize the journey that has shaped me into what I am. I have no regrets about anything that I have done in the past and look forward to many wonderful years in the future. I freely take every step of life during the day knowing that there is something that will haunt me at night.
For those who are like me, there is help. Seek it out. You were strong enough to make it this far, don’t give up. Dig a little deeper and make that final push. If you do not know where to go or have fallen astray, contact me. I will help. We are all brothers and sisters in this battle that will rage invariably for eternity and the one constant is that we have each other.
To the rest of society and particularly the media: I have PTSD!
Thursday, January 19, 2012
Army suicide rates decline for first time in 4 years
By Gregg Zoroya, USA TODAY
Tuesday, January 17, 2012
"A study published in the Archives of General Psychiatry in October found that soldiers were two to four times more willing to report PTSD, depression, and suicidal thoughts if they were allowed to answer a survey anonymously, rather than put their names on a routine post-deployment screening form."
Idea to take the 'D' out of PTSD being studied
Dr. John Oldham, who serves as senior vice president and chief of staff at the Houston-based Menninger Clinic, said he is looking into the possibility of updating the association's diagnostic manual with a new subcategory for PTSD. The subcategory could be "combat post-traumatic stress injury," or a similar term, he said.
"It would link it clearly to the impact and the injury of the combat situation and the deployment experience, rather than what people somewhat inaccurately but often assume, which is that you got it because you weren't strong enough," Oldham said.
The potential change was prompted by a request from Gen. Peter Chiarelli, the Army's vice chief of staff, who wrote to Oldham last year, suggesting APA drop the world "disorder" from PTSD.
"Calling it a disorder contributes to the stigma and makes it so some folks -- not all, but some folks -- don't get the help they need," Chiarelli said.
The general doesn't like to use the word disorder. "It's not a dirty word, but I think it's misused here," he said. "I don't think that the post-traumatic stress that soldiers experience is a disorder. It's not something that happens just to weak people or people that are somehow inclined to be affected by horrible things that they see or are required to do. I think it causes an actual injury to the brain and how the brain works."
After receiving Chiarelli's letter, Oldham wrote back to say he appreciated his concern, but dropping the word disorder might not be the best way to go. He said he was eager to work with Chiarelli to see what APA could do.
The general invited Oldham to the Pentagon to discuss the situation. They met for about an hour and a half on Dec. 9. Oldham agreed to bring the general's suggestion to the APA work group tasked with reviewing PTSD for the next version of the association's Diagnostic and Statistical Manual of Mental Disorders, the classification book used by psychiatrists in America. APA is finalizing the fifth edition of the manual, due in May 2013.
Oldham cautioned the discussion is very preliminary but speculated that a new subcategory like "combat post-traumatic stress injury" might work.
Although Chiarelli still would prefer to lose "disorder" entirely, he said a new subcategory would be a start. "I'm frustrated with how long this is taking to be honest," he said.
The general pointed out that PTSD has had many names over the years, from shell shock to battle fatigue. "It's been called all kinds of different things and somehow we decided to go with PTSD and I think that's just wrong," he said.
Chiarelli's campaign to change the name of PTSD is part of the Army's effort to reduce alarming suicide rates among soldiers. Statistics released last month identified 260 potential suicides in 2011. Of that total, 154 were active-duty soldiers, 73 were National Guard troops and 33 were reservists.
Silence over stigma
Stigma is a major problem. A study published in the Archives of General Psychiatry in October found that soldiers were two to four times more willing to report PTSD, depression, and suicidal thoughts if they were allowed to answer a survey anonymously, rather than put their names on a routine post-deployment screening form.
Of the soldiers who screened positive for PTSD or depression, 20 percent said they weren't comfortable answering honestly on the routine form. The study concluded that the Army's screening process misses most soldiers with significant mental health problems.
Dr. Harry Croft, a psychiatrist in San Antonio, said the findings jibe with what he hears from veterans he treats for PTSD.
"Even though the rules, as I understand them, say you don't get kicked out if you get diagnosed with PTSD, depression or any other issues, a lot of veterans say, 'I knew damn well if I answered the questions right my chance to get promoted was gone,' " Croft said.
Croft has mixed feelings about changing the name of PTSD. He understands the concern about stigmatizing troops but thinks whether the condition is called PTSD or something else will have little effect on the suicide rate.
"Rather than concentrate on what we call it, we need to concentrate more on how to help warriors coming back from the combat zone, because I don't think the name we give it will have much of an impact on the 18 suicides a day and all the other problems that we see," Croft said. "That's putting a Band-Aid on a much bigger wound."
Chiarelli says his main concern is getting soldiers into treatment, so if calling post-traumatic stress a disorder keeps them from seeking help, then the wording needs to change, the sooner the better.
"You can have the very, very best treatments in the world, but if you can't get people take advantage of them, they don't do any good," he said.