Tuesday, February 4, 2014

Education

Employment

Healthcare

Quality of Life

MISSION: The West Michigan Veterans Coaliti...
I.

Welcome

II.

Pledge of Allegiance

III. Spotlight Session:
•

Education Subcommittee - VA Work Study Program
- Jonath...
Jonathan Highman,
Chairman of Education Subcommittee
jhighman@davenport.edu
Work-study Department
VA Regional Office
St. Louis, Missouri
Telephone: (314) 552-9861
Fax: (314) 552-9533
 Allows veterans to earn
additional pay by working on
behalf of the VA while at least a ¾
time student.
 Limited to work...
 Veterans can work no more than
25 hours for every week in their
current semester.
 Once the veteran reaches 50
hours, t...
 Read and understand the
Work-study Supervisor’s Handbook.
 Provide direct supervision to VA
work-study students.
 Ensu...
 You are required to maintain the
work-study file for 3 years. You are
also required to maintain a current
class schedule...
 Determined by the VA
 Must be enrolled in classes at
least ¾ time
 Must be receiving one of these
VA funds:





...
 Locate a work site and determine if
an opening exists.
 The Work-site Supervisor must agree
to hire the student.
 Supe...
 Telephone: (314) 552-9861
(10am-2pm central)
 Fax: (314) 552-9533 (24 hours)
 WS.VBASTL@VA.GOV (Inquiries)
 WKSRTN.VB...
VA Work Study
Supervisor’s Handbook

Application for Work-study
allowance (VA Form 22-8691)
Brandi McBride & Michael Poyma,
Co-Chairs of Employment
Subcommittee
bmcbride@goodwillgr.org
michael.poyma@va.gov
Employment
Focus
PARTNERS
•
•
•
•
•
•
•
•
•

U.S. Dept. of VA
Goodwill Industries
TALENT 2025
H2H
ESGR
WGVU
DoL
VetBiz Central
MRS

•
•
•
•...
KEY INSIGHT
Two unique veteran populations
facing different challenges
Veterans with
Significant Barriers
Homeless

Disabilities

Substance Abuse/
Mental Illness

HCHV

In-between

Felonies

Go...
WHAT IS THE SYSTEM…
for veterans to work through
service providers to get to
employers to eventually find
employment?
• Suits for Soldiers

• VOA

• Army One Source

• Buddy 2 Buddy

• Career Counselors • VA
• Disability Advocates
• VetBiz ...
CURRENT PRACTICES
TAP | Job Fairs | Job Boards | MI Talent

Hola, estoy buscando un
trabajo. ¿Tiene alguna
posición abiert...
HOW DO WE
CHANGE IT???
GOAL #1
Networking/educational
workshops for employers
SERVICE
PROVIDERS

ESGR
TALENT
2025

MVAA

TRAINING
WORKSHOPS

*

Employers will be
able to …

Understand populations | Tr...
GOAL #2
Small networking events to
connect smaller employers to
veterans
SERVICE PROVIDER

VETERAN

EMPLOYER

SERVICE PROVIDER

VETERAN

EMPLOYER

KENT
APRIL

OTTAWA
AUGUST
MONTCALM
JUNE

Sponsor...
THE WAY FORWARD
Employment programming
in a collaborative
environment
DELIVERABLES - 2014
• Streamline process of preparing vets for
employment
• Increase # of Veteran-Friendly Employers
• Edu...
Employment
Focus
QUESTIONS?
Carrie Roy & Elena Bridges,
Co-Chairs of Healthcare Subcommittee
Elena.bridges@altarum.org
carrie.roy@kentcountymi.gov
Health Care Subcommittee
Barriers
• Lack of Education/Information/Family Support
• Cumbersome System
• Transportation
• Me...
PTSD 101
A short history, symptoms, and treatments.

Mark S. Kane, Ph.D. Licensed Psychologist
Fellow of the Michigan Psyc...
National Center for Post Traumatic
Stress Disorder Statistics
7.8 % of Americans experience PTSD (Keane et al., 2006)
Wome...
“Best Practice Treatment” of Shell
Shock after WWI

34
* DISCLAIMER
Information during this presentation is for educational purposes
only—it is not a substitute for informed med...
A Short History of PTSD From
Homer to “Irritable Heart” Civil War
• In the “Odyssey” in the 8th Century B.C. Homer
describ...
In 1597, William Shakespeare's Henry IV had
Lady Percy describe her husbands PTSD
symptoms
•

LADY PERCY: O my good lord, ...
History of PTSD: “Shell Shock”
World War I

38
PTSD first used in 1980 in DSM-III
Current Definition of PTSD used in DSM V
• A Trauma related disorder in which exposure ...
PTSD Stressors
• Violent human assault
• Natural catastrophes
• Accidents
• Deliberate “man”-made disasters

40
U.S. Depar...
Combat Fatigue
Immediate psychological and functional impairment that
occurs in war or during other severe stressors durin...
Symptoms of PTSD
• Recurrent, involuntary, and intrusive thoughts of event
• Traumatic nightmares, flash backs
(visual, so...
DSM – V Criteria
• A: stressor
• B: intrusion symptoms
• C. voidance
• D. negative alterations in cognitions and mood
• E....
Duration of PTSD
Full diagnosis is not met until at least six months after the
trauma(s). Although onset may occur immedia...
Comorbid/Coexisting Problems
• *Depression, Anxiety and Pain
• *Substance abuse/dependence

• *Other addictions, i.e., gam...
TBI Comorbidity
TBI is trauma to the brain triggered by externally
acting forces (i.e., direct penetration, sustained
forc...
Blast Injuries
Blast injuries are injuries that result from the
complex pressure wave generated by an explosion
• Ears, lu...
Why Blast Injures are of Interest
Now?
Armed forces are sustaining attacks by rocket-propelled
grenades, improvised explos...
PTSD and TBI symptoms
Overlap:
Emotional Liability• Difficulty with attention and concentration
• Amnesia for the event
• ...
Identifying PTSD Consultants and
Trauma Specialists
• Expert therapists Psychiatrists (MD/DO)
• Clinical Psychologists (Ph...
Therapeutic Approaches &
Techniques
Prolonged Exposure Therapy (PE) – Prolonged Exposure
Therapy (PE) – Imaginal exposure:...
Therapeutic Approaches &
Techniques
Cognitive Processing Therapy (CPT) - Modify the
relationships between thoughts and fee...
Therapeutic Approaches &
Techniques
Eye Movement Desensitization and Reprocessing (EMDR)
• Information processing therapy ...
Therapeutic Approaches &
Techniques
Medications: SSRI’s

• http://www.ptsd.va.gov/professional/pages/clinicians-guide-tome...
Take Home Points
Essential Features of PTSD
• Re-experiencing symptoms (nightmares, intrusive
thoughts) Avoidance of Traum...
“Courage is learning to ask for help”

56
Thank you!
Mark S. Kane, Ph.D. Licensed Psychologist
Fellow of the Michigan Psychological Association
Riverview Psychologi...
Elena Bridges & Debra Unseld
Co-Chairs of Quality of Life
Subcommittee
Elena.bridges@altarum.org
debra.l.unseld.ctr@us.arm...
Judge David Jordon, Retired, Ingham County VTC
Jon Caterino, 1st Mentor Coordinator Ingham County VTC
Worthiness of Veterans
“Those who sacrifice in military service
rightly enjoy profound honor. They
sacrifice their lives a...
MSU ALUMNI CHAPEL
JOHNNY‟S HIGH SCHOOL
YEARBOOK
A LEADER IN HIGH
SCHOOL
Reflections on Another Soldier Killed


Rick Atkinson wrote of another soldier killed
in the Normandy invasion:
- Corpora...
Losses Beyond the Veterans


Patricia O‟Malley visited the grave of her
father. She … was a year old when her
father, Maj...
Why a Veterans’ Treatment
Court?


“My goal is a flourishing, good human
life for veterans, their families, and
their com...
 Mission

- To support the veteran through
readjusting to civilian life, to assist the
veteran in navigating the Court
sy...
Assessing the Need


A survey that evaluates the number of
justice-involved veterans in your
jurisdiction should be done....
 Identify

eligible veteran-defendants

- through evidence based screening and
assessments.
 Divert

those defendants

-...
COMMUNITY RESOURCES
• The scope of the undertaking and
your community will dictate the
people and groups to engage.


A bond occurs between veterans regarding
shared values and sacrifices made



When veterans have difficulties and need...
 Judge
 Prosecuting

Official(s), Defense

Counsel
 Probation
 VA representative(s)
- Health/treatment
- Benefits (pen...
Plea
Typically veterans enter by a plea
bargain.
 This is between the parties.
 People could enter post-sentencing
from ...
 Review by treatment team
 Sentencing
 Typical term is eighteen months

- Conditions
- Pledge for Veteran Defendant

In...
 Ideally

a veteran of

- same service and conflict
- same gender (Buffalo, NY Experience)
- approximately same age
 Ass...
 Role

of mentor

- Generally
 Coach, Facilitator, Advisor, Sponsor, Motivator

- In court
 Discuss at review how veter...
FEATURES OF PROBATIONARY
TERM
Again, the planning process of each
community will dictate the details of
probationary overs...
“…Well, I gotta say, you know and it’s
hard to say it, but maybe drunk driving
was probably one of the best things that’s
...
…It’s actually given me back—I care to live
now. Before I couldn’t have cared less. I
mean I wasn’t suicidal or anything o...
“I wanted to take the time to let you know
how happy and thankful my family and I
are with the amount you have helped
[def...
1.

HELP VETERANS NAVIGATE THE
COURT,VA AND TREATMENT
SYSTEMS

2.

ASSESS “OTHER” NEEDS AND
HELP HIM OR HER ADJUST TO
CIVI...
“It is my hope that this program will
serve our veterans as well as they
have served us.”

Chief Justice Marilyn J. Kelley...
Material used by generous permission of Mr. Trudeau

Note the “thousand yard stare” of Ray
and B.D.
THE CHALLENGE


If we can help, we should help.
Judge David Jordon, Retired, Ingham County VTC
Jon Caterino, 1st Mentor Coordinator, Ingham County VTC
To register please go to
http://www.healingthewoundedwarriormi.com/
West Michigan Veterans Coalition Feb 2014 Quarterly Meeting
West Michigan Veterans Coalition Feb 2014 Quarterly Meeting
West Michigan Veterans Coalition Feb 2014 Quarterly Meeting
West Michigan Veterans Coalition Feb 2014 Quarterly Meeting
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West Michigan Veterans Coalition Feb 2014 Quarterly Meeting

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The West Michigan Veterans Coalition met on Feb 4, 2014 and presented to a group of veterans, veterans service providers, local and state agencies, and veteran service organizations.
Topic in the presentation:
- VA Work Study Program
- Veteran Employment Barriers, Resources, and Next Steps
- Veteran Barriers and PTSD
- Veteran Treatment Courts

Published in: Education, Career, Business
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West Michigan Veterans Coalition Feb 2014 Quarterly Meeting

  1. 1. Tuesday, February 4, 2014 Education Employment Healthcare Quality of Life MISSION: The West Michigan Veterans Coalition is a collaboration between local military friendly organizations that provide support, information, and resources to veterans and their families, employers, and other organization throughout West Michigan. We meet quarterly to highlight military friendly organizations and businesses, network with one another, and to help promote and enhance services to our heroes.
  2. 2. I. Welcome II. Pledge of Allegiance III. Spotlight Session: • Education Subcommittee - VA Work Study Program - Jonathan Highman, Representative, Military & Veteran Services, Davenport University • Employment Subcommittee - Employment Barriers, Resources, and Next Steps - Brandi McBride, Goodwill Industries Workforce Development Manager • Healthcare Subcommittee - Brief History, Condition, and Therapies of PTSD - Mark Kane, Ph.D. • Quality of Life - Veteran Treatment Courts - Judge David Jordon, Retired, Ingham Veterans Treatment Court - Jon Caterino, 1st Mentor Coordinator Ingham Veterans Treatment Court IV. NOON – Lunch provided by Aquinas College V. 1:00PM- End
  3. 3. Jonathan Highman, Chairman of Education Subcommittee jhighman@davenport.edu
  4. 4. Work-study Department VA Regional Office St. Louis, Missouri Telephone: (314) 552-9861 Fax: (314) 552-9533
  5. 5.  Allows veterans to earn additional pay by working on behalf of the VA while at least a ¾ time student.  Limited to working only with veterans’ programs.  Funded by the VA.  Not used to replace existing staff.  The veteran will be paid the state’s minimum wage ($7.40/hr. for Michigan).
  6. 6.  Veterans can work no more than 25 hours for every week in their current semester.  Once the veteran reaches 50 hours, the supervisor will submit VA Form 22-8690 (time record).  Payment is direct deposited to the same account as the veterans other VA benefits.
  7. 7.  Read and understand the Work-study Supervisor’s Handbook.  Provide direct supervision to VA work-study students.  Ensure the student is trained to do the work as stated in the Position/Job Description.  Ensure the work-study does not begin before their assigned start date.  Ensure the work-study does not work more than 8 hours per day.  Initial the Time Record as new entries are recorded.
  8. 8.  You are required to maintain the work-study file for 3 years. You are also required to maintain a current class schedule in the work-study file to ensure verification of availability.  Confirm cumulative totals for hours worked.  Email the Time Record to the work-study department: WKSRTN.VBASTL@VA.GOV in 50hour increments.  Report any changes in the workstudy’s address to the work study department ASAP.  Make all work-study inquiries on behalf of the veteran.
  9. 9.  Determined by the VA  Must be enrolled in classes at least ¾ time  Must be receiving one of these VA funds:      Chapter 30 (Montgomery GI Bill) Chapter 31 (Vocational Rehabilitation) Chapter 32 (VEAP) Chapter 33 (Post-9/11 GI Bill) Chapter 35 (Survivors and Dependents Assistance)  Chapter 1606 or 1607 (Reserve Education Assistance)
  10. 10.  Locate a work site and determine if an opening exists.  The Work-site Supervisor must agree to hire the student.  Supervisor has the student complete VA Form 22-8691 and Position/Job Description form.  If a student does not know of a work site, they may call the V.A. Regional office at: (888) 442-4551 and ask to be transferred to work-study desk where they will help to locate a site within a close proximity.
  11. 11.  Telephone: (314) 552-9861 (10am-2pm central)  Fax: (314) 552-9533 (24 hours)  WS.VBASTL@VA.GOV (Inquiries)  WKSRTN.VBASTL@VA.GOV (Timesheets, applications, contracts)  General VA Education Questions: (888) 442-4551 or http://gibill.va.gov  Veterans Services: (800) 827-1000 or http://www.va.gov
  12. 12. VA Work Study Supervisor’s Handbook Application for Work-study allowance (VA Form 22-8691)
  13. 13. Brandi McBride & Michael Poyma, Co-Chairs of Employment Subcommittee bmcbride@goodwillgr.org michael.poyma@va.gov
  14. 14. Employment Focus
  15. 15. PARTNERS • • • • • • • • • U.S. Dept. of VA Goodwill Industries TALENT 2025 H2H ESGR WGVU DoL VetBiz Central MRS • • • • • • • • • • VOA Michigan Works MVAA State of MI Army One Source GR Chamber Hello West Michigan Axios Staffing Herman Miller Meijer
  16. 16. KEY INSIGHT Two unique veteran populations facing different challenges
  17. 17. Veterans with Significant Barriers Homeless Disabilities Substance Abuse/ Mental Illness HCHV In-between Felonies Goodwill VA 211 (Coming) VOA Job-Ready Veterans Student Veterans Student Vets of America VOA MRS Community Rebuilders Transitional Housing Shelters * Disability Advocates Network 180 Disability Advocates Veteran’s Court Veteran Services Officers Career Counselors Ind. Living Centers Felonyfriendly employers Job Seekers MI Talent H2H Job Fairs Consortium of Military and Veteran Educators We need to educate employers about these populations
  18. 18. WHAT IS THE SYSTEM… for veterans to work through service providers to get to employers to eventually find employment?
  19. 19. • Suits for Soldiers • VOA • Army One Source • Buddy 2 Buddy • Career Counselors • VA • Disability Advocates • VetBiz Central THE SYSTEM The Service Provider • Michigan Works • Veteran’s Services • Goodwill Industries Division • MVAA Portal • H2H • TALENT 2025 • SHRM • MI Talent The Employer Resource The Veteran • Disabled • Retired • Active Duty • Separated What• isPrisoners the system? • Homeless The JOB • Entry Level • General Labor • Management • Hello West Michigan • Prisoner Re-entry Programs • Higher Education • Part-Time / Full-Time • Job Fairs • MVAA Portal • Guard/Reserves • WGVU • Executive Level • Chamber • Entrepreneurial
  20. 20. CURRENT PRACTICES TAP | Job Fairs | Job Boards | MI Talent Hola, estoy buscando un trabajo. ¿Tiene alguna posición abierta? The Veteran Ich habe eine offene Position, sind Sie interessiert an der Arbeit? The Employer Interaction between both but neither one understands the other
  21. 21. HOW DO WE CHANGE IT???
  22. 22. GOAL #1 Networking/educational workshops for employers
  23. 23. SERVICE PROVIDERS ESGR TALENT 2025 MVAA TRAINING WORKSHOPS * Employers will be able to … Understand populations | Translate skills Communicate at Job Fairs | Post Jobs on H2H
  24. 24. GOAL #2 Small networking events to connect smaller employers to veterans
  25. 25. SERVICE PROVIDER VETERAN EMPLOYER SERVICE PROVIDER VETERAN EMPLOYER KENT APRIL OTTAWA AUGUST MONTCALM JUNE Sponsored by GR Chamber and Hello West Michigan * NEWAYGO OCTOBER KENT DECEMBER
  26. 26. THE WAY FORWARD Employment programming in a collaborative environment
  27. 27. DELIVERABLES - 2014 • Streamline process of preparing vets for employment • Increase # of Veteran-Friendly Employers • Educate employers on resources to support veteran hiring/retention • Link the resources of WMVC to employers through TALENT 2025 • Align regional and statewide efforts
  28. 28. Employment Focus QUESTIONS?
  29. 29. Carrie Roy & Elena Bridges, Co-Chairs of Healthcare Subcommittee Elena.bridges@altarum.org carrie.roy@kentcountymi.gov
  30. 30. Health Care Subcommittee Barriers • Lack of Education/Information/Family Support • Cumbersome System • Transportation • Mental Health- Stigmas, specifically PTSD
  31. 31. PTSD 101 A short history, symptoms, and treatments. Mark S. Kane, Ph.D. Licensed Psychologist Fellow of the Michigan Psychological Association Riverview Psychological Services, P.C. drmskane@gmail.com 616-464-0811 32
  32. 32. National Center for Post Traumatic Stress Disorder Statistics 7.8 % of Americans experience PTSD (Keane et al., 2006) Women=2X risk • MVA-related PTSD 25-33% or higher-comorbidity 48% major depression (NIH, 2008) • 30% of combat veterans experience PTSD (Duke and Vasterling, 2005) - Approximately 50% of Vietnam veterans experience symptoms - Approximately 8% of Gulf War veterans have demonstrated symptoms • www.ncptsd.va.gov 33
  33. 33. “Best Practice Treatment” of Shell Shock after WWI 34
  34. 34. * DISCLAIMER Information during this presentation is for educational purposes only—it is not a substitute for informed medical advice or training. You should not use this information to diagnose or treat a mental health problem without consulting a qualified professional/ provider. 35
  35. 35. A Short History of PTSD From Homer to “Irritable Heart” Civil War • In the “Odyssey” in the 8th Century B.C. Homer described Odysseus as a veteran of the Trojan Wars who was afflicted with flashbacks and survivor’s guilt. In 490 B.C. Herodotus documented an incident where a soldier became blind due to witnessing the death of his comrade. 36
  36. 36. In 1597, William Shakespeare's Henry IV had Lady Percy describe her husbands PTSD symptoms • LADY PERCY: O my good lord, why are you thus • Of palisadoes, frontiers, parapets, alone? • Of basilisks, of cannon, culverin, • For what offense have I this fortnight been • Of prisoners' ransom, and of soldiers slain, • A banished woman from my Harry's bed? • And all the currents of a heady fight. • Tell me, sweet lord, what is't that takes from thee • Thy spirit within thee hath been so at war, • Thy stomach, pleasure, and thy golden sleep? • And thus hath so bestirred thee in thy sleep, • Why dost thou bend thine eyes upon the earth, • That beads of sweat have stood upon thy brow • And start so often when thou sit'st alone? • Like bubbles in a late-disturbèd stream, • Why hast thou lost the fresh blood in thy cheeks • And in thy face strange motions have appeared, • And given my treasures and my rights of thee • Such as we see when men restrain their breath • To thick-eyed musing and cursed melancholy? • On some great sudden hest. O, what portents are • In thy faint slumbers I by thee have watched, • And heard thee murmur tales of iron wars, • Some heavy business hath my lord in hand, • Speak terms of manage to thy bounding steed, • And I must know it, else he loves me not • Cry 'Courage! to the field!' And thou hast talked • Of sallies and retires, of trenches, tents, these? 37
  37. 37. History of PTSD: “Shell Shock” World War I 38
  38. 38. PTSD first used in 1980 in DSM-III Current Definition of PTSD used in DSM V • A Trauma related disorder in which exposure to a traumatic or stressful event resulting from exposure to an experience involving direct or indirect threat of serious harm or death; may be experienced alone (rape/assault) or in company of others (military combat). 39
  39. 39. PTSD Stressors • Violent human assault • Natural catastrophes • Accidents • Deliberate “man”-made disasters 40 U.S. Department of Defense Images: http://www.defense.gov/DODCMSShare/NewsStoryPhoto/200109/hrs_200109205g_hr.jpg
  40. 40. Combat Fatigue Immediate psychological and functional impairment that occurs in war or during other severe stressors during combat Caused by stress hormones - Features of the stress reaction include: • +Restlessness • +psychomotor deficiencies • +withdrawal • +Stuttering • +Confusion • +Nausea • +Vomiting • +Severe suspiciousness and distrust APA, 1994 41
  41. 41. Symptoms of PTSD • Recurrent, involuntary, and intrusive thoughts of event • Traumatic nightmares, flash backs (visual, sound, smell, taste, pressure etc…/bad dreams) • Emotional numbness (“it don’t matter”); reduced interest on a continuum from brief episodes to complete loss of consciousness • Intense guilty or worry/anxiety including survivor guilt • Angry Outbursts and irritability • Feeling “on edge,” hyper-arousal/hyper-alertness • Avoidance of thoughts/situations that remind person of the trauma 42
  42. 42. DSM – V Criteria • A: stressor • B: intrusion symptoms • C. voidance • D. negative alterations in cognitions and mood • E. alterations in arousal and reactivity • F. duration B,C,D,E, for 30 days • G. functional significance/work, social • H. Exclusion/not meds, illness, substance abuse • Diagnosis 6 months or more post trauma 43
  43. 43. Duration of PTSD Full diagnosis is not met until at least six months after the trauma(s). Although onset may occur immediately. Specify if :With dissociative symptoms. In addition to meeting criteria for diagnosis: 1. Depersonalization: Detached from oneself/outside observer 2. Derealization: experience of unreality, distance, or distortion (e.g. “Things are not real”) • Often, the disorder is more Severe and lasts longer when the stress is of human design(i.e., war-related trauma) 44
  44. 44. Comorbid/Coexisting Problems • *Depression, Anxiety and Pain • *Substance abuse/dependence • *Other addictions, i.e., gambling, sex, work • *Spectrum of severe mental illnesses • *Aggressive behavior problems • *Sleep problems like nightmares, insomnia, irregular sleep schedules, Sleep Apnea, Restless Leg Syndrome • *Acquired Brain Injury/Traumatic Brain Injury (TBI) • *Conversion/Somatization Disorders • *Hormone/ Hypothalamic,pitutary,adrenal (HPA) axis It can be difficult for healthcare providers to prioritize target treatment areas given the range of symptoms and difficulties seen. 45
  45. 45. TBI Comorbidity TBI is trauma to the brain triggered by externally acting forces (i.e., direct penetration, sustained forces, etc.) • A significant portion of falls, car accidents, physical abuse, gun shot wounds and soldiers from OEF/OIF have sustained a brain injury. • Blast injuries are the leading cause of injury in the current conflict. 46
  46. 46. Blast Injuries Blast injuries are injuries that result from the complex pressure wave generated by an explosion • Ears, lungs, and GI tract, brain and spine are especially susceptible to primary blast injury. • Those closest to the explosion suffer from the greatest risk of injury • Additional means of impact: • Being thrown, debris, burns, vehicle accidents. 47
  47. 47. Why Blast Injures are of Interest Now? Armed forces are sustaining attacks by rocket-propelled grenades, improvised explosive devices, and land mines almost daily in combat. • Injured soldiers require specialized care acutely and over time. Not all combat vets are treated by the VA. Many of them are in the Reserve, National Guard, have TRICARE or private insurances. They can and do show up in the ER’s and civilian employer jobs. 48
  48. 48. PTSD and TBI symptoms Overlap: Emotional Liability• Difficulty with attention and concentration • Amnesia for the event • Irritability and anger • Difficulty with over-stimulation • Social isolation/difficulty in social situations 49
  49. 49. Identifying PTSD Consultants and Trauma Specialists • Expert therapists Psychiatrists (MD/DO) • Clinical Psychologists (Ph.D./Psy.D.) Social worker (LCSW/MSW) Psychiatric Nurse • VA Medical Centers/VA PTSD programs/VA Vets Centers/Community Bases Outpatient Clinics (CBOCs) • Hospital/Medical Clinic Affiliations 50
  50. 50. Therapeutic Approaches & Techniques Prolonged Exposure Therapy (PE) – Prolonged Exposure Therapy (PE) – Imaginal exposure: Repeated and prolonged recounting of the traumatic experience • In vivo exposure: Systematic confrontation of trauma-related situations that are feared and avoided, despite being safe • Goal: Increase emotional processing of the traumatic event, so that memories or situations no longer result in: • Anxious arousal to trauma • Escape and avoidance behaviors 51
  51. 51. Therapeutic Approaches & Techniques Cognitive Processing Therapy (CPT) - Modify the relationships between thoughts and feelings • Identify and challenge inaccurate or extreme automatic negative thoughts • Develop alternative, more logical or helpful thoughts • Goals: • Help the individual recognize and adjust traumarelated thoughts and beliefs • Help the individual modify his/her appraisals of self and the world 52
  52. 52. Therapeutic Approaches & Techniques Eye Movement Desensitization and Reprocessing (EMDR) • Information processing therapy and uses an eight phase approach to address the experiential contributors for a wide range of pathologies with a strong body of research to support its effectiveness with PTSD. It attends to the past experiences that have set the groundwork for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and mental health. 53
  53. 53. Therapeutic Approaches & Techniques Medications: SSRI’s • http://www.ptsd.va.gov/professional/pages/clinicians-guide-tomedications-for-ptsd.asp • http://www.ptsd.va.gov/public/PTSD-overview/basics/index.asp • Connecting and Networking • PTSD/ Stress Disorder Treatment Units inpatient within the VA; Battle Creek VA, Saginaw VA, Ann Arbor VA and their related CBOCs, ie Grand Rapids VA Outpatient, Private Hospitals with insurance. • Captain Lovell Federal Health Care Center. An integration of the VA and DOD systems Approach for the 21st Century. CARF and JCAHO accredited. All Medical and PTSD. 54
  54. 54. Take Home Points Essential Features of PTSD • Re-experiencing symptoms (nightmares, intrusive thoughts) Avoidance of Trauma cues • Numbing/detachment from others • Hyperarousal (i.e. increased startle, hypervigilance) *A variety of factors including personal, cultural, and social characteristics, coping abilities, experiences in war, and the post- deployment/civilian environment all contribute to the level, severity and duration of stress reactions. 55
  55. 55. “Courage is learning to ask for help” 56
  56. 56. Thank you! Mark S. Kane, Ph.D. Licensed Psychologist Fellow of the Michigan Psychological Association Riverview Psychological Services, P.C. drmskane@gmail.com 616-464-0811 57
  57. 57. Elena Bridges & Debra Unseld Co-Chairs of Quality of Life Subcommittee Elena.bridges@altarum.org debra.l.unseld.ctr@us.army.mil
  58. 58. Judge David Jordon, Retired, Ingham County VTC Jon Caterino, 1st Mentor Coordinator Ingham County VTC
  59. 59. Worthiness of Veterans “Those who sacrifice in military service rightly enjoy profound honor. They sacrifice their lives and parts, sometimes their sanity, and according to my analysis, they sacrifice their freedom when plunged into war. In a peace-ensuring system, of trustworthy collective security, those who offer to do the soldier‟s work, to risk all that, and sacrifice all that for peace, truly deserve our honor.” Dr. Jonathan Shay, Odysseus in America, Combat trauma and the Trials of
  60. 60. MSU ALUMNI CHAPEL
  61. 61. JOHNNY‟S HIGH SCHOOL YEARBOOK
  62. 62. A LEADER IN HIGH SCHOOL
  63. 63. Reflections on Another Soldier Killed  Rick Atkinson wrote of another soldier killed in the Normandy invasion: - Corporal William Preston wrote of one dead soldier in particular who caught his eye: “I wonder about him … [w]hat were his plans never to be fulfilled, what fate brought him to that spot at that moment? Who was waiting for him at home?” Rick Atkinson, The Guns at Last Light (Holt, 2013), p 87.
  64. 64. Losses Beyond the Veterans  Patricia O‟Malley visited the grave of her father. She … was a year old when her father, Major Richard James O‟Malley, a battalion commander in the 12th infantry, was killed by a sniper in Normandy ….[She] wrote of seeing his headstone for the first time in the cemetery at Colleville, above Omaha Beach. - „I cried for the joy of being there and the sadness of my father‟s death. I cried for all the times I needed a father and never had one. I cried for all the words I had wanted to say and wanted to hear but had not. I cried and cried.‟” Ibid. p 638.
  65. 65. Why a Veterans’ Treatment Court?  “My goal is a flourishing, good human life for veterans, their families, and their communities.” -Dr. Jonathan Shay, Odysseus in America, Combat Trauma and the Trials of Homecoming (Scribner, 2002), p. 59.
  66. 66.  Mission - To support the veteran through readjusting to civilian life, to assist the veteran in navigating the Court system, the treatment system, and the VA system. More importantly, to act as a friend and ally through this difficult period.  Vision - That “no veteran is left behind.”
  67. 67. Assessing the Need  A survey that evaluates the number of justice-involved veterans in your jurisdiction should be done. Nothing fancy is necessary. We had all the probation officers in our three district courts ask.  You could start capturing the data at intake, the jail population, or otherwise.
  68. 68.  Identify eligible veteran-defendants - through evidence based screening and assessments.  Divert those defendants - with substance dependency and/or mental illness - charged with typically felony or misdemeanor criminal offenses - to a specialized criminal court docket
  69. 69. COMMUNITY RESOURCES • The scope of the undertaking and your community will dictate the people and groups to engage.
  70. 70.  A bond occurs between veterans regarding shared values and sacrifices made  When veterans have difficulties and need support it is the responsibility of the veteran community to advocate for and support those veterans coming in contact with Criminal Justice
  71. 71.  Judge  Prosecuting Official(s), Defense Counsel  Probation  VA representative(s) - Health/treatment - Benefits (pension, grants, etc) - County Veterans‟ Counselors   Other treatment providers Court Staff
  72. 72. Plea Typically veterans enter by a plea bargain.  This is between the parties.  People could enter post-sentencing from a probation not going well.  The goal is to be creative and inclusive. 
  73. 73.  Review by treatment team  Sentencing  Typical term is eighteen months - Conditions - Pledge for Veteran Defendant Ingham County Veterans Treatment Court Participant Pledge:      I recognize that my sobriety and mental health must be my first priority, every day. I will be honest with myself and others. I will be accountable for my actions. I will respect the Ingham County Veterans‟ Treatment Court I will succeed.
  74. 74.  Ideally a veteran of - same service and conflict - same gender (Buffalo, NY Experience) - approximately same age  Assign at first court appearance if possible
  75. 75.  Role of mentor - Generally  Coach, Facilitator, Advisor, Sponsor, Motivator - In court  Discuss at review how veteran is doing - Outside court  Meet regularly with veteran  Be available when veteran needs assistance  Help veteran through benefit and court systems  Convey new programs/opportunities to veteran
  76. 76. FEATURES OF PROBATIONARY TERM Again, the planning process of each community will dictate the details of probationary oversight. Frequent substance testing is important. Judicial reviews should be regular and carefully done. Research has shown at least three minutes of time spent with treatment court defendants materially reduces recidivism. (Thus a mandate for judges to talk longer.) But defendants having positive interactions in Court with the Judge is a big deal.
  77. 77. “…Well, I gotta say, you know and it’s hard to say it, but maybe drunk driving was probably one of the best things that’s happened to me in a long time. Me, going through this program and some of the people I’ve come in contact with, through this program, and just the change of my whole heart. You know, I’m back in church. Going to meetings, different things, you know, that I wouldn’t have done otherwise.…
  78. 78. …It’s actually given me back—I care to live now. Before I couldn’t have cared less. I mean I wasn’t suicidal or anything of that nature. I didn’t care from day to next what happened. And now I look forward to today and I look forward to tomorrow. The Court: Great. And if you’d asked me that seven months ago, I’d say, whatever. I’ve come a long ways in a short period of time and, you know, I’ve got to give credit to God for that. And I just look forward to keep moving in that direction.”
  79. 79. “I wanted to take the time to let you know how happy and thankful my family and I are with the amount you have helped [defendant] and our family! He’s been sober for seven months now and truly is a changed man! He’s so happy and fun to be around! His true personality shines through once again, and we can’t thank you enough for your help and support!” - VTC Participant Family Member
  80. 80. 1. HELP VETERANS NAVIGATE THE COURT,VA AND TREATMENT SYSTEMS 2. ASSESS “OTHER” NEEDS AND HELP HIM OR HER ADJUST TO CIVILIAN LIFE 3. HELP VETERANS RECEIVE THE SERVICES THEY NEED TO BE PRODUCTIVE MEMBERS OF SOCIETY
  81. 81. “It is my hope that this program will serve our veterans as well as they have served us.” Chief Justice Marilyn J. Kelley addressing the Ingham County Veterans‟ Treatment Court on May 3, 2010.
  82. 82. Material used by generous permission of Mr. Trudeau Note the “thousand yard stare” of Ray and B.D.
  83. 83. THE CHALLENGE  If we can help, we should help.
  84. 84. Judge David Jordon, Retired, Ingham County VTC Jon Caterino, 1st Mentor Coordinator, Ingham County VTC
  85. 85. To register please go to http://www.healingthewoundedwarriormi.com/

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