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EDUCATION: Masters Degree Counseling (MS), Licensed Mental Health Counselor (LMHC), and Nationally Certified Counselor (NCC). Multiple trainings ; trauma,

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Presentation on theme: "EDUCATION: Masters Degree Counseling (MS), Licensed Mental Health Counselor (LMHC), and Nationally Certified Counselor (NCC). Multiple trainings ; trauma,"— Presentation transcript:

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2 EDUCATION: Masters Degree Counseling (MS), Licensed Mental Health Counselor (LMHC), and Nationally Certified Counselor (NCC). Multiple trainings ; trauma, PTSD, TBI, substance abuse, death and dying, suicide prevention, anger management and crisis counseling. EMPLOYMENT SUMMARY:  GOVERNMENT CONTRACTOR: Currently, (5+) years as an Advocate for our Severely Wounded Soldiers returning home from Iraq (OIF) and Afghanistan (OEF).  ADJUNCT PROFESSOR: SUNY Oswego University. Developed and currently teaching a Master and Post Master level course designed for students who wish to specialize in or expand upon existing clinical skills when working with various populations affected with PTSD, Post Combat, and TBI. The course has a strong military and post combat outline. The course is designed to provide the student with skills leading to assessment, diagnosis, and treatment for populations diagnosed with PTSD and TBI. Upon completion of this course, students will be familiar with various types of brain injuries, anatomy of the brain, neuropathology, assessment tools, research, scales, and theory.

3  PSYCHOTHERAPIST: Specializing in grief, loss, and trauma  CLINICAL DISCHARGE PLANNER: Over (5 ½) years experience as Clinical Discharge Planner for a 287 bed hospital facility in upstate New York that services the Ft Drum Army Base which is the home of the 10 th Mountain Division and over 19,500 Soldiers as well as the local community. Responsible for Physical Medicine & Rehabilitation (PMR), ICU, PCU, CCU, and Emergency Mental Health. COMMITTEES and VOLUNTEERISM:  NYS Chair, Wounded Warrior Adaptive Sports Committee (WWASC): 2011 to Present; Connecting, organizing, and promoting adaptive sports for Wounded Veterans and their families  Veterans Employment Summit Committee (VISN II): 2012 to Present  Volunteer Mentor, Team Red White & Blue: 2011 to Present  Active Member NYSID Veterans Employment Committee: 2010 to Present  Battle Buddy Center: 2010 to Present

4 Founded in 1861 as the Oswego Primary Teachers' Training School by Edward Austin Sheldon (above, center), who embraced and popularized some of the most innovative teaching methods of his day.

5 The campus today consists of 46 buildings with classroom, laboratory, residential and athletic facilities. Recent years have witnessed the launch of a $700 million campus-wide renovation and renewal program, highlighted by the October 2006 opening of the Campus Center – the college's first new building in 35 years. Oswego is one of 13 university colleges in the SUNY system. More than 8,200 students enroll, and there are more than 73,000 living alumni with known addresses. Oswego offers more than 100 undergraduate majors and minors and graduate programs.undergraduate majors and minors and graduate programs The Counseling and Psychological Services (CPS) Department, led by an outstanding faculty, offers three graduate programs that lead to Master of Science Degrees in Counseling Services, Human Services/Counseling, or School Psychology. Students in the Counseling Services program may choose the School Counseling track or the Student Affairs track. Additionally, a Certificate of Advanced Study (CAS) is offered in the Counseling Services and School Psychology program and a CASAC certification is offered in the Human Services/Counseling course of study.

6  Challenges of Recruitment  PTSD & TBI  Physical and psychological benefits of athletics/exercise; sport specific  Creative resolutions of successful recruitment and commitment  Team Red White & Blue  DVBIC (Defense and Veterans Brain Injury Center)  Sports and recreation statistics  Closing thoughts(?)

7  Mental Health/Depression  Embarrassment  Fear  Concerned activity may lower rating= less pay  Transportation issues  Medication issues  Fatigue/weakness  Poor Sleep  Injury specific  Social Phobias  Pre-existing conditions; medical, behavioral, personality, mental health  Pain Issues  Mobility / prosthetic issues  Memory issues  Migraines  Light sensitivity  Dizziness  Shakes  Substance Abuse  PTSD, TBI, Injury/wound/illness  Non compliance with treatment recommendations  OTHER…….

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9 1. R e-experiencing symptoms (nightmares, intrusive thoughts) 2. Avoidance of trauma cues and Numbing/detachment from others 3. Hyperarousal (increased startle, hypervigilance) APA, 2000

10 Definition of PTSD An anxiety disorder resulting from exposure to an experience involving direct or indirect threat of serious harm or death; may be experienced alone(rape/assau lt) or in company of others (military combat)

11 Recurrent thoughts of the event Flashbacks/bad dreams Emotional numbness (“it don’t matter”); reduced interest or involvement in work our outside activities Intense guilt or worry/anxiety Angry outbursts and irritability Feeling “on edge,” hyperarousal/ hyper-alertness Avoidance of thoughts/situations that remind person of the trauma Depression APA, 1994

12  Social and interpersonal issues  Relationship issues  Low self-esteem  Alcohol and substance abuse  Employment problems  Legal issues  Isolation  Worsening mental health issues  Health issues  Loss interest in fun things

13 Stein & McAllister 2009

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15 TRAUMATIC BRAIN INJURY (TBI) Traumatic brain injury (TBI): a blow or jolt to the heard that disrupts the normal function of the brain. The severity of the (TBI) is determined at the time of the injury and may be classified as: mild, moderate, or severe. Concussion: Another word for a mild (TBI) or (mTBI). Is the most common form of (TBI) in the military. Symptoms of concussion often resolve within days or weeks.

16 1. PHYSICAL: Headaches, sleep disturbances, dizziness, balance problems, nausea/vomiting, fatigue, visual disturbances, light sensitivity, ringing in the ears. 2. COGNITIVE: Slowed thinking, poor concentration, memory problems, difficulty finding words. 3. EMOTIONAL: Anxiety, depression, irritability, mood swings

17  Traumatic brain injury (TBI): injury to the brain caused by an external trauma to the head or violent movement of the head, such as from a fall, car crash or being shaken. TBI may or may not be combined with loss of consciousness, an open wound or a skull fracture (Thurman et al., 1994).Thurman et al., 1994  Acquired brain injury (ABI): An injury to the brain that occurred after birth. An ABI may be caused by TBI, stroke, near suffocation, infections in the brain, etc. (Brain Injury Association of America, 1997).Brain Injury Association of America, 1997  Coup-contracoup: (Coo-contracoo) After a traumatic brain injury, contusion (i.e., bruising and bleeding) can occur anywhere in the brain. Most contusions are on the underside of the frontal and temporal lobes because of the irregular and rough texture of the bones underlying these parts of the brain. In addition, specific sites of bruising and bleeding can occur at the site of the blow to the head (“coup”) and the site directly opposite the blow (“contracoup”).  Depressed skull fracture: Bones of the skull are broken or cracked, loose bone fragments may actually place pressure on or penetrate the brain, thereby causing damage.

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19  LEFT SIDE OF THE BRAIN: Difficulties in understanding language (receptive language), Difficulties in producing language (expressive language), Catastrophic reactions (e.g., depression, anxiety),Verbal memory deficits, Decreased control over the right side of the body Impaired logic, Sequencing difficultiesSequencing  RIGHT SIDE OF THE BRAIN: Impairments in visual-spatial perception, Left-neglect, or inattention to the left side of space or the body, Decreased awareness of deficits, Altered creativity and music perception, Loss of the Gestalt, or "big picture“, Visual memory deficits, Decreased control over left-sided movements.  FRONTAL LOBE: Executive functions, Initiation, Organization, Self- monitoring, Cognitive functions, Problem solving, Judgment, Inhibition of behavior Planning/anticipation, Motor planning, Personality and emotions, Awareness of abilities and limitations, Attention/concentration, Mental flexibility, Speaking (expressive language)Executive functionsInitiationSelf- monitoring

20  PARIETAL LOBE: Sensory functions, Touch perception, Differentiation of size, shape, and color, Spatial perception, Visual perception,  OCCIPITAL LOBE: Sensory functions, Visual perception  TEMPORAL LOBE: Cognitive functions Memory Understanding language(receptive language)Executive functions Organization and sequencing, Sensory functions Hearing  CEREBELLUM: Motor functions Balance Coordination Skilled motor activity  BRAIN STEM: Regulatory functions Breathing Heart-rate Arousal/consciousness, Sleep/wake functions, Attention/concentration

21  Headache  Sleep Disturbances  Fatigue  Dizziness  Light sensitivity  Sound sensitivity Immediately post-injury 80% to 100% describe one or more symptoms Most individuals return to baseline functioning within a year Ferguson et al. 1999, Carroll et al. 2004; Levin et al. 1987

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23 In the acute and late periods following TBI, the domains of cognition most commonly affected by TBI include:  arousal/disturbances of consciousness  processing speed/reaction time  attention (selective, sustained, alternating, divided)  working memory  memory (new learning, retrieval, or [usually] both)  functional communication (use of language)  executive function (Reviewed in: Bigler 2007; Arciniegas and Silver 2006; Nuwer 2005; Meythaler et al. 2001)

24  Depression  Mania  Pathological Laughing and Crying  Anxiety  Irritability or loss of temper (“rage episodes”)  Disinhibition  Agitation/Aggression (“socially inappropriate behavior”)  Apathy (loss of drive to think, feel, and/or behave)  Psychosis

25 (Adapted from Silver and Arciniegas 2006) Traumatic Brain Injury Disturbed Consciousness Impaired Attention Slowed Processing Working Memory Problems Memory Disturbance Functional Communication Impairments Executive Dysfunction Depression Anxiety Irritability/Lability Rage Agitation Aggression Disinhibition Apathy Sleep Disturbance Headaches Pain Visual Problems Dizziness/Vertigo Seizures Cognitive Disturbance Behavioral Disturbance Emotional Disturbance Physical Disturbance Post-Injury Psychosocial Factors Pre-Injury Factors

26 Rotational force vector Translational force vector Figure adapted from Arciniegas and Beresford 2001 Center of mass

27 Stein & McAllister 2009 This shared anatomy also implicates aggression

28 Agitation Aggression Medical illness DepressionInsomniaAnxietyPsychosis Adverse Environment Substance Abuse Figure adapted from Silver 2005 Aggression as a Target for Suicidality

29 SUICIDE: Hundreds of troops have come home from war, left the military and committed suicide. That is the finding of preliminary Veterans Affairs Department research obtained by The Associated Press that provides the first quantitative look at the suicide toll on today's combat veterans. The ongoing research reveals that at least 283 combat veterans who left the military between the start of the war in Afghanistan on Oct. 7, 2001, and the end of 2005 took their own lives. The numbers, while not dramatically different from society as a whole, are reminiscent of the increased suicide risk among returning soldiers in the Vietnam era. Today's homefront suicide tally is running at least double the number of troop suicides in the war zones as thousands of men and women return with disabling injuries and mental health disorders that put them at higher risk. A total of 147 troops have killed themselves in Iraq and Afghanistan since the wars began, according to the Defense Manpower Data Center, which tracks casualties for the Pentagon. Add the number of returning veterans and the finding is that at least 430 of the 1.5 million troops who have fought in the two wars have killed themselves over the past six years. And that doesn't include those who committed suicide after their combat tour ended and while still in the military. That compares with at least 4,229 U.S. military deaths overall since the wars started — 3,842 in Iraq and 387 in and around Afghanistan.

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31 U.S. Army Wounded Warrior Soldier (AW2) Curtis Winston prepares to shoot his recurve bow during training at the Warrior Transition Command (WTC) archery clinic in Sumter, South Carolina on March SPC Justin Miller receives one-on-one training from MSG Howard Day, the Army’s Warrior Games shooting coach during the first Warrior Transition Command (WTC) shooting clinic held March in El Paso, Texas. Photo Credit: SSG Emily Anderson SSG Krisell Creager-Lumpkins, Warrior Transition Unit (WTU), Fort Carson and SPC Jasmine Perry from Warrior Transition Battalion (WTB), Fort Campbell along with more than 70 other wounded, ill, and injured Soldiers and Veterans participated in the largest adaptive and reconditioning clinic hosted by the WTC at Fort Meade’s Mullins Field on March 8. Photo credit: retired LTC Sue Bozgoz

32  Improved overall health  Build new friendships  Better quality of life  Weight management  Control blood pressure  Manage diabetes  Decrease depression  Improved balance and mobility  Gain Independence  Ease readjustment /reintegration issues  Improved problem solving skills/coping  Build confidence  Improve breathing  improved gross and fine motor skills  Decrease embarrassment  Reduce stress  Improved speech and language skills  Strengthen families and relationships  Enhance mental focus and facilitate memory  Extend lifespan

33 Air Rifle or air pistol shooting; focus and control of breathing for accuracy which has a calming effect Fishing: Calming effect and adaption's can easily be made for all “ability” levels Recumbent Trikes or handcycles: excellent option for those with balance issues because they are low to the ground. You can go at your own pace and lots of biking options. Indoor climbing wall: enhances mental focus, helps overcome dizziness and balance issues. For all “abilities.” Scuba diving and skiing: Easily adapted like shallow pool diving or sit skiing lowering risks and worry. Facilitate memory by utilizing cues, simple instruction, and repeating them, frequent rests, and focus on one instruction.

34 Cycling - Ride to Recovery (The American Legion) Ride to Recovery is a 501(c)3 organization that supports Spinning® Recovery Labs and outdoor cycling programs at military and VA medical facilities to help injured veterans overcome physical obstacles. Cycling is an important part of the recovery and rehabilitation program for two reasons: cycling is an activity in which almost all patients with mental and physical disabilities can participate, and participation in R2R helps speed up the recovery and rehabilitation process. Golf - Skills 4 Life (Military Warriors Support Foundation) Golf is one of the most popular sports and hobbies for our wounded vets. Some are learning how to swing differently, adapting and overcoming their injury while many others are attracted to the game and picking it up for the first time.

35 ROCK VENTURES: Rock Ventures LLC and Shared Adventures Inc, Rochester, NY 1460 KENT WINCHESTER e fax A professional, neutral facilitator, guides discussion on goals, expectations and reinforces challenge by choice philosophy. Floor problem solving & debriefing encourage participants to consider behaviors and goals (day to day, work, family, career) High ropes course, Rappelling, Leap of Faith and other learning modules may be included. Your place or ours. ALL ABILITIES PARTICIPATE!www.rockventures.net OASIS ADAPTIVE SPORTS INC: BOB HOOVER ~ Honeoye NY OASIS Adaptive Sports, Inc. a non-profit organization offering instruction, equipment and support to disabled military veterans in a variety of sports activities. We assist veterans in reconnecting and resuming productive lives in society through participation in outdoor recreational activities that promote independence, and social and emotional well-being.http://www.oasisadaptivesports.com/wordpress/

36 SPORT AND RECREATION : examples continued Sailing, cruising, diving - Veterans Ocean Adventures (South Florida) Our mission is to create an opportunity for veterans to experience the healing power of water. Create an opportunity for disabled veterans to experience open ocean sailing, cruising and diving. VOA provides an introduction to cruising in the Florida Keys and the Bahamas. Select participants may continue on to join a leg of an ongoing world circumnavigation.

37 GOLFING: FOREHOPE: or First of its kind to provide a therapeutic approach to golf resulting in cognitive, emotional, physical and social development. Golf is a viable means an individual can rejoin life to its fullest - activity, social opportunities and fun. SCUBA: Dive Pirates Dive Pirates Foundation 70 W Thymewood Pl The Woodlands, TX phone: 877-EYE-DIVE ( ) fax: Traditionally, pirate crews cared for injured crew members by making them peg legs, hooks, eye patches, etc. Disabled crew members were not banished from the ship, but were given new tasks they could perform and be useful to the rest of the crew. Dive Pirates continues that spirit by bringing the Adaptive SCUBA Divers in the Caribbean.

38 Hunting and Fishing - Fishing Has No Boundaries (FHNB) non-profit organization offering the great outdoors for people with disabilities through the world of fishing. FHNB is a National Organization with 23 chapters in 11 states, enabling thousands of individuals with disabilities to participate fully in this spirit lifting, morale booster, trouble free recreational activity. Hunting and Fishing - Project Healing Waters Fly Fishing Project Healing Waters Fly Fishing, Inc. is dedicated to the physical and emotional rehabilitation of disabled active military service personnel and veterans through fly fishing and fly tying education and outings. Hunting and Fishing - Wounded Warriors in Action Foundation; ; WWIAF aids in healing hearts and minds of combat wounded heroes (Purple Heart recipients) from OIF/OEF. Provides world-class outdoor sporting activities,. Healing veterans - mentally, physically and spiritually from their war experiences.

39 Ice hockey - USA Warriors Ice Hockey Program The USA Warriors Ice Hockey Program trains and supplies Injured Servicemen and women with Hockey equipment and the skills needed to use the sport of Ice Hockey as a rehabilitation tool to overcome both physical and mental injuries sustain either in combat or in defense to the United States of America. Adaptive Paddling: USCA's Adaptive Paddling; CAOO's mission is to provide the opportunity for individuals with disabilities to gain confidence and dignity through participation in paddle sports, recreation and related educational programs. Outrigger canoeing, canoeing and kayaking are excellent recreational, fitness and competitive paddle sports for individuals with physical and/or intellectual disabilities.

40 Art classes - American Healing Art Foundation: American Healing Arts Foundation (AHAF) non-profit organization promoting art classes at no cost to veterans. Our mission: give veterans new hope, offer them support, friendship and an art career opportunity. Art is proven to be therapeutic for the mind body and soul. Veterans will gain encouragement, hopefulness, inspiration and a sense of self-satisfaction. Baseball - Wounded Warrior Amputee Softball Teamwww.woundedwarrioramputeesoftballteam.org The WWAST is comprised competitive, athletic veterans and active duty soldiers who have lost limbs post-9/11. The team includes individuals with a variety of amputations of the arm, above knee, below knee, bilateral below knee, and foot.www.woundedwarrioramputeesoftballteam.org

41 Outdoor adventures - Camp Patriot Camp Patriot exists to take Disabled U.S. Veterans on outdoor adventures. Camp Patriot wants to renew the dreams and visions of our disabled veterans for a meaningful future. We will be bringing disabled American Veterans to the great state of Montana for outdoor adventures of their choosing. However, outdoor adventures are just some of the activities we provide disabled U.S. military veterans at Camp Patriot. We want to create relationships for them through outdoor adventures that will promote positive, life changing experiences.www.camppatriot.org Outdoor adventures - Challenge Aspen Military Opportunities (C.A.M.O.) C.A.M.O. provides recreational and cultural experiences for wounded warriors with cognitive or physical disabilities. We encourage family and friends to share in these experiences. Wounded warriors are able to realize their life potential, bridging the gap between injuries and moving forward with life's challenges despite adversity.

42  Should begin immediately after injury, illness, wounds  MTF’s  WTC/WTU  CBHCO’s  Department of Veteran Affairs; VBA, VHA, OIF OEF OND, Providers, and various other programs  SFAC’s, ACS, MWR  In-Patient rehabilitation; Physical Medicine & Rehabilitation (PMR), Acute, Sub-acute  Out-Patient rehabilitation; OT, PT, Speech, Aqua therapy, mental health, addiction, recreation therapy, and other specialists  Residential Programs  Home based programs  Specialized treatment facilities; Example: NeuroRestorative  Sport specific agencies/specialists  Civilians resources

43 SITRIN/STARS ADAPTIVE SPORTS

44 Provides our Wounded Veterans rehabilitation multi- disciplinary and team approach and recreational opportunities: curling, basketball, paddling, golf, road racing, biathlon, shooting, and more. Benefits of Adaptive Sports: substantial physical benefits. Participation promotes healing, and fosters positive, mutually supportive relationships between fellow athletes, building morale through shared experiences both on and off the playing field. The Sitrin STARS program helps improve: Endurance, Balance, Strength, Coordination, Range of Motion, Socialization, Self- esteem. / /MARK DePERNO STARS Director /www.sitrin.com/

45 SPORT & RECREATION STRIDE ADAPTIVE SPORTS:

46 Since 1985, STRIDE has been fulfilling dreams, removing boundaries, enhancing self-esteem, and empowering individuals with disabilities through participation in sport and recreational activities Since 2005, STRIDE Adaptive Sports has been providing opportunities for our nation’s heroes to become rehabilitated and learn how to live with a disability through our Wounded Warrior programs. Our affiliation with Warfighter Sports, and Disabled Sports USA, allow us to help our military service members and their families rebuild their lives through sports and recreation. Wounded and disabled servicemen and women fight even tougher battles here at home as they struggle to adjust to their new circumstances and post- war life. Giving these heroes a chance to accomplish new skills and realize their potential, regardless of their disabilities, is a small way our communities can thank them for all they’ve given to us. Our programs restore hope, independence and freedom while improving self-esteem, confidence and a sense of satisfaction.

47 Mary Ellen Whitney, CEO & Founder 476 North Greenbush Road #9 Rensselaer, NY (office) (mobile)

48 RECRUITMENT

49  Early Intervention; recreational therapists, OT, PT, rehabilitation, mental health  Providers: Behavioral Health and Medical  Mentors/Battle buddies  Partnering less active Soldiers with more active Soldiers and or Soldiers more advanced in the recovery process  Involve family and or community  Provide empowerment  Education  Collaboration among agencies and supportive services  Get to know your Soldier; likes and dislikes  Discuss fears and or concerns in detail  Discuss options and details surrounding each program/event  Ensure prosthetics are appropriate for the event  Be creative with opportunities and delivery of information  Understand injury, wounds, illness

50  Simultaneously address rehabilitation and medical needs  Neuropsychological evaluation to determine baseline cognitive status and to define realistic treatment goals and capabilities to avoid negative consequences  Medication; pain issues, psychological issues, other.  Medical clearances  Ensure injury appropriate  Early intervention: Theater, MTF, Acute/sub-acute rehab, SNF, CHHA’s, HAS, MSC, Personal Care Assistance, home and community based supportive services.  Therapeutic Intervention: EMDR, Stress inoculation training, CBT, Exposure Therapy, Psychotherapy/talk therapy, Psychodynamic, & combination  Think outside of the box

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52 Team Red, White & Blue (Team RWB) enriches the lives of wounded veterans and their families. Our community is comprised of a diverse group of people---wounded veterans, advocates, athletes and supporters. Team RWB uses a multifaceted approach, driven by our commitment to support the men and women who have sacrificed so much for our country. We focus on 4 key areas:

53 1. We impact wounded veterans through one-on-one relationships. We believe the most effective way to impact a veteran's life is through a meaningful relationship with someone in their community. Our advocate program pairs wounded veterans with citizens we call "Team RWB advocates."The relationship between the wounded veteran and the advocate is unique to the needs of the veteran. Typical interaction includes meeting for meals, assistance with attending medical appointments, attending local sporting events and other social activities. This interaction allows veterans to grow in their community, meet supportive people and find new passions in life.

54 2. We host community level events with wounded veterans and Team RWB advocates. We believe in the power of community. Team RWB hosts charity events, post-marathon gatherings, awareness dinners and other events that bring wounded veterans and "everyday Americans" together. These events build a sense of community and allow citizens an opportunity to connect with wounded veterans and others who want to help. These events often enlist the help of local veteran support groups. By empowering communities we aim to transform the way wounded veterans are reintegrated into the towns and neighborhoods after their combat service.

55 3. We use athletic events as a tool to inspire people to action, raise awareness for our mission and fundraise to support the Team RWB advocate program ; Team RWB athletes run anything between 5Ks and 100 mile races, compete in triathlons, climb mountains and belong to a Cross fit gyms. Our athletes use these and other physical activities as a way to raise awareness for wounded veterans, their service, injuries and needs. Athletes train in and wear Team RWB wicking shirts and serve as ambassadors for the charity. Their fundraising efforts are essential to the organization as they generate capital that is used to directly support wounded veterans and Team RWB programs.

56 4. We provide opportunities for everyday Americans to get involved to support wounded veterans by utilizing their unique skills Team RWB understands that there are countless individuals who want to express their gratitude to these men and women who have courageously served our country and these supporters want to assist with wounded veterans' reintegration. To this end, we provide opportunities for people to use their talents to support wounded veterans and Team RWB's mission. Whether you build furniture, paint art work, provide legal assistance, review professional resumes, offer sporting lessons, make clothing, bake goods or any other activity- Team RWB wants you to use these talents as a member of our organization. Mark Erwin

57 EXCUSES & CHALLENGES  NO Transportation or cant drive  Don’t have patience or energy to make event arrangements  Concerns about special accommodations  Financial concerns; costs of events and or transportation  Fear not knowing anyone or having someone to rely on if they have a problem; medical issue, anxiety, so forth  Fear of failure  Mental health or medical issues  Family issues ELIMINATION OF EXCUSES & CHALLENGES  Mentors will provide transportation as needed  TRWB Organize event details  TRWB pay for all event costs and provide reimbursement for transportation costs as appropriate  TRWB will partner you with a genuinely caring mentor / battle buddy.  Events are individualized, as a group, and or involve families  TRWB will not put you in a position of failure. Each event is individualized and full details discussed prior to ensure success.  TRWB require a release and medical history. They collaborate with case managers and provide follow up reports to them after the event.

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59 OUR MISSION: To serve active duty military, their beneficiaries, and veterans with traumatic brain injuries (TBIs) through state-of-the-art clinical care, innovative clinical research initiatives and educational programs. DVBIC fulfills this mission through ongoing collaboration with military, VA and civilian health partners, local communities, families and individuals with TBI.

60 CARE COORDINATION: Connect SMs with TBI sustained during OEF and OIF to healthcare and resources. Follow SMs for 2 yrs or until symptoms resolve Assist SMs during transition from DoD to VA and Civilian life EDUCATION: Provides educational materials on awareness, prevention, diagnosising, treatment and management of TBI Provides education and training for health care providers, Military leadership, SMs, veterans, families and civilian Communities PROTECTING SMs: Offers in –theater support to medical providers through training resources, tele-health consultations and technology. Collects and analyzes data that enhance TBI care and TX

61  CLINICAL CARE: Provides assistance at medical sites for TBI related evaluation, diagnosis, treatment and f/u care  RESEARCH: Conducts research to better understand assess, prevent and treat TBI  HEADQUARTERS: Silver Spring, MD  MILITARY and VA MEDICAL CENTERS: WRAMC, San Antonio, NMC San Diego, Camp Lejeune, Camp Pendleton, FT Belvoir, FT Bragg, FT Carson, FT Hood, Landstuhl Regional Medical Center, Richmond VA, Tampa, Minn., Palo Alto, Boston.  NEURO REHABILITATION and COMMUNITY REINTEGRATION: DVBIC Charlottesville, VA and DVBIC Johnstown PA  FREE MATERIALS: PTSD & TBI DVBIC: Defense and Veterans Brain Injury Center

62 or or FOR DVBIC INFORMATION & REFERRAL (24/7): Defense Centers of Excellence (DCoE) Outreach Call Center

63 CONCUSSION: Most common brain injury in sports (CDC and Prevention). Estimated 300,000 sports related concussions in the US each year.  BRAIN INJURIES: cause more deaths than any other sports injury. Example: brain injury accounts for 65 to 85% of all fatalities in football.

64 SOCCER: Approximately 5% of soccer players sustain a brain injury as a result of head-to-head contact, falls or being struck on the head by the ball. Repeatedly, heading or hitting the ball with your head is the riskiest activity and can cause a concussion. BOXING: Nearly 90% of professional boxers have sustained a brain injury.

65 SKIING: (CPSC) Estimates in 1997 there were 84,200 skiing injuries ~ 17,500 head injuries, treated in the US Eds. They estimated 7,700 of those head injuries including 2,600 were children and could have been prevented or reduced in severity with use of helmets. About 11 skiing and snowboarding related deaths would be prevented annually with helmets. (EX: Sonny Bono) FOOTBALL: Injuries to the brain occur at a rate of (1) in every (3.5) games. Responsible for more than 250,000 head injuries in the US. In any given season 10% of all college players and 20% of all high school players sustain brain injuries. Football players with brain injuries are (6) times more likely to sustain new injuries.

66 BASEBALL: The head is involved in more baseball injuries than any other body part. Almost half of the injuries involve a child’s head, face, mouth or eyes. The leading cause of injury and death is being hit by the ball, the second leading cause is collision. IN-LINE SKATING: Brain injuries occur most often when skaters fall and hit their heads on the pavement. Skating on roads causes a risk of colliding with cars, bicyclists, pedestrians, and pets. HORSEBACK RIDING: Brain injuries account for 60% of equestrian related fatalities and 17% of all equestrian injuries are brain injuries. 90% of the cases injuries to equestrians require hospitalization are caused by the rider being separated from the horse while riding or falls. (EX: Christopher Reeves).

67  Education and knowledge; medical and psychological issues, assessment, treatment, early intervention, and resources  Know your Soldier(s) and their families; history, likes, dislikes, interests, fears, concerns, strengths, and goals  Don’t make assumptions; often Soldiers don’t understand concussion, TBI, PTSD and other combat related injury issues  Medical Clearance: ensure they have fully healed from any prior or suspected head injury before risking another head injury  Protective gear: use helmets and other protective gear to minimize risk of injury ~ further injury ~ worsening pre-existing condition  Utilize Professionals: mental health professionals, OT, Speech, PT, recreation therapists, and other specialists to support recruitment, activity, safety, and individualized benefits/treatment goals.  Family: Involve family whenever possible which will help build healthier relationships  DON’T GIVE UP!

68 CYNTHIA M. CUPPERNELL MS LMHC NCC CASAC-T Personal Cell Personal Work Phone: X52867 Work s: @va.gov


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