1. Armor For The Mind [INTRO SLIDE 1]
HELLO, MY NAME IS COL JOE PECKO AND I AM AN ARMY SOCIAL WORK OFFICER ASSIGNED AS THE CHIEF OF BEHAVIORAL HEALTH TRAINING AT THE ARMY MEDICAL DEPARTMENT’S CENTER AND SCHOOL. WITHIN THE ARMY, ONE OF OUR MAJOR BEHAVIORAL HEALTH INITIATIVES IS THE BATTLEMIND TRAINING SYSTEM. AND WHETHER YOU ARE A DOD, VA, FAITH BASED OR A CIVILIAN MENTAL HEALTH PRACTITIONER YOU WILL WANT TO LEARN MORE ABOUT THE RESOURCES AVAILABLE THROUGH THIS RESILIENCY BASED PROGRAM.

2. SLIDE 2] BY WAY OF INTRODUCTION, THE BATTLEMIND PROGRAM WAS FIRST DEVELOPED BY THE WALTER REED ARMY INSTITUTE OF RESEARCH AS A RESULT OF DATA COMPILED FROM THEIR LAND COMBAT STUDY. THE LAND COMBAT STUDY REPRESENTS THE FIRST RIGOROUS INVESTIGATION OF MENTAL HEALTH AND WELL-BEING OF SERVICE MEMBERS CURRENTLY INVOLVED IN SUSTAINED GROUND COMBAT OPERATIONS DURING WARTIME. 2

3. [SLIDE3] FINDINGS FROM THE LAND COMBAT STUDY PROVIDE A UNIQUE GLIMPSE INTO THE PSYCHOLOGICAL IMPACT OF WAR ON OUR NATION’S SERVICEMEMBERS.  
THIS STUDY HAS REVEALED A SUBSTANTIAL PERSONAL AND SOCIETAL TOLL IN TERMS OF PTSD AND RELATED OCCUPATIONAL AND FAMILY IMPAIRMENT.
THE FINDINGS HIGHLIGHTED THE NEED FOR THE DEVELOPMENT AND IMPLEMENTATION OF INNOVATIVE STRATEGIES FOR ACUTE AND EARLY INTERVENTION, PREVENTION, AND OPTIMAL DELIVERY OF CARE 3

4. Definition
The official term for the U.S. Army’s psychological resiliency building program. This term describes the Warrior’s inner strength to face fear and adversity during combat, with courage and speaks to resiliency skills that are developed to survive.
[SLIDE 4] BATTLEMIND TRAINING IS AN EXAMPLE OF ONE SUCH INNOVATIVE STRATEGY. THE TERM “BATTLEMIND” IS USED TO DESCRIBE THE WARRIOR’S INNER STRENGTH TO FACE FEAR AND ADVERSITY DURING COMBAT, WITH COURAGE AND SPEAKS TO THE INDIVIDUAL’S RESILIENCE WHICH PERMITS THE WARRIOR TO MAINTAIN OR RETURN TO PREVIOUS LEVELS OF WELL-BEING AND FUNCTIONING. THE BATTLEMIND TRAINING SYSTEM FOCUSES ON THE SKILLS THEY USED FOR SURVIVAL IN COMBAT AS PROVEN STRENGTHS IN TRANSITION TO POST-COMBAT OR OPERATIONAL FUNCTIONING. 4

5. Handle future challenges Mental toughness:
Components
Self-confidence:
Take calculated risks
Handle future challenges
Mental toughness:
Overcome obstacles or setbacks
Maintain positive thoughts during times of adversity and challenge
[SLIDE 5] THE BATTLEMIND TRAINING SYSTEM IS A STRENGTHS-BASED APPROACH GEARED TOWARDS ENHANCING AND SUSTAINING THE WARRIOR’S SELF-CONFIDENCE AND MENTAL TOUGHNESS. BATTLEMIND PROVIDES A RELEVANT, RELIABLE AND EFFECTIVE BEHAVIORAL HEALTH TRAINING PLATFORM FOR SOLDIERS AND THEIR FAMILIES, ENHANCING THEIR WELL-BEING AND OVERALL QUALITY OF LIFE, AS THEY REMAIN READY FOR THE CONTEMPORARY ENVIRONMENT OF FULL SPECTRUM OPERATIONS. 5

6. The U.S Army’s psychological resiliency building program
LIFE-CYCLE
DEPLOYMENT-CYCLE
SOLDIER-SUPPORT
Basic Battlemind Training (BBT)
Battlemind Warrior Resiliency (BWR)
Battlemind Warrior Resiliency-Transition (BWR-T)
Battlemind Warrior Resiliency-Recertification (BWRR)
Battlemind For Leaders (BFL)
Battlemind For Leaders-Intermediate (BFL-I)
Battlemind Pre-Command and Senior Leaders (BSL) Training
Pre-Deployment Battlemind
Leaders
Junior Enlisted
Helping Professions
Spouse/Couples
Post-Deployment Battlemind
PDHA Battlemind
PDHRA Battlemind
Battlemind Psychological Debrief
In Theater (Time and Event Driven)
Post Deployment
Traumatic Event Management
Spouse/Couples During Deployment Battlemind
Battlemind Warrior Resiliency Advanced (BWR-A)
Battlemind for GME
COSC Course
Suicide Prevention
Spouse/Kids Battlemind
DA Civilians Battlemind
USAR/ARNG Battlemind
VA/Network Provider Battlemind
Joint Operations Battlemind
Military Community Battlemind
mTBI/PTSD Chain Teach
[SLIDE 6] BATTLEMIND TRAINING CONSISTS OF A COMPREHENSIVE APPROACH OF LIFE-CYCLE, DEPLOYMENT-CYCLE AND SOLDIER-SUPPORT PRODUCTS DESIGNED AND DEVELOPED BY THE BATTLEMIND TRAINING OFFICE (BTO), SOLDIER AND FAMILY SUPPORT BRANCH, ARMY MEDICAL DEPARTMENT CENTER & SCHOOL AS PROPONENT,WITH WALTER REED ARMY INSTITUTE OF RESEARCH
CONTINUING TO PROVIDE CONSULTATION, SUBJECT MATTER EXPERTISE AND CONTENT QUALITY ASSURANCE. 6

7. The U.S Army’s psychological resiliency building program
LIFE-CYCLE
DEPLOYMENT-CYCLE
SOLDIER-SUPPORT
Basic Battlemind Training (BBT)
Battlemind Warrior Resiliency (BWR)
Battlemind Warrior Resiliency-Transition (BWR-T)
Battlemind Warrior Resiliency-Recertification (BWRR)
Battlemind For Leaders (BFL)
Battlemind For Leaders-Intermediate (BFL-I)
Battlemind Pre-Command and Senior Leaders (BSL) Training
Pre-Deployment Battlemind
Leaders
Junior Enlisted
Helping Professions
Spouse/Couples
Post-Deployment Battlemind
PDHA Battlemind
PDHRA Battlemind
Battlemind Psychological Debrief
In Theater (Time and Event Driven)
Post Deployment
Traumatic Event Management
Spouse/Couples During Deployment Battlemind
Battlemind Warrior Resiliency Advanced (BWR-A)
Battlemind for GME
COSC Course
Suicide Prevention
Spouse/Kids Battlemind
DA Civilians Battlemind
USAR/ARNG Battlemind
VA/Network Provider Battlemind
Joint Operations Battlemind
Military Community Battlemind
mTBI/PTSD Chain Teach
[SLIDE 7] BATTLEMIND LIFE-CYCLE TRAINING: SPEAKS TO THE SOLDIERS MILITARY CAREER LIFE CYCLE AND INSTITUTIONALIZES BATTLEMIND PRINCIPLES AND CONCEPTS INTO THE U.S. ARMY TRAINING AND EDUCATION SYSTEM. EVERY SOLDIER AT EVERY LEVEL OF THEIR PROFESSIONAL DEVELOPMENT TRAINING WILL RECEIVE BATTLEMIND TRAINING THAT IS CUSTOMIZED FOR THEIR TIME IN SERVICE AND CAREER DEVELOPMENT NEEDS. 7

8. Battlemind Training System: Deployment-Cycle
Tough Facts about Combat
Battlemind AAR
Psychological Debriefing
and what leaders can do to
mitigate risk and build confidence
Transition to Post-Conflict
Alert
Pre-Deployment Battlemind For:
Leaders
Junior Enlisted
Helping Professionals
Spouse/Couples Pre-Deployment Battlemind
Battlemind AAR
Psychological Debriefing
[SLIDE 8] BATTLEMIND DEPLOYMENT-CYCLE TRAINING: UTILIZES TRAINING MODULES TO PROVIDE SUPPORT THROUGHOUT THE SEVEN DEPLOYMENT PHASES IN ORDER TO PROMOTE RESILIENCE IN FACING THE PSYCHOLOGICAL IMPACT THAT MAY RESULT FROM COMBAT AND OTHER MILITARY OPERATIONS. EACH OF THE BATTLEMIND DEPLOYMENT-CYCLE TRAINING COURSES INCLUDES A POWER POINT PRESENTATION WITH SPEAKER NOTES AS WELL AS HANDOUTS IN PDF FORMAT.
Preparing for a Military Deployment
PDHRA Battlemind
Brief and DVD
Post-Deployment Battlemind
Spouse/Couples Post-Deployment Battlemind
Battlemind Training II
Battlemind Training I
Continuing the
Transition Home
Transitioning from
Combat to Home 8

9. 9 Preschoolers “Talk, Listen, Connect”
6 to 11 year olds “Mr. Po and Friends Discuss… Family Reunion After Deployment”
12 to 19 year olds “Youth Coping with Military Deployment: Promoting Resilience in Your Family”
Parents “Talk, Listen, Connect”
[SLIDE 9] BATTLEMIND SOLDIER-SUPPORT TRAINING: CAPTURES THE UNIQUE POPULATIONS AND SUBJECTS THAT LIFE-CYCLE AND DEPLOYMENT-CYCLE MODULES DO NOT. TRAINING IN THIS CATEGORY WILL PROVIDE TRAINING TO EXTENDED SUPPORT SYSTEMS, INCLUDING SPECIALIZED POPULATIONS SUCH AS OUR WARRIOR TRANSITION UNITS AND MILITARY FAMILIES. 9

10. To assist the Warrior in the transition home process.
Objectives
To prepare the Warrior mentally for the rigors faced in of all types of military operations including combat.
To assist the Warrior in the transition home process.
To provide the Warrior the skills to assist their Battlemind-Buddy with their transition back home.
[SLIDE 10] THE OBJECTIVES OF BATTLEMIND TRAINING ARE:
PREPARING WARRIORS MENTALLY AND EMOTIONALLY FOR WHAT TO EXPECT IN A COMBAT ENVIRONMENT
ASSISTING WARRIORS WHO HAVE COMPLETED A DEPLOYMENT IN MAKING A SUCCESSFUL TRANSITION BACK HOME
PREPARING WARRIORS WITH THE SKILLS TO ASSIST THEIR BATTLEMIND BUDDY TO TRANSITION HOME 10

11. Includes both Soldiers and Families.
Objectives (cont’d)
To prepare the Warrior as quickly as possible to conduct continued military operations and possibly deploy again in support of all types of military operations including additional combat tours.
Includes both Soldiers and Families.
Reduce Stigma associated with behavioral health.
[SLIDE 11]
AND THEN PREPARING THE WARRIORS PSYCHOLOGICALLY FOR THEIR NEXT DEPLOYMENT
THE BATTLEMIND TEAM REALIZES THAT YOU CAN’T HELP SOLDIER-WARRIORS IN A VACUMM—YOU MUST EDUCATE, TRAIN AND ASSIST FAMILY MEMBERS AS WELL
AND EVERY BATTLEMIND PRESENTATION HAS SOME CONTENT THAT IS SPECIFICALLY GEARED TOWARD REDUCING THE STIGMA ASSOCIATED WITH MENTAL HEALTH AND SPECIFICALLY ACCESSING MENTAL HEALTH CARE 11

12. Evidence-based: Built on findings from the Land Combat Study.
Experience-based: Uses examples that Warriors can relate.
Strengths-based: Builds on existing Warrior strengths and skills; rejects a deficit or illness model.
Training-based: Focuses on skill development – not education.
Explanatory: Highlights conflicted/ misunderstood reactions.
Team-Based: Self-awareness through helping buddy.
Action-Focused: Discusses specific actions to guide Warrior behavior.
[SLIDE 12] WHAT MAKES THE BATTLEMIND TRAINING SO EFFECTIVE?
FIRST OFF, IT IS EVIDENCED-BASED – AS WAS ALREADY MENTIONED BATTLEMIND TRAINING IS BUILT ON THE FINDINGS FROM THE LAND COMBAT STUDY. THERE IS NO SPECULATION ABOUT WHAT THE SOLDIERS ARE GOING THROUGH. THE TRAINING IS BASED ON WHAT THEY TELL US THEY ARE GOING THROUGH BY PARTICIPATING IN THE LAND COMBAT STUDY. 12

13. Battlemind Training Evaluation Study
"Battlemind Training was the best training I've had in the last 10 years in the Army" Senior NCO
[SLIDE 13] THERE HAVE BEEN VERY POSITIVE REACTIONS TO BATTLEMIND TRAINING BY THE PARTICIPANTS, BUT WE WANTED TO DO OUTCOMES RESEARCH TO SEE IF THE PROGRAM WAS TRULY MAKING A DIFFERENCE. WALTER REED ARMY INSTITUTE OF RESEARCH CONDUCTED A BATTLEMIND TRAINING EVALUATION STUDY THAT WAS DESIGNED TO DETERMINE THE EFFECTIVENESS OF POST-DEPLOYMENT BATTLEMIND TRAINING. 13

14. Battlemind Training Evaluation Study
Intervention Comparison Groups include:
Small Group
Battlemind
(Groups of
~30)
Large Group
Battlemind
(Groups of
100+)
Large Group
Stress
Education
(Groups of
100+)
[SLIDE 14] THE RESEARCH PROJECT USED TWO BRIGADE COMBAT TEAMS FROM TWO SEPARATE ARMY INSTALLATIONS. THE SURVEY INSTRUMENT USED MEASURED MENTAL HEALTH DIFFICULTIES, CARE UTILIZATION AND SATISFACTION. THE PARTICIPANTS WERE SURVEYED BEFORE AND IMMEDIATELY AFTER TRAINING. ALSO, THERE WERE FOLLOW-UP SURVEYS AT 3 AND 9 MONTHS POST-TRAINING.
AS INDICATED ON THIS SLIDE, THE INTERVENTION COMPARISON GROUPS INCLUDED: 1) ONE GROUP THAT RECEIVED SMALL GROUP BATTLEMIND TRAINING IN GROUPS OF ABOUT 30. 2) THE SECOND GROUP RECEIVED THE SAME POST-DEPLOYMENT BATTLEMIND TRAINING BUT IN LARGE GROUPS OF 100 OR MORE. 3) AND THE THIRD GROUP RECEIVED MORE OF A GENERIC STRESS EDUCATION TRAINING THAT WAS ALSO GIVEN IN GROUPS OF 100 OR MORE. 14

15. Battlemind Training Evaluation Study
Preliminary data is based on 2,039 Soldier surveys
Small Battlemind training was rated significantly higher than large Battlemind and large Stress Education training
[SLIDE 15] THE PRELIMINARY DATA IS BASED ON 2,039 SOLDIER SURVEYS AND CONTROLLING FOR: COMPANY-LEVEL EFFECTS, PRE-INTERVENTION SYMPTOM SCORES, EXPOSURE TO DEPLOYMENT RELATED EVENTS, UNIT TYPE, GENDER AND RANK, 15

16. Battlemind Training Evaluation Study
A lot
[SLIDE 16] THE FINDINGS DEMONSTRATED THAT IN TERMS OF SATISFACTION, USEFULNESS OF TRAINING, AND FINDING IT RELEVANT, SMALL GROUP BATTLEMIND CONSISTENTLY SCORED HIGHER THAN THE OTHER TWO INTERVENTION GROUPS AND THE LARGE GROUP BATTLEMIND CONSISTENTLY SCORED HIGHER THAN THE TRADITIONAL STRESS TRAINING CLASS.
Not at all 16

17. Battlemind Training Evaluation Study- Outcomes
Soldiers with high levels of exposure to combat who received Battlemind Training reported
Reduced post-traumatic stress symptoms
Less sleep problems
Minimal perceived stigma associated with mental health problems
[SLIDE 17] BUT EVEN MORE SIGNIFICANT IN THE FINDINGS WAS THAT SOLDIERS WITH HIGH LEVELS OF EXPOSURE TO COMBAT WHO RECEIVED BATTLEMIND TRAINING REPORTED REDUCED POST-TRAUMATIC STRESS SYMPTOMS, LESS SLEEP PROBLEMS AND REPORTED MINIMAL PERCEIVED STIGMA ASSOCIATED WITH MENTAL HEALTH PROBLEMS. REMEMBER WHAT I MENTIONED EARLIER-- THAT EVERY BATTLEMIND TRAINING ADDRESSES THE ISSUE OF STIGMA IN SOME MANNER. 17

18. Battlemind Training Evaluation Study- Outcomes
Soldiers with high levels of exposure to combat who received BMT reported
Perceived organizational support
NS: no effects on depression, alcohol, or anger
[SLIDE 18] THESE SAME SOLDIERS REPORTED THAT THEY FELT THEIR UNIT SUPPORTED THEM BY ALLOWING THEM THE TRAINING. HOWEVER, THE RESEARCH SHOWED NO SIGNIFICANCE IN TERMS OF THE TRAINING EFFECTS ON DEPRESSION, ALCOHOL, AND ANGER. 18

19. Soldiers receiving pre-deployment Battlemind training feel more prepared for the deployment and also report fewer mental health problems (Mental Health Advisory Team (MHAT) V).
[SLIDE 19] DURING THE MOST RECENT MENTAL HEALTH ASSESSMENT THAT WAS CONDUCTED BY WRAIR IN IRAQ AND AFGHANISTAN IN 2007, THE TROOPS WERE ASKED IF THEY HAD RECEIVED THE PRE-DEPLOYMENT BATTLEMIND TRAINING. REMEMBER THE OTHER STUDY FOCUSED ON POST-DEPLOYMENT TRAINING. THOSE WHO ATTENDED THE PRE-DEPLOYMENT TRAINING REPORTED THAT THEY WERE MORE PREPARED FOR WHAT TO EXPECT DURING THE DEPLOYMENT AND THEY ALSO REPORTED FEWER MENTAL HEALTH PROBLEMS AS IS DEPICTED ON THIS SLIDE. SO PRELIMINARY DATA SUPPORTS THE VALUE OF THE BATTLEMIND TRAINING AND WE ARE CONTINUING TO EXPAND AND IMPROVE THE BATTLEMIND RESOURCES. 19

20. Battlemind Training System: Current Web Page (www.battlemind.org)
Battlemind Training System: New Web Page ( 3rd Quarter ‘08
[SLIDE 20] AS CLINICIANS PLEASE KNOW THAT MANY OF THE TRAINING MODULES DISCUSSED TODAY ARE AVAILABLE TO YOU AT OUR WEB SITE. ALTHOUGH YOU WILL TEMPORARILY GO TO FOR REVIEW AND DOWNLOAD OF OUR TRAINING PRODUCTS, SOON YOU WILL GO TO 20

21. [SLIDE 21] IN CONCLUSION I WANT TO SHARE ABOUT OUR ARMY VALUES—
Warrior Ethos
We take care of our own
Seeking help shows courage
Warriors encourage growth and resiliency
No Warrior will be left behind
[SLIDE 21] IN CONCLUSION I WANT TO SHARE ABOUT OUR ARMY VALUES—
WE SOLDIER-WARRIORS ARE TAUGHT THAT WE TAKE CARE OF OUR OWN. WE MAINTAIN LOYALY TO OUR BATTLE BUDDIES WHO HAVE THE COURAGE TO GET HELP WITH THEIR NEEDS. SOLDIER-WARRIORS ARE IMPORTANT, THEIR TOTAL HEALTH IS IMPORTANT, AND TAKING CARE OF THEM IS PART OF THE WARRIOR ETHOS. IN OUR SOLDIER’S CREED WE DECLARE THAT NO ONE WILL BE LEFT BEHIND—EVERY WARRIOR AND THEIR FAMILIES ARE A KEY PART OF MISSION SUCCESS. THIS IS WHY THERE IS STRONG AND THEN THERE IS ARMY STRONG AND ARMY FAMILY STRONG!!
ARMY STRONG. 21