1. Supporting Service Members and Their Families in the Tasks of Reintegration Ursula B. Bowling, PsyD

2. Topics for Today  Importance of including family based services  Ensuring availability and accessibility of services  Structuring early sessions to maximize engagement

3. A Family Issue “in many instances, a traumatized soldier is greeting a traumatized family, and neither is ‘recognizing’ the other.” - Hutchinson & Banks-Williams

4. Tasks of Reintegration  Redefining roles, expectations, and division of household responsibilities  Managing strong emotions  Abandoning emotional constriction and creating intimacy in relationships  Creating a sense of shared meaning surrounding the deployment experience.

5. Why Family Services?  Address family reintegration challenges  Address veteran’s mental health needs  For some, reduces stigma associated with mental health care  Social and family support are important protective factors

6. Developing Family Services  Create a referral network with natural helpers  Pay special attention to needs of rural, Guard and Reserve veterans  Develop creative ways to increase access to services

7. Increasing Accessibility  Have a direct phone line to your clinic  Schedule first sessions quickly  Location, location, location  Evening and weekend programs  Pair clinical services with enjoyable activities or refreshments

8. Provider Characteristics  Familiarity with military culture and current conflicts  Demonstrate consistency, warmth, flexibility, and a willingness to learn  Collaborative, egalitarian approach

9. Assessment Domains  Traumatic brain injury  Anxiety disorders including PTSD  Depression and suicidality  Violent or impulsive behavior  Changes in social, occupational, or family functioning  Domestic violence, child abuse, and other aggressive behavior problems

10. Risk and Protective Factors  Protective factors – Flexible gender roles – Use of active coping strategies – Presence of community and social supports.  Risk factors, – families lacking support – young or newly married families – families with other stressors

11. Focus of Initial Sessions  Normalizing the family’s experience  Providing readily accessible symptom relief  Instilling hope  Developing an understanding of the family’s goals  Explaining how your services or programs can help to meet those goals.  Strengths of family

12. Early Treatment Sessions  GOAL – Create a sense of safety and responsiveness  Don’t assume that patients know what to expect  Make expectations explicit  Respect pace of the family  Focus on stated needs of your family  Provide concrete, tangible tools

13. A Unique Opportunity