1. Title | 1 RESET – Family Members| 1 Preparing To Be Together 2010

2. Title | 2 RESET – Family Members| 2 What Changes Have You Experienced?  Changes in everyday life experiences  Personal changes and contributions  Changes in Family roles and relationships  Changes in finances and property issues (that require immediate attention)

3. Title | 3 RESET – Family Members| 3 Objectives  To understand the reintegration challenges Family members may face  To identify useful approaches to these challenges  To learn to recognize when assistance may be needed  To review where Family members can get help

4. Title | 4 RESET – Family Members| 4 Common Expectations  Reintegration anticipation, fantasies and expectations  Realistic expectations  Homecoming is an event but Reintegration is a process and process takes time – Remember to pace yourself – everyone has a different timeline!

5. Title | 5 RESET – Family Members| 5 Deployment Cycle Support – Emotional Cycle

6. Title | 6 RESET – Family Members| 6 Challenging - First Questions  Will my Soldier be different?  Will I need to change the way we have been doing things?  Will my Soldier still love / need me?  Will he/she want to spend more time with battle buddies than with me?  What about future Deployments?  When will things feel normal again?

7. Title | 7 RESET – Family Members| 7 Realistic Expectations  Change  Emotional letdown  Restlessness or sleeplessness  Feeling that your Soldier will not understand you  Financial problems (e.g., preparing for a loss of any additional income due to redeployment, property issues)  Getting used to and getting to know each other again

8. Title | 8 RESET – Family Members| 8 Change Change Happens! Expect that things will be different than they were prior to deployment … “Things do not change, we change” - Henry David Thoreau

9. Title | 9 RESET – Family Members| 9 Restarting, Committing, Adjusting…  Expect and accept that things have changed  Be caring and compassionate with yourself, as well as your Soldier  Get support from others and give yourself permission to be vulnerable with your Soldier  Do things that help relieve stress  Exercise  Get enough rest  Use your support systems, including friends, Family, clergy, and other unit members  Set realistic short term goals and do things for fun  Avoid unhealthy coping strategies, such as drinking, over-eating, overworked, smoking or excessive TV watching

10. Title | 10 RESET – Family Members| 10 Reconnecting – Adding and Subtracting Roles, Routines, and Rules  New roles have been assumed  Different Family rules and routines Change may cause some concerns  Newfound independence Difficulty assuming, letting go or sharing roles and responsibilities Renegotiate roles, routines, rules and reestablish relationships!

11. Title | 11 RESET – Family Members| 11 Restarting, Reconnecting – What to Do  Share information during deployment so that there is less tendency to “dump” information on one another  Let go of anger  Listen to your Soldier talk about feelings and experiences  Spend quality time together

12. Title | 12 RESET – Family Members| 12 Communication is Crucial “The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention…A loving silence often has far more power to heal and to connect than the most well-intentioned words.” ~ Rachel Naomi Remen “Being vulnerable doesn't have to be threatening. Just have the courage to be sincere, open and honest. This opens the door to deeper communication all around. It creates self- empowerment and the kind of connections with others we all want in life. Speaking from the heart frees us from the secrets that burden us.” ~ Sara Paddison, The Hidden Power of the Heart

13. Title | 13 RESET – Family Members| 13 Common Homefront Experiences That May Make Conversations Difficult  Combat skills, such as emotional control, may make it difficult for Soldiers to talk openly about feelings  A habit of sharing only positive news  May be used to sharing what you are really going through only with friends or other spouses in the unit  Family members – develop “social bonds”  Soldiers – connect with “battle buddy”

14. Title | 14 RESET – Family Members| 14 Talking It Out – Healthy Communication Listen  Set aside time to talk without distractions  Check in regularly at the first signs of a problem  Create a receptive frame of mind  Listen with eyes and ears Empathize  Clarify the other’s point of view, paying attention to their feelings  Convey a connectedness, having a willingness to compromise

15. Title | 15 RESET – Family Members| 15 Talking It Out – Healthy Communication Listen Empathize Recognize the impact of stress on communication

16. Title | 16 RESET – Family Members| 16 Problem Solving  Brain Storming  Pros and Cons  Consensus or Compromise Be spontaneous and know when to be serious or silly, but always show kindness.

17. Title | 17 RESET – Family Members| 17 Tips: Handling Challenges  Resolve anger  Sustain preparedness

18. Title | 18 RESET – Family Members| 18 Tips: Handling Challenges (continued)  Re-learn forgiveness  Be resilient

19. Title | 19 RESET – Family Members| 19 Tips: Handling Challenges (continued)  Share marital responsibilities  Two out of three unhappily married adults who avoided divorce or separation ended up happily married 5 years later.  Divorce did not reduce symptoms of depression for unhappily married adults.  Divorce did not raise self-esteem or increase sense of mastery, on average, compared to unhappy spouses who stayed married.

20. Title | 20 RESET – Family Members| 20 Reestablishing Intimacy Possible Concerns:  Feeling like strangers  Anxiety and concerns: affection, intimacy, sexual relations  Fidelity in the relationship Things that will help:  Commit to communicate  Court each other  Set the stage for intimacy  Take time readjusting to being together again

21. Title | 21 RESET – Family Members| 21 Financial Concerns Possible concerns:  A decrease in pay due to the discontinuance of deployment incentives, (i.e., combat pay, separation pay, etc.)  Debt increases with the decrease in pay, as there may be an increase in spending in an effort to “make up for lost time”  Changes in Family circumstances Things that will help:  Communicate  Make needed adjustments to budget  Get assistance from unit’s Financial NCO and ACS/NG & AR Finance Counselor

22. Title | 22 RESET – Family Members| 22 Reestablishing Connections with Children It is important to remember that…  Children process and understand life events differently than adults  Children react differently according to age, personality, and individual coping styles

23. Title | 23 RESET – Family Members| 23 Issues of Particular Concern  Traumatic Brain Injury (TBI)  Combat Related Stress Response and PTSD  Depression  Alcohol and Substance Abuse  Suicidal Thoughts  Domestic Abuse  Child Abuse and Neglect Emotional fitness – Resiliency – Preparedness – Safety

24. Title | 24 RESET – Family Members| 24 Traumatic Brain Injury (TBI)  More Soldiers are surviving with head injuries that have long term consequences  TBI can be hard to diagnose - it mimics other disorders  If you suspect a Soldier has a TBI, a neurological or neuropsychological exam is crucial  Rehabilitation therapies may be appropriate

25. Title | 25 RESET – Family Members| 25 Post Traumatic Stress Disorder (PTSD) Symptoms  Flashbacks, dreams, or intrusive thoughts  Avoidance of thoughts, things, people or conversations that remind one of the traumatic event  Reduced ability to experience emotions, diminished interest in previously enjoyed activities, or may feel estranged or detached from others  Increased anxiousness, difficulty sleeping, hyper- vigilance, and having an overactive startle response  Other symptoms may include difficulty concentrating or completing tasks, irritability, or outbursts of anger

26. Title | 26 RESET – Family Members| 26 Vicarious Traumatization  Family members may develop mental health problems of their own, including anxiety, depression, especially if they have experienced violence or erratic behaviors as a result of their Soldier’s combat stress or PTSD.  21% stated that stress or emotional problems impacted negatively on the quality of their work or other activities.  19% met screening criteria for either major depression or generalized anxiety disorders.  Most spouses (46% sought help from specialty mental health providers).  Spouses experience greater levels of psychological symptoms when they perceived high levels of symptoms in their Soldier. …when Family members experience psychological symptoms similar to a Soldier’s combat stress or PTSD

27. Title | 27 RESET – Family Members| 27 Related Mental Health Concerns  Depression  Abuse of Alcohol or other Substances  Suicidal Thoughts  Domestic Abuse  Child Abuse

28. Title | 28 RESET – Family Members| 28 Symptoms of Depression  Feeling depressed or down most of the day, most days  Repeated crying episodes  Feelings of hopelessness or helplessness  Sleeping too little or too much  Changes in appetite – significant weight loss or gain  No longer enjoying things that used to be enjoyed  Fatigue or low energy  Difficulty concentrating or making decisions  Thoughts of death or suicide  Feelings of guilt or worthlessness

29. Title | 29 RESET – Family Members| 29 Indicators that Alcohol or Substance Use May Be a Problem  Drinking or using drugs to deal with painful feelings or to block memories of your combat experience  Drinking to get to sleep  Binge drinking  Drinking and driving  Feeling guilty about your drinking  Combining alcohol with other drugs or medications  Drinking against Family or medical advice  Problems in Family relationships  Missing work or school because of alcohol or substance use

30. Title | 30 RESET – Family Members| 30 Suicide Prevention  Suicidal thoughts sometimes occur when someone is depressed, using alcohol or drugs, or is experiencing other mental health problems  If someone you know talks about having thoughts of suicide, always take them seriously  Seek professional help immediately

31. Title | 31 RESET – Family Members| 31 Suicide Prevention (continued) Follow the ACE model:  A sk your Soldier or Family member: Have the courage to ask the question, but stay calm. Ask the question directly, e.g., Are you thinking of killing yourself?  C are for your Soldier or Family member: Remove any means that could be used for self-injury. Calmly control the situation; do not use force. Actively listen to produce relief.  E scort your Soldier or Family member: Never leave them alone. Escort to the chain of command, a Chaplain, a behavioral health professional, or a primary care provider. (Source: http://chppm-www.apgea.army.mil/Suicide Awareness for Soldiers, 2008, adapted)

32. Title | 32 RESET – Family Members| 32 Mental Health Concerns  Traumatic Brain Injury (TBI)  Post Traumatic Stress Disorder (PTSD)  Vicarious Tramatization  Depression  Abuse of Alcohol or other Substances  Suicidal Thoughts  Child Abuse Prevention  Domestic Abuse

33. Title | 33 RESET – Family Members| 33 Child Abuse Prevention Seek help “early on”  New Parent Support Program - offering home visitation for expecting parents  Parenting workshops or classes  Fathering programs  Play mornings for children  Respite care  Counseling support

34. Title | 34 RESET – Family Members| 34 Domestic Abuse Prevention Seek help right away  Behaviors – pushing, slapping, kicking or hitting, stalking  Remarks – threatening, belittling, menacing  Risk issues – unresolved infidelity, separation-divorce; Family trauma; isolation; mental health problems  Relationship Programs – Family Advocacy Programs (FAP); Strong Bonds Retreats; Guard and Reserve Marriage Enrichment Seminars

35. Title | 35 RESET – Family Members| 35 Sleep Deprivation and Effects on Well-being  The “average person” needs seven to eight hours of uninterrupted sleep per 24 hours.  Lack of adequate sleep results in every day performance problems such as: Reduced alertness Inability to sustain vigilance Memory deficits Reduced mental flexibility Slower information processing Impaired judgment and initiative *Other possible consequences – heightened anger, depression, and anxiety  Seek help when:  Sleep disturbance persists more than a few months  Poor sleep is negatively affecting relationships or physical health  It is suspected that there may be other sleep disorders (e.g., sleep apnea)

36. Title | 36 RESET – Family Members| 36 Grieving  Expect varying emotions and thoughts  Know that a positive outlook nurtures acceptance  Work with Family and friends for comfort  Caution masking pain and disappointment  Seek spiritual support

37. Title | 37 RESET – Family Members| 37 Staying Healthy  Dare yourself to try new things, attend new events, or discover new skills.  Laugh at unexpected stories and try not to apologize for everything.  Relax using many strategies: Meditation, deep breathing, yoga, reading inspirational books, listening to quiet music etc.  Have healthy conversations with peers, buddies, Family members and other helpful people.  Change thinking patterns and be open to new solutions.  Be resourceful by making creative decisions.  Learn to accept responsibility for one’s feelings and behaviors.  Use spirituality to provide courage and hope – a time honored source of strength.

38. Title | 38 RESET – Family Members| 38 Where and How to Get Support  Military OneSource  Army OneSource  Comprehensive Soldier Fitness (CSF)  Army Community Service (ACS)  Army National Guard Family Program  Army Reserve Family Programs  Family Readiness Group  Chaplain  Military Life Consultants  Behavioral Health: Social Work Service, Psychiatry, Psychology  Red Cross and other Community Service Agencies  Department of Veteran Affairs

39. Reintegration – Family Members| 39 Tips…  Anticipate that things will be different  Commit to communicate  Pace things out  Seek support “early on”

40. Reintegration – Family Members| 40 Questions?

41. Reintegration – Family Members| 41 Closing Remarks

42. Reintegration – Family Members| 42 Additional Slides (keep handy as a reference)

43. Reintegration – Family Members| 43 Key Findings: Many children adjust to the challenges of deployment with parental support. When problems do develop, other Family risk factors are typically present. (Cozza, 2005; Hardaway, 2004; Huebner & Mancini, 2005; Orthner & Rose, 2005) The effects of deployment on children & youth are determined in part by parent’s reactions and ability to cope. (Cozza, 2005; Hardaway, 2004; Huebner & Mancini, 2005; Orthner & Rose, 2005). Adolescents who experienced OIF and OEF deployments (Huebner & Mancini, 2005)  Talked about deployed parents not recognizing changes that the adolescent (and Family) had made  Indicated being worried about how the deployed parent had changed, and what different rules might be imposed upon the parent’s return.  Reported that friends and Family were helpful in providing opportunities to talk and engage in activities, which mediated the potential negative effects. In interviews, children’s fear of the risk of possible death to their parent was disproportionate to the percent killed in Iraq. These fears may be exacerbated by the high media coverage of the war. (Cozza et al., 2005) Reestablishing Connections with Children (continued)

44. Reintegration – Family Members| 44 Infants may:  Cry or fuss more  Pull away from the deployed parent  Cling to the main caregiver  Not recognize the returning Soldier Spouses or Caregivers can:  Encourage the returning Soldier to spend time with the baby  Give their Soldier space to become an active parent again Returning Soldiers can:  Hold, hug, bathe, feed, and play with the baby Reconnecting with Infants

45. Reintegration – Family Members| 45 Children aged 1-3 years may:  Be shy around or not recognize the returning parent  Cling to the parent or caregiver who remained home  Cry, have tantrums, or regress to earlier behaviors (no longer potty trained) Spouses or Caregivers:  Encourage the returning Soldier to give the child time to warm up and make the first approach Returning Soldiers:  Learn the games and activities the child enjoys  Give “Family hugs” at first and do not force affection Reconnecting with Toddlers

46. Reintegration – Family Members| 46 Preschoolers may:  Act sad or frustrated  Cling to the parent or caregiver who remained home  Act out to get attention, have bad dreams, and talk a lot to bring the returning Soldier up to date Spouses or Caregivers:  Encourage the returning Soldier to listen to the child, accept their feelings, and not over react to the negative behavior Returning Soldiers:  Play with the children and find out what are the new, important things going on in their lives Reconnecting with Preschoolers

47. Reintegration – Family Members| 47 School age children may:  Display a range of feelings and moods  Talk non-stop or act “grown up”  Be fearful that they are not good enough Spouses or Caregivers:  Encourage the returning Soldier to spend time with the child and learn what has been going on in their life Returning Soldiers:  Take time to look at your child’s artwork, school work, and learn about their activities Reconnecting with School-Age Children

48. Reintegration – Family Members| 48 Adolescents may:  Be excited, yet feel too old or unwilling to meet or spend time with the returning parent  Be concerned about changes in rules and responsibilities  Have difficulties in school, with mood swings, or become rebellious Spouses or Caregivers:  Encourage the returning Soldier to spend time with the child and learn what has been going on in their life Returning Soldiers:  Share what is appropriate about the deployment  Practice listening Reconnecting with Adolescents

49. Reintegration – Family Members| 49 Watch for and seek help if:  Lingering stress reactions and unusual behaviors interfere with day-to-day living  There are significant changes in –  Appetite or sleep  Participation in favorite activities  Mood: Unhappy, sad or depressed  Acting-out behaviors: Getting into fights  Withdrawal from friends  Academic performance  Controlling his/her temper When Children May Need Help