1. Title | 1RESET Readiness| 1 RESET Readiness How Are Things Going? 2010

2. Title | 2RESET Readiness| 2 Objectives  To understand the challenges Soldiers/deployed Civilians and their Families face during the reintegration process  To identify approaches to these challenges  To learn to recognize when assistance may be needed  To review use of resources that are available to help

3. Title | 3RESET Readiness| 3 Restarting - Reconnecting  How are things going?  Was being “reunited,” everything you thought it would be?  How are you feeling?  What things are starting to feel normal? Soldiers/DA Civilians and Family members need to be proactive by talking about their worries and concerns, prior to the Soldiers’/Civilians’ return home as well as upon their return.

4. Title | 4RESET Readiness| 4 Difficult areas may be:  Family members unsure about “who is in or out of the Family”  Home again/gone again process  Changes that have taken place during the deployment  Adjusting to the Soldier’s/deployed Civilians ‘ personality/moods  Communication/conversations  Reestablishing roles Challenges The most stressful stage is “the reunion” especially within the first three months. (National Family Military Association (2006)

5. Title | 5RESET Readiness| 5 Pace yourselves! It will take time to gradually ease into responsibilities at home. It will take time for everyone to adjust! Challenges (continued)

6. Title | 6RESET Readiness| 6 Questions You May Be Asking Yourself Soldier –  What happened while I was gone?  I feel like a stranger.  Where do I fit in now?  What about finances?  When will things feel normal again? Spouse/Adult Family Member –  Will my Soldier be different?  Will I need to change the way I have been doing things?  Will I feel like a stranger to my Soldier.  Will he/she spend more time with a battle buddy? Children –  Will I have to do things differently?  Will there be new or different rules?  When will Dad or Mom have to leave again?

7. Title | 7RESET Readiness| 7 Restarting – Realistic Expectations  Expect things to be different or changed  Be caring and compassionate  Recognize that there may be a few doubts and worries  Redirect fantasies and keep expectations realistic  Set aside time to talk openly  Pace adjusting to being together again

8. Title | 8RESET Readiness| 8 Expect change - things will be different than they were prior to the deployment… “ You’ve changed, your kids have changed, your spouse is different. It becomes a problem when no one admits to the changes…it seems to work as long as you have someone to talk to.” “Everyone grows and changes with separation. Everyone is a little shy to come home, even if they don’t admit it. Sometimes the relationships are better and sometimes they are worse. It depends on the situations.”

9. Title | 9RESET Readiness| 9 Adding and Subtracting Roles, Routines, and Rules  New roles established  Different Family rules and routines - Change may cause some concerns  Newfound competence and independence - Difficulty assuming, letting go, or sharing roles and responsibilities Renegotiate roles, routines and rules, and reestablish relationships!

10. Title | 10RESET Readiness| 10 Restarting – Reconnecting When restoring relationships, it is important to…  Spouses/Family Members –  Let go of anger/resentment/disappointment  Share information; new skills learned  Listen to one another  Be proud of your accomplishments and contributions  Soldiers –  Take time to listen  Share your experiences  Be proud of your accomplishments  Be proud of your Family’s accomplishments

11. Title | 11RESET Readiness| 11 Restarting – Reconnecting (continued)  For everyone –  Spend quality time to get to know one another  Pace family activities – it’s important to not try and make up for lost time all at one  Build in quiet time  Take time to listen and acknowledge thoughts and feelings  Find different solutions to deal with tougher hurdles Remember…it is important to acknowledge each other’s contributions and accomplishments.

12. Title | 12RESET Readiness| 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 | 13RESET Readiness| 13 Common Homefront Experiences That May Make Conversations Difficult  Combat experience may make it difficult for the Soldier to talk openly about feelings  Soldier may discount feelings and experiences by comparing them to combat  Soldiers and Families may have a habit of sharing only positive news  May be used to sharing with “battle buddy” - whether Soldier or Spouse/Family member

14. Title | 14RESET Readiness| 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 | 15RESET Readiness| 15 Talking It Out – Healthy Communication Listen Empathize Recognize the impact of stress on communication

16. Title | 16RESET Readiness| 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 | 17RESET Readiness| 17 Tips: Handling Challenges  Resolve anger  Sustain preparedness

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

19. Title | 19RESET Readiness| 19 Tips: Handling Challenges (continued)  Monitor marital satisfaction  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 | 20RESET Readiness| 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 | 21RESET Readiness| 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 | 22RESET Readiness| 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 | 23RESET Readiness| 23 Reestablishing Connections with Children (continued) Key Findings:  Many children adjust to the challenges of deployment with parental support. When problems do develop, other Family risk factors are typically present.  The effects of deployment on children & youth are determined in part by parent’s reactions and ability to cope.  Adolescents who experienced OIF and OEF deployments  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.

24. Title | 24RESET Readiness| 24 Reconnecting with Infants 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

25. Title | 25RESET Readiness| 25 Reconnecting with Toddlers 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

26. Title | 26RESET Readiness| 26 Reconnecting with Preschoolers 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

27. Title | 27RESET Readiness| 27 Reconnecting with School-Age Children 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

28. Title | 28RESET Readiness| 28 Reconnecting with Adolescents 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

29. Title | 29RESET Readiness| 29 When Children May Need Help 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

30. Title | 30RESET Readiness| 30 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

31. Title | 31RESET Readiness| 31 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

32. Title | 32RESET Readiness| 32 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

33. Title | 33RESET Readiness| 33 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.

34. Title | 34RESET Readiness| 34 Related Mental Health Concerns  Depression  Abuse of Alcohol or other Substances  Suicidal Thoughts  Domestic Abuse  Child Abuse

35. Title | 35RESET Readiness| 35 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

36. Title | 36RESET Readiness| 36 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

37. Title | 37RESET Readiness| 37 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

38. Title | 38RESET Readiness| 38 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)

39. Title | 39RESET Readiness| 39 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

40. Title | 40RESET Readiness| 40 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

41. Title | 41RESET Readiness| 41 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

42. Title | 42RESET Readiness| 42 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)

43. Title | 43RESET Readiness| 43 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

44. Title | 44RESET Readiness| 44 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.

45. Title | 45RESET Readiness| 45 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

46. Title | 46RESET Readiness| 46 Questions?

47. Title | 47RESET Readiness| 47 Closing Remarks

48. Title | 48RESET Readiness| 48 Additional Slide (keep handy as a reference)

49. Title | 49RESET Readiness| 49 Reconnecting with Child Caregivers Who Are Not Your Spouse or Partner  Giving up full time care giving can be a loss, and/or a relief  Help Caregivers stay involved and connected with your child(ren)  Share information with the Caregiver  Resume active care of your children as soon as you are able

50. Title | 50RESET Readiness| 50 Deployment Cycle Support – Emotional Cycle

51. Title | 51RESET Readiness| 51 Life Skills Education, Supportive Counseling, and Treatment Programs  Life Skills Education – Information & activities that facilitate self potential to maintain a healthy and productive life; make informed decisions; communicate effectively; and develop coping skills Briefings, workshops, and information – literature and resources – Service providers are generally Bachelors degree level  Supportive Counseling – Interpersonal education that provides tangible and emotional guidance throughout a short-term and situational life event, to help sustain well-being and productive life Community outreach, individual or Family counseling, support groups, or new parent support home visits – Service providers are generally Masters degree level Family service providers and Chaplains  Treatment/Therapy Programs – Clinical or medical intervention that is typically long term aimed at remediation of symptoms, to support health and well-being treatment goals Clinical and therapeutic sessions, or in-patient care – Service providers are licensed social workers, psychologists, psychiatrists, marriage and family therapists, or medical personnel