When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members...

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When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D. Dr. John Schupp, Ph.D. Dr. Roger P. Buck, Ph.D.

Transcript of When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members...

Page 1: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

When Johnny Comes Marching Home

Reintegration Problems and Concerns of Military Service Members Returning

from Combat

Presenters

Dr. Edgardo Padin, Ph.D.Dr. John Schupp, Ph.D.Dr. Roger P. Buck, Ph.D.

Page 2: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Human Toll of Traumatic Events

Page 3: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

This Presentation will . . .

Be presented in three general topic subsections: War’s impact on the

individual

How stress reactions impact interpersonal relationships of the returning veteran

College program recommendations to best meet the needs of returning veterans

Explore the complexities of human responses to, and recovery from traumatic experience.

Characteristics needed in program development and support programs to ensure academic and vocational success in military veterans

Page 4: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

You may be permanently changed by a traumatizing experience, but you do not

have to be permanently “damaged”.

Roger P. Buck, Ph.D.

Page 5: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

War and human stress reaction

Page 6: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

The Five Major Trauma Research Topic Areas

Psycho-Physiological

Individual/Personal Characteristics

Trauma Specific Characteristics

Treatment Modalities/Outcomes

Social Factors

Page 7: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Psycho-Physiological

Studies that provide insight into alteration in the brain as well as other physical reactions to trauma. Including the impact that Traumatic Brain Injury (TBI) has on cognitive processes.

Individual/Personal Aspects

Identification of characteristics such as age, sex, moral development, and cognitive level and how these factors might determine an individual’s reaction to traumatic experiences.

Page 8: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Trauma Specific Issues

These research investigations reveal how different aspects such as intensity, duration, and type of trauma, impacts human responses.

Treatment Modalities/Outcomes

There is a significant amount of literature which focuses on treatment outcomes and modalities utilizing the knowledge obtained from research. Evidence based best practice models are derived from this research.

Page 9: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Social Factors

The impact social support or lack of support has on an individual and their ultimate reactions to crisis/traumatic experiences.

Page 10: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.
Page 11: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Five Major Topic Areas

1. Psycho-Physiological2. Individual/Personal

aspects3. Social Aspects4. Trauma Specific

Characteristics5. Treatment Modalities

and Outcomes

Page 12: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What is Trauma?

Page 13: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Researchers attempt to develop a clear understanding of “trauma” through critique and description of its characteristics - there is no single definition of trauma

Judith Herman reported: “trauma overwhelms the ordinary human adaptations to life” . . . “and trauma events generally involve threats to life, or bodily integrity or close personal encounters with violence and death” . . . And “confronts people with extremes of helplessness and terror and evokes the responses of catastrophe”

R. Cohen said that “a traumatic event is an event that severely challenges the long-held cherished beliefs and expectations of the individual exposed to it”

C. Monohan stated: “Trauma is an extraordinary frightening event that overwhelms the victim with feelings of terror and helplessness. . . . Encounter with defenselessness can create memorable emotional pain, confusion, and behavioral disruption.”

Page 14: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Diagnostic and Statistical Manual of Mental Disorders (4th ed.) DSM-IV Trauma is referred to as “an extreme traumatic stress involving

direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity, or witnessing an event that involves death, injury, or a threat to the physical integrity of another person.”

Symptoms that occur following traumatic events fall into many different diagnostic categories with “anxiety disorders” (Post Traumatic Stress Disorder, PTSD) being one of the most prominent.

Page 15: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What factors determine response to potentially traumatic events

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16 Things We Know About Trauma 1. People with childhood

trauma are higher risk of health problems as adult

2. Childhood trauma victims do increased risk behaviors (smoking, excessive alcohol use)

3. Many people have significant trauma history which they don’t reveal

4. Domestic violence, child abuse, alcoholic and neglectful parents cause trauma responses in their children

5. Suicide rate among trauma survivors is higher than nation avg

6. Military Reserves have higher suicide rate than regular military

Page 17: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

16 Things We Know About Trauma 7. Combat veterans of today’s

war have higher suicide rate than at any time in U.S. History

8. Military personnel with multiple tours of duty in combat are higher risk for PTSD

9. Trauma victims often don’t seek professional help

10. Many military men and women do not seek professional help

11. Much of the public and even many mental health professionals are uninformed of lifelong impact of trauma

12. Some trauma victims become perpetrators

Page 18: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

16 Things We Know About Trauma 13. Divorce rates and failed

relationships are higher among people with trauma history

14. There are predictable and normal responses to abnormal events that appear extreme but subside over time

15. The whole person is affected by traumatic events: Physical, Cognitive, Emotional, Behavioral, Spiritual

16. Population exposure model indicates the closer a person is in proximity to an event the more severe the response

Page 19: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Complex PTSD

Chronic Trauma results in more complex symptoms:

Concentration Camps Prisoner of War Prostitution Brothels Repeated Child Abuse Repeated tours of Combat

in war zone

Page 20: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Complex PTSD

Difficulties experienced by those who have history of chronic trauma

Avoid talking and thinking about trauma experience due to overwhelming nature

Alcohol and substance abuse to avoid and to numb feelings

Self mutilation and other forms of self harm

Suicide

Page 21: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Complex PTSD Cont’d

Additional issues:

Person repeatedly abused is often mistaken as someone who has a “weak character” when they don’t leave a perpetrator

Survivors of chronic trauma are often misdiagnosed as having Borderline, Dependent, or Masochistic personality disorder

Survivors who are faulted for the symptoms they experience as a result of victimization are unjustly blamed

A new diagnosis may prevent clinicians, the public and those who suffer from trauma from mistakenly blaming survivors for their symptoms

Page 22: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Healing and Recovery

Page 23: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

7 Things Trauma Victims Seek to Recover 1. Sense of Personal

competency

2. Personal autonomy (understand self and how to relate to the world)

3.Understand personal impact & how to integrate the objective experience and their subjective responses

4. Intimacy & Trust

5. Trust in self and capacity to build trusting relationships

6. Develop an understanding about the traumas impact on sense of connection with the world and others

7. Personal identity, personality, self-image

Page 24: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Values/Spirituality

The importance of the spiritual component cannot be “understated” when traumatic experiences occur.

Those who have some belief in a power greater than themselves

tend to develop an understanding of the event through “meaning” they assign.

Understanding and meaning are the first steps toward recovery and resilience.

Page 25: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

5 Major Aspects of Recovery and Resilience Trauma focused Cognitive Behavioral Therapy –

Treatment as needed

Four Central Dimensions of Recovery

Grief and Bereavement

Anniversaries

Memorials, Ceremonies and Rituals

Page 26: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Foci of Treatment

CRAFTS Cognitive problems Relationship problems Affective problems Family problems Traumatic behavior problems Somatic problems

(From Judith A Cohen, M.D., Medical Director, Center for Traumatic Stress in Children & Adolescents, Allegheny General Hospital, Pittsburgh, PA)

Page 27: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Four Central Dimensions of Recovery

Aspects of the Four Central Dimensions

Self Problem Others System

Internal External (The self that does the action) (The self is acted upon)

“Self” is based on:

Beliefs Fears Identity-Who I am in this

world Health Attitude-Positive or

Negative Knowledge-Self

Recognizes about world Meaning-Way self

interprets world

“Problem” The (what happened) or

the thing that the person must recover.

From the problem we derive:

A. Cause B. Effect C. Possible Solutions

“System” Primarily the Mental Health System:

Diagnosis Medications Facilities/Programs Professionals Disincentives

Other systems that affect recovery:

Educational Legal/Penal Human Services Larger Society

“Others” Significant people & events:

Family Peers Providers Larger Society

Page 28: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Grief and Bereavement

Grief: Process we go through in adjusting to loss of close relationship

Grief: inevitable companion to love and attachment

Death evokes realization of one’s own mortality & causes fear of death or conversely desire for death (Join a fallen comrade)

Page 29: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Grief and Bereavement Cont’d

Survivor guilt often exists Guilt due to fact they are still

living

Guilt for not saving the person

Guilt for not making the dying process easier for the person that died

Page 30: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Grief and Bereavement Cont’d Complications of bereavement

Prolonged grief or traumatic grief Onset or recurrence of Major Depressive disorder Onset or recurrence of Panic Attacks Increased vulnerability to PTSD Alcohol and other substance abuse Poor nutrition, low levels of exercise Suicidal ideation Onset or worsening of health problems

Page 31: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Anniversaries

Symptoms of anniversary reactions include: Re-experiencing symptoms of PTSD

Reactivate feelings, physiological responses and thoughts that occurred at the time of the event

Avoidance symptoms as in PTSD Avoid situations, places, or people that are connected to the

event Arousal symptoms as in PTSD

Nervous and on edge, unable to sleep or concentrate, increased irritability, and are more on guard

Page 32: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Memorials, Ceremonies and Rituals Ritual can be defined as an expressive, symbolic act that

creates a special time and space in which the participants experience themselves as a unique group

Rituals may be performed repetitively or once, public or private

Rituals may be sacred or secular, traditional or created A created ritual may be appropriate for a specific

individual or set of circumstances For example: At the Oklahoma City Bombing during the

ceremony all participants were given roses – there was a spontaneous act where many rescue workers threw their roses into the pit in honor of those killed on the site.

Page 33: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What is “Trauma Informed” All supports and interventions:

Are based on the knowledge that symptoms exhibited by survivors are directly related to the traumatic event.

These experiences are the cause of mental health, substance abuse and behavioral problems.

Must address survivor needs with an awareness of the link between trauma event and predictable human responses which are normal responses to abnormal life events.

Page 34: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Resource Listing

National Center for Post Traumatic Stress Disorder (NCPTSD) (www.ncptsd.va.gov)

National Child Traumatic Stress Network (NCTSN) (www.nctsn.org)

National Center for Trauma Informed Care (NCTIC) (www.mentalhealth.samhsa.gov/nctic/)

Sidran Institute (www.sidran.org)

Page 35: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What the Soldier Brings Home:

Combat Stress, Trauma & Readjustment

““No one comes No one comes back unchanged”back unchanged”

COL (Dr.) Tom Burke,Department of Defense,Director of Mental Health Policy

Edgardo Padin-Rivera, Ph.D.VA Medical CenterCleveland, Ohio

Page 36: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Life on the FrontLife on the Front

To understand what the soldier brings home, one needs to look at how the environment of war gets inside the mind.

Page 37: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Prolonged exposure to combat stress

• Soldiers are under constant stress over long period of time

• Are exposed to multiple types of terrorism and life threatening events.

• May witness or participate in multiple atrocities

• Develop a mindset of“act immediately, debate later”.

• Habituated to rigid, highly structured “military” concrete thinking.

• Being on constant alert, or“hyper-aroused” becomes a way of life.

Life on the Front:Life on the Front:How Combat Shapes Minds, Emotions, How Combat Shapes Minds, Emotions,

& Behaviors& Behaviors

Page 38: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

86% received artillery fire.

93% were shot at with small arms.

77% fired at the enemy.

95% saw dead bodies or remains.

89% were attacked or ambushed.

86% know a troop injured or killed.

65% saw dead or injured American.

69% saw injured women/children and were unable to help.

-- These numbers correspond in part to a study in the New England Journal of Medicine and pertain to service members in Iraq.

Life on the Front:How Combat Shapes Minds, Emotions,

& Behaviors

Page 39: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

In Iraq & Afghanistan, there is no true ‘safe zone’ or ‘rear’, there is a sense ofdanger in all areas and occupations all the time. The stresses and demandson cognitive and emotionalcapacities are many andalmost constant.

Life on the Front:How Combat Shapes Minds, Emotions,

& Behaviors

Page 40: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Exhaustion is constant. The soldier does not have energy or time to process events until after leaving the battlefield.

The violence is scary, but also exhilarating and immediately rewarding.

Many returning soldiers say combat wasthe most exciting and importantthing they have ever done. Many are bored when they come home.

Life on the Front:How Combat Shapes Minds, Emotions,

& Behaviors

Page 41: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Many face loss of comrades that can be emotionallydevastating. Nothing is moreimportant to a soldier than his warbrothers.

For many service members,a comrade’s death is an overwhelmingexperience, often leadingto prolonged unresolvedmourning and anger.

Life on the Front:How Combat Shapes Minds, Emotions,

& Behaviors

Page 42: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

The PTS Syndrome

• Intrusive thoughts/memories

• Nightmares

• Avoidance/isolation

• Anger/angry outbursts

• Hyper-startle response

• Flashbacks

• Hyper vigilance

• Feelings of grief, guilt, & loss…

What the Soldier Brings Home

Page 43: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

It’s not just about PTSDIt’s not just about PTSD

• Disillusionment with “civilian life” & activities.

– Challenging of one’s identity& core beliefs.

– Irritability & anger toward non-military. – Profound feeling of alienation

from others.– Social isolation.

• Memories of events that can bedifficult to integrate. • Self-blame or guilt for acts of war.

• Despair or hopelessness about future. • Physical health problems • Alcohol and drug abuse

What the Soldier Brings Home

Page 44: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Post-Combat Battlemind• Heightened sensory awareness of sights, sounds & smells. • Action oriented ways of coping with new experiences. • Identification and closeness with their military unit and

comrades who have shared similar experiences.• Regimentation into highly structured and efficient routines. • Profoundly realigned ideals, values & identity shaped by war.

• Habituation to intensity and extreme emotions of combat life.

What the Soldier Brings Home

Page 45: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Greatest need after traumaticexperiences is for activeengagement, affiliation, andcomfort available throughsupportive relationships.

Greatest (unrealized) fear of most returning soldiers is engagement, affiliation, and intimacy.

Coming Home: Life, Work, Learning

Page 46: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What They Say Are Problems (from Focus Groups)

● Wanting to be left alone - Social avoidance/isolation

● Sensitivity to loud noises and jumpiness – hyper-arousal

● Anger, lack of patience - irritability

● Chronic joint pain, generally ankle, knee and back pain

● Memory problems or "lapses“ - trouble concentrating

● Drinking or smoking too much Drinking or smoking too much

● Personality changes, emotionally distressed

● Body image issues: scars, weight changes, etc.

Coming Home: Life, Work, Learning

Page 47: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Coming Home: Life, Work, Learning

Obstacles to Restoring Previous Ties

• Homecoming feelings of joy and euphoria are short lived (Eventually not reinforcing).

• Attempts to restart old ways of interacting, old roles fail.

• Difficulties arise in trying to generate a “new normal” (rigidity, fears, isolative struggles get in the way).

• Civilian life at home may not have the edge and adrenaline and “life or death” purpose associated with wartime duty.

• Problems of internal chaos impinge on relationships.

Page 48: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Coming Home: Life, Work, Learning

Problems Reconnecting with Friends & Community

• Difficult for soldier to feel “at ease” with previous friends.

• Soldier may find self unable to share experiences with non-combat acquaintances.

Problems Reconnecting in Family

• Military is seeing highest divorcerate and domestic violenceincidents in 30 years.

• Stress, distrust, fear of intimacy, readjustment to new relationship.

Page 49: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Coming Home: Life, Work, Learning

Difficulties with Public Interactions

• Tension about the “politics” of war• Public has mixed views of the war.

• Awkwardness on both sides: • Public may not always know what to do or say.

• Veteran too often becomes a community media event.

• Veteran unsure who he/she can talk to.• Questions can arise about:

What will they want me to talk about? What can I talk about?How will they react to a story or event?

Page 50: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Coming Home: Life, Work, Learning

Learning Environment Problems Veteran learning capacity vs instructor expectations.– May not be able to focus on single subject for long periods of time.– Has difficulty with “vague” subject matter or mixed conclusions. Need for

concrete outcomes.– mTBI issues may create short term memory deficits

(difficulty with details, memorization, etc)

Page 51: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Coming Home: Life, Work, Learning

Learning Environment Problems

• Internal chaos (intrusive combat images and memories) may intrude on ability to concentrate, pay attention.

• Hyper-arousal (on guard), in crowds, among new persons, changing environments (new classroom each course), may create tension, irritability, anxiety.

• May feel others expect things he/she may not be able to do or meet.

• Other students may behave differently toward him/her.

• Social isolation leads to difficulty seeking help for studies, working with other students.

• Subject Matter or Presentation may arouse anger, irritation, isolating response (politics, history, social sciences are especially red flags).

Page 52: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Coming Home: Life, Work, Learning

The perception of positive community supportwhether or not it is used is one of the best known antidotes to chronic mental health problems after a traumatic event. So…

Page 53: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

If you see a returning service member this month, just say thank you.

Page 54: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Edgardo Padin-Rivera, Ph.D.

Chief, Psychology Services

Cleveland DVA Medical Center Cleveland, Ohio

Email: [email protected]

Phone: 440-526-3030 x6900

Contact Information

Page 55: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Roger P. Buck, Ph.D.

Director, Counseling Services

Hocking College

3301 Hocking Parkway

Nelsonville, OH 45764

Phone: 740 753-6133

[email protected]

Contact Information

Page 56: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Helping America’s Best, Brightest and Bravest get their degreeBy Dr. John Schupp- SERV National Director

Page 57: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

To create a Successful First year veteran program

First day they walk onto the campus- What works, What doesn’t.

How to impact retention What works, what doesn’t

How to make it self-sustaining Don’t cancel the program when the grant runs out

Page 58: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Guidance Counselors/High School experience

Decision to join the military Usually happens in 7-8th grade They do not fall into the College prep category Not exposed to College process

Grades tend to drop after the decide Classes won’t apply to the military Good enough to just pass

Focus is on their military life Preparing their family/friends for when the enlist

Page 59: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

The first day they walk onto the campus

Show/Tell them where to park E-mail them a map if possible

No uniforms- they don’t know who is in charge Campus is mass chaos compared to the military

Provide a personal walk through All the important areas (with a fellow vet if possible)

Veteran lounge (if you have one) Student Veteran Association/group official Certifying official Cashiers/Financial Aid Registrars

Page 60: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

The first day they walk onto the campus cont’d

Provide them what they need to know- Nothing frivolous

They don’t need to know all the other organizations on the 1st day

Introduce them to faculty/staff that are veterans Get this list ahead of time

They will make sure that they look out for the new student vet

Give them a list of what is needed from them Transcripts, placement exam dates, etc

They will follow these directions very closely

Page 61: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Veteran Orientation Try to have a group veteran orientation

Most student orientations are for 18yr olds Most veterans cannot tolerate them

Bring reps from the community to the event Dept of Veteran Affairs-

Health and Benefits if possible Local Vet Center Community Based Outpatient Clinics

County services Veteran Service Commission

Community Veteran Organizations AMVETS, VFW, Local Service Officers

Important people for filing claims

They will do this for free

Page 62: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Veteran Orientation cont’d

Certifying official Important to meet with them

This paperwork is of the utmost importance

Student Veteran Advisor Very important position

Someone adept at military transcripts and MOS Must understand time constraints of GI Bill

They cannot waste semesters on non-important classes

Page 63: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

The 1st day of class- the 1st semester Class selection very important

Try to group with other veterans for Gen Ed classes Place with veteran friendly professors Try to have all classes on 2 days/wk or 3 days/wk

Allows them to schedule VA appts on other off days Allows them to get a part-time job if needed

Show classroom locations before school starts Warn them of the cost of books

Book stipend won’t kick in until after 1st month

Page 64: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

The 1st day of class- the 1st semester cont’d Encourage tutors on first day of school

They won’t want to at first Sign of weakness

Try to find student veteran tutors

Warn them of the cost of living allowance delays

Won’t get first check until 6-8 weeks after 1st day

Page 65: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

1st semester- Their Class Experience- professor The Lecture

They are used to ‘briefing’ This is what you need to know, now go do it

It is difficult to determine what they need to know Many lectures are full of all kinds of information Professor does not tell them what they need to know

Up to the student to figure it out

The professor

Some do not agree with their decision to serve Daily subject matter may drift to volatile topics Many veterans are trained to diffuse conflicts

Some have a more difficult time than others If it gets to bad, try to have them change classes

Page 66: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

1st semester- Their Class Experience- students

Briefings 100% concentration Arrive 15 minutes early-

and prepared If late, do push-ups

Information given can be life and death

Absolutely no talking Questions afterward

Lecture Not 100% concentration Students arrive late

No push ups Students leave early Texting Talking Face-booking

All of this causes distractions to the student veteran

Page 67: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

1st semester- Their Class Experience- Classroom

Military Environment can cause harm 20-30 members in squad People/houses are checked

Weapons IED’s Insurgents

When room is ’cleaned’ Squad can occupy it safely Risk has been reduced

Classroom Room is not ‘cleaned’

Have to occupy it anyways Students are not ‘checked’

Backpacks can cause alarm

Environment not cleared Environment can cause harm

Focus is on the environment Not the lecture/assignment

Grades drop

Page 68: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Degree Completion Variables- Credits earned after 1st and 2nd year

Overall GPA after 1st and 2nd year

Summer credits

Full or Part Time

Page 69: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Graduation variables- Credits Earned/GPA

Earned 4yr degree 1st yr

20 or more Credits earned 2.75 GPA Univ 2.39 GPA Comm College

2nd yr- 58 or more credits earned 2.91 GPA

Attended-no degree 1st yr

Less than 20 credits Less than 2.50 Univ Less than 2.32 Comm College

2nd yr- 31.6 or more credits earned 2.13 GPA

Civilians- Full time needed (12/more credit hrs) 1st year

First year GPA is critical to graduation

Page 70: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

SERV Proprietary and Confidential

Avg Avg Avg Avg Students grade level Cr hrs GPA Students grade level Cr hrs GPA

2 senior 110 2.65 0 senior 110 N/A1 junior 90 2.55 3 junior 90 3.473 sophomore 64 2.84 8 sophomore 64 2.864 freshmen 32 2.48 12 freshmen 32 2.38

10 Total AVG 2.63 23 2.69

Retention/GPA data after cohort completion- student vets in

civilian classes

Page 71: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Veteran Variables- Courses Offered

Some Gen Eds are more difficult than others They have been out of high school for 4yrs or more English and Math are most difficult

Have not had math in awhile Proper english not spoken/written

Acronyms, commands etc.

Communications, Sociology, Psychology 1st semester They have been taught to communicate in many cultures Military is all about Psychology, Sociology Sign language is a good foreign language course

Page 72: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Credits earned/GPA’s veterans- Veteran Cohort classes 1st year

Youngstown State University- Fall 2009 Sociology-

17 students 3 cr hrs-3.33 GPA General Psychology-

21 students 3 cr. Hrs-2.70 GPA Communication-

5 students 3 cr. Hrs- 3.60 GPA Math. Elementary Algebraic models –

6 students1.14 GPA

26 total different students in these 4 classes

Page 73: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Summer Classes and decreasing drop out rate

One Summer term (4 credits) 54.8% Continue on to complete next full academic year

10 credits or more- 61.1% Continue on to complete next full academic year

Every summer term completed Increases graduation by 11.2%

Graduation variables- Summer courses

Page 74: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Veteran Variables- Summer classes Many veterans will take summer courses

65% take them on 3 univ campuses sampled They are on a tight schedule

It’s a mission to complete They continue their BAH

Are used to the monthly expense check They continue enrollment

Less chance for VA to mess it up

Summer courses Increase graduation chances

Page 75: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Graduation Variables-Full or Part Time Degree attainment after 6 years

Part Time students 14.9% obtained degrees or certificates

2.2% associates degrees 12.7% certificates 0% Bachelors degrees

73.4% were no longer enrolled after 6 years

Full time students 64.4% obtained degrees or certificates

8.3% associates 12.4% certificates 43.7% Bachelors degrees

28.2% were no longer enrolled after 6 years

Page 76: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Veteran Variables- Full/Part time Most Veterans will go full time

Latest data shows 82% are full time They get full time BAH

Like the monthly expense check Their time is limited

Only 36 months allowed- not credit dependent Need to finish in 4 each 9 month academic years

They want to finish and get on with their lives They feel that they are behind everyone else

Full time increases chances for graduation

Page 77: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What type of campuses are they at?

% at Univ

Total on Univ campus 6,964 61.1%

% at CC

Total on CC campus 4,432 38.9%

Total on OH campuses 11,396

SERV Proprietary and Confidential

Universities have 4yr of veteransCC’s only have 2yrs of veterans

Page 78: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Was there a shift to Univ’s?

  Fall 08% of total

Fall 09

% of total

Spring 2010

% of total

Universities 5,132 59.3% 6,708 60.6% 6,964 61.1%

Community Colleges 3,522 40.7% 4,356 39.4% 4,432 38.9%

Totals 8,654   11,064   11,396  

New GI Bill makes Universities more attractive than Community Colleges

Page 79: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What the trends show Universities are gaining enrollment

No longer limited by ~ $1,300/month Montgomery Older age group at Universities

Student veterans avg age ~24

Community Colleges are losing enrollment 1st version GI Bill makes the Univ’s more attractive

New GI Bill version 2.0 Allows for OJT/certificates-

May create an increased demand for CC’s

Page 80: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Other variables affecting enrollment Veteran dept/person Certifying official

Full time job, or other responsibilities

Veteran Lounge/center on campus Providing a gathering place for the veterans

Total student veteran population Is there a critical mass that is needed

Page 81: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Veterans Dept or Person?

University

  Department Person

% change 3.42% 5.14%

total 5,654 1,247

% of total 81.93% 18.07%

Comm College

  Department Person

% change 1.36% 4.28%

total 3,658 779

% of total 82.44% 17.56%

Page 82: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Other VariablesComm College

Location Of Veteran office Web Page

VariableStudent union Administration   yes no

% Change -2.49% 11.23%   1.19% 5.17%

% enrollment 65.40% 34.60%   82.58% 17.42%

Universities

Location Of Veteran office Web Page

VariableStudent union Administration   yes no

% Change 2.67% 5.41%   3.13% 7.56%

% enrollment 37.25% 62.75%   85.99% 14.01%

Page 83: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Certifying Official DutiesComm Colleges

Sole responsibility one of many

% Change 4.43% -6.34%

% enrollment 74.57% 25.43%

Universities

Sole responsibility one of many

% Change 6.90% -4.60%

% enrollment 74.57% 25.43%

Page 84: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Impact of a veteran lounge

Comm Colleges

yes no

% Change 3.90% 1.20%

% enrollment 25.24% 74.46%

Universities

yes no

% Change 5.60% 2.70%

% enrollment 36.75% 63.25%

Page 85: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Total campus veteran population

Universities

Over 400 Under 400

% Change 4.90% -2.86%

% enrollment 88.19% 11.81%

If the vet population is high enough, the veterans find each other, support each other and enrollment increases. This shows that Veteran Resource Centers are needed

Comm Colleges

over 300 under 300

% Change 2.7% 0.27%

% enrollment 66.58% 33.42%

Page 86: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Student Veteran organization

Universities

Yes No

% Change 5.10% 3.20%

% enrollment 30.52% 69.48%

Comm Colleges

Yes No

% Change -3.10% 2.70%

% enrollment 13.41% 86.59%

Page 87: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Dedicated Web Page Impact- 11,000 veterans total

  Have Don’t Have

  1.19% 5.17%

  82.58% 17.42%

• Community Colleges • Universities

  Have Don’t Have

  3.13% 7.56%

  85.99% 14.01%

Veterans will not make their decision based on a web site.

They did not decide to defend their country based on a website

Page 88: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

SERV Proprietary and Confidential

The Reality

2,142,719 Deployed since 9/11- as of June 2010 260,610 Currently Deployed

1,532,980 Active Duty, 609,739 Guard/Reserve The vast majority of them are already home!

CTS Deployment File June 10

Page 89: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

SERV Proprietary and Confidential

21,249

24,218

31,935

13,044

7,108

11,554

12,022

18,245184,721

25,568

65,497

37,748

17,243 28,482

25,557

18,453

12,071

11,562

5,531

33,360

23,914

29,209

20,89325,744

12,678

267,720

19,396

63,192

55,274

48,690

29,410

52,440

206,699

81,898

9,866

36,303

63,550

32,969

76,846

56,444

8,761

13,76439,940

4,622

83,027

15,772 26,413

10,725

5,325

Total Deployed by State- Active Duty +Guard/ Reserve since June 2010

CTS deployment File Jan 2010

Page 90: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

States with most Deployed

StateDeploye

d% of state population

1.Texas 267,720 0.99%

2.Florida 206,699 1.01%

3.California 184,721 0.46%

4.New York 83,027 0.39%

5.Pennsylvania 81,898 0.60%

6.Illinois 76,846 0.54%

7.Ohio 65,740 0.51%

8.Washington 65,497 0.90%

9. Tennessee 63,192 0.88%10. Michigan 59,985 0.54%

Texas, Florida and California

make up 31% of the total deployed

Page 91: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Total Deployed Branch Of Service-Nation

ARMY NAVYMARINE CORPS

AIR FORCECOAST GUARD

TOTAL ACTIVE DUTY

657,801 345,240 228,345 297,615 3,979 1,532,980

30.48% 16.43% 10.58% 13.95% 0.19% 71.63%

ARMY GUARD & RESERVE

NAVY RESERVE

MARINE CORPS

RESERVE

AIR GUARD & AIR

FORCE RESERVE

COAST GUARD

RESERVE

TOTAL RESERVE FORCES

416,578 38,861 39,725 113,687 888 609,739

19.31% 1.78% 1.91% 5.34% 0.03% 28.37%

Page 92: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What the data shows

If given the right environment Student veterans will succeed in greater numbers than

civilians Happened in 1948-1956, 78% graduation rate

“Right environment” Veteran only classes Veteran Resource Centers on campus Veteran professors Veteran Advocates

Page 93: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

What the campuses need Funding- start up costs

Centers of Excellence for Veterans Student Success (FIPSE act) Grant July 2010 16 campuses received $6M in grants Schupp needs your help for 2nd round of funding for 2011

Veteran Resource Center Act 2011 Schupp needs your help for this to be enacted/funded

1/3 $ from campus, 1/3 $ from community = matching federal $

Alternative methods of funding (non-govt, non grant) Start up costs can be covered Stay tuned for more details in future webinars Let Schupp/Innovative Educators know if this interests you

Page 94: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

Campus Responsibility

Once program is started-must be self-sustained Cannot cancel program due to grant money ending This is not your typical freshmen demographic

Once faith/trust is given by veterans to campus Campus must return the faith/trust

Cancelling successful program will cause major problems Veterans leave, and never come back Veterans feel misled, betrayed

Can cause re-enlistments, major Psychological challenges

Campus must have a sound business plan Tuition dollars from veteran enrollment can support program

Page 95: When Johnny Comes Marching Home Reintegration Problems and Concerns of Military Service Members Returning from Combat Presenters Dr. Edgardo Padin, Ph.D.

WE can make this generation The Next “Great Generation”

With Their Military Experience and Their College Degree

John Schupp [email protected] (440) 488 – 6416