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Gift From Within - PTSD Resources for Survivors and Caregivers
Post Traumatic Stress and the Military
The following is an excerpt from "Your Military Family Network," a new book by The Military Family Network (MFN). Their mission is to support military families and increase their readiness and well being by connecting them with their communities and the organizations that provide the best service and value. This chapter features an interview with Dr. Frank Ochberg, Founder of Gift From Within, plus many helpful resources.
The goal of this section is to provide an introduction to PTSD for both the individual and the family. It is our hope that the information lays the groundwork for further exploration into this subject matter.
"Post Traumatic Stress and the Military"
Voices from the Field
"I recovered from PTSD. I served in Vietnam. Now my son is deploying to Iraq. I am afraid it will all come back and when he comes back, I am scared it will be the same for him," said a middle aged Army nurse looking at some of the videotapes on PTSD produced by Gift from Within on display at a recent Military Family Network event.
She is not alone in her experience or her fears. In 2005, almost 216,000 veterans received PTSD benefit payments totally almost $4.3 billion dollars.
A 2006 Journal of the American Medical Association study shows that 9.8 percent of service members returning from Iraq have screened positive for PTSD symptoms and 11.9 percent were diagnosed with a mental disorder within the first year home. An additional 50,000 veterans from Iraq and Afghanistan are believed to be suffering from mental health problems - nearly half of them from Post Traumatic Stress Disorder, or PTSD.
When 22 soldiers killed themselves - accounting for nearly one in five of all Army non-combat deaths in 2005, Congress mandated a review of how the Department of Defense works to identify and treat members of the Armed Services suffering from PTSD.
PTSD as a Political issue
The United States is engaged actively in an ongoing war against terrorists. Although deployed to countries like Afghanistan and Iraq, territory or borders do not define the war. The tactics and strategies of the enemy are those of a new age- urban warfare where a-traditional, guerrilla attacks place service members on the frontline wherever they find themselves.
The majority of troops returns home and will not experience any long-term psychological concerns from their combat service.
However, the extended nature of the war has resulted in multiple redeployments and extensions for many military service members and their families. It is estimated by that nearly 20% of all returning veterans of this war will develop PTSD in their lifetime. Still more will experience a wider range of psychological affects from depression to anxiety concerns. Service members returning from war also experience higher rates of divorce, anger management and drug and alcohol issues.
The combat action faced by service members place them in constant and immediate danger of loss of limb and life. As the following chart demonstrates, almost all members of the Army know someone who has been seriously injured or killed in action.
Source: National Center for PTSD
Dr. Frank Ochberg has decades of experience with traumatic stress. He is a founding board member of the International Society for Traumatic Stress Studies, founder of Gift From Within, author of the Stockholm Syndrome and former Associate Director of the National Institute for health.
According to Dr. Ochberg, increasing the education, awareness and availability of treatment for service members experiencing combat stress should be one of the highest priorities of the Armed Services.
|If this doesn't come from military families, it's not going to get the attention it deserves. And military families are in a powerful political position. They're not powerful in raising concerns that aren't asked for within the military chain of command. But at the ballot box, and in writing articles, and in entering into the national conversation, it's terribly, terribly important. People listen to widows. People listen to the parents of military, who have sacrificed. So we are talking about something that is crucial, and it's relevant, and it's timely. We can do what we're attempting to do here, which is to de-stigmatize, and normalize, symptoms of PTSD. If you are having flashbacks, and you know it, and yet, you are you have a military career, and you want to keep that career, you don't talk about the flashbacks.|
|Front-line soldiers face extreme violence in Iraq. According to Department of Defense studies, more than 90 percent said they had been shot at. Nearly 20 percent said they saved someone's life. More than 80 percent of Marines said they saw injured women and children they had been unable to help.
Of those Iraq veterans surveyed who reported symptoms of mental distress, 40 percent of Army troops and 29 percent of Marines said they had sought professional help. The top reasons given for avoiding such help, from a multiple-choice list provided by the researchers, were, in order: "I would be seen as weak"; "My unit leadership might treat me differently"; "Members of my unit might have less confidence in me"; and "It would harm my career."
A terrible irony exists for these combat veterans experiencing distress. Reporting has an impact on their careers, but reporting ensures timely help at the earliest point of onset and supports a rapid therapeutic process. Self-reporting is also complicated by the veteran's perception of negative peer judgment, his own feelings of weakness for having distress and his internal struggle with guilt over leaving his unit to receive treatment.
Dr. Ochberg stresses that education is the key to removing the negative perceptions of PTSD:
|Once you've got it, it is a medical disorder, and it's best to consider it as such. Helps to get treatment for it. Helps to get information about it. Helps to have [ongoing] discussions so that family members can be up to speed and realize 'there but for the grace of God go I.' There's nothing morally wrong or physically wrong with the person who gets PTSD... and with a lot of adults who have served in uniform, branches of government, they manage to do their service, despite their feelings. All while they were on duty. But afterward, when you're safe, when you're in an entirely different environment, your body and your mind starts to react.|
|War changes a person. Service members train everyday to serve their country, to fight and win America's wars. Prolonged exposure to hazardous environments, daily exposure to violence and death has a deep affect.
Dr. Ochberg's life work speaks to helping people who have been exposed to trauma to heal. His message is one of hope and support to all service members and their families.
|"I want to thank our men and women in uniform for their service. That service carries risk. That risk is to the body and to the spirit. Some of the wounds to the spirit take the pattern of PTSD or depression. They can be treated and treatment is good, and hopeful. Post-traumatic stress, depression; even alcoholism and even family discord are all treatable conditions. Sometimes, some of us have gone through hell, and we're never going to be exactly the same. We've seen things that we'd rather not admit exist. So, we may not be 'the same' but not being the same is okay," he said.|
Frequently Asked Questions about PTSD With Dr. Frank Ochberg
Q. What is PTSD?
A. PTSD is three different things at once.
The first of those three things is "trauma memory". Trauma memory is different from usual memory. It comes back when you don't want it to come back. It can wake you up in the middle of the night. It can be very subtle, so you're not quite sure what it is until you realize, oh, my God, I'm having the feelings that I had when I was raped. That's what's going on. Or it can be very, very specific, like a hallucination. 'I'm smelling what I was smelling when I was raped...I hear his voice, I feel his hand on me'. When it is what I just said, so real, like a hallucination, you don't have any time sense. That's very important. You don't realize that it's in the past. And it feels like it's in the present. So it's called "Re-experiencing" rather than remembering.
One of the things that is most important in working with people, who have a "trauma memory" is to help them develop a time sense, so they are not scared out of their wits. And therapy is all about transforming a trauma memory into an autobiographical memory. You don't forget about it, but you know it's in the past.
The second cluster of symptoms is almost the opposite. It's feeling numb. It's like having emotional anesthesia. And you're really not the person you once were, and even though that emotional anesthesia may dampen down feelings of terror, they take away feelings of love, and hope, and connection. And there is a tendency of a person who feels numb is to avoid things. They avoid people, often people who might trigger the reminder of the traumatic event. They move into a shell and they're not the person that they once were. It's a very sad part of the disorder.
The last part of the disorder is being a nervous person. You're easily startled, you don't concentrate well, you don't sleep well, you're irritable. You can think of it as having a lot of adrenaline, although it doesn't necessarily mean you do, it means that your threshold for being made anxious has been lowered a lot. That's why, for a lot of people, PTSD is primarily an anxiety disorder, and they do well when they're treated with the medication that helps with anxiety.
Q. Is PTSD the same as depression?
A. Because of the second cluster, it feels like depression. It technically is not depression. There's nothing in a PTSD diagnosis that says that you are sad, hopeless, helpless, worthless, and if you are sad, hopeless, helpless, worthless, you have to call it both PTSD and depression.
For PTSD, there's a clear precipitating event, and when it happened, you felt very scared, or horrified, or helpless at the time. That's number one. Number two is you have all three clusters of symptoms and they're all happening within a period of a month. The last part of the diagnosis is that the symptoms have gone on for at least a month after you were traumatized. You don't call it PTSD if on the second day after you have symptoms.
Q. What is Acute Stress Disorder?
A. Acute Stress Disorder is used to identify the kind of people who are more likely to develop PTSD, based on their behavior, a few days after exposure. It's almost exactly the same as PTSD, except you look for a little more trance-like symptoms early on, and that's called, technically, dissociation.
When we are very, very shocked, traumatized, nervous, we go into a trance. If you think of the first meaning of shellshock, it is the image of the soldier on the battlefield, in a daze, corpses around, and the smell of gunpowder. There were battle scenes and people were thrown into an altered state of consciousness.
What's meant by Acute Stress Disorder is that you have a reaction right away, you're in a daze, and if that lasts for a while, there's more of a chance of it becoming PTSD. If it continues for over a month, you no longer call it Acute Stress Disorder, you call it Post Traumatic Stress Disorder.
Need to Know
Some service members report feeling upset or "keyed up" even after they return home. Some may continue to think about events that occurred in combat, sometimes even acting as if back in a combat situation. These are common "combat stress reactions" (also called acute stress reactions) that can last for days or weeks and are a normal reaction to combat experiences. When these reactions continue for over a month, the service member may be experiencing PTSD.
Below is a list of common reactions:
Some of Dr. Frank Ochberg's articles include:
The Iraq War Clinician Guide, 2nd Edition
The Unique Circumstances and Mental Health Impact of the Wars in Afghanistan and Iraq
Traumatic Grief: Symptomatology and Treatment for the Iraq War Veteran
Recommendations for Pharmacological Treatment of Acute Stress Reactions
"Treatment and Considerations for Post Traumatic Stress Disorder in Service Members"
"Ochberg's Counting Method Supporting the Healing of Traumatic Memory"
The Counting Method is a newly devised brief treatment approach to the desensitization of PTSD symptoms. Developed by Frank Ochberg, MD, the Counting Method provides a parsimonious way to help clients process their traumatic memories without provoking high levels of affect. By overcoming their avoidant responses, clients are able to process the entire memory and thereby reduce their fear response, as in other behavioral treatments for anxiety.
The core of the method consists of a Preparation Phase, the Counting Phase where the therapist counts out loud from 1 to 100 as the client remembers the traumatic event, followed by a Review Phase. Preliminary research as well as clinical experience indicates significant reductions in arousal to traumatic memories can often by achieved in only a few sessions. Dr. Ochberg explains how the counting method would work with a client:
|When a client is ready to try it, we set up a time. I'll have told them about the process. I count out loud, to a hundred; while I'm doing the counting they are letting themselves remember the traumatic event, without talking about it.
I'm sitting in my chair, they're sitting in theirs, and I can see them. By the time I'm counting to forty, fifty, there can be tears flowing, or their fists are all clenched up.
The instruction is to go through the whole event. I already pretty much know what they are going to be re-living. I tell them; when I'm counting in the forties and fifties, make sure that you're in the worst of it. And when I'm counting in the nineties, make sure you've reached a point in the memory where you're relatively safe. I time it very carefully. If I have an hour with the person, I do this in the beginning of the hour, so they have plenty of time to recover afterward.
Right after they're done with it, they usually come up as though they've come back from a trip to China. I give them time, sometimes they talk right away, sometimes I have to say,'Tell me what you just went through.' I have my yellow pad and I start writing down almost verbatim what they say. I try to get it all down.
Then, I go over it with them, and I read it back, and as I'm reading it back, I'll say things that are acknowledging, respecting them for what they have been through. I may say,' Well, it's not easy, and you remembered it all. That's good.' It puts me in memory. Because too often, people tell the trauma story in a mechanical way. They've told it to police officers, they've told it to another doctor, they're telling it, they're not really re-living it. This allows them to relive it in a safe environment- retelling it connected to their feelings.
For more information see
Article: Frank M. Ochberg, M.D. The Counting Method for Ameliorating Traumatic Memories
Article: David Read Johnson, Ph.D., and Hadar Lubin, M.D. The Counting Method as Exposure Therapy: Revisions and Case Examples
Dr. Ochberg on "Getting Treatment"
My goal is to make sure service members know that I respect them, for their service to my country, to our country. I respect them a lot. And as a doctor, who's gone to Johns Hopkins Medical school, I am sure that emotional wounds are as significant as physical wounds.
|As a country, as a species, as human beings, it's high time we paid the proper attention to emotional wounds, not be ashamed of them, or embarrassed by them, and when we need professional treatment, we get professional treatment.
And there are many doctors out there like me, who have a lot of respect for members of the Armed Forces, and have a lot of respect for PTSD. It's a powerful enemy, in a way. And the way to defeat PTSD is to bring it out into the light.
Frequently Asked Questions (FAQ) With Dr. Frank Ochberg
Q. How can I find a good therapist? A. A lot of people say 'trust your gut', I never say trust your gut, because I don't know if the person I'm talking to has the gut that they should trust. Some people don't have very good instincts to help themselves. Good therapists have good reputations. Good therapists usually have no problems telling you about their education, their own life story; you can interview your therapist.
A good therapist can make you feel comfortable and confident. And it's important to distinguish between-and this is hard to do-what the therapist is saying, or how they look, that makes you feel anxious, or awkward, and what you yourself are now beginning to bring up that makes you feel anxious or awkward.
A good therapist is going to lead you back through difficult experiences, and will try to lead you back in a way that you can tolerate it, grow from it, benefit from it, and you just feel it happening.
Need to Know: Treatment options for PTSD from the National Center for PTSD
Participating in treatment for PTSD can be challenging, as patients are invited to directly face memories and feelings that they may have avoided for many years. Patients are much more likely to succeed in treatment if the following pre-requisites are in place:
Although each patient's individualized treatment plan is unique, the following goals are often important aspects of therapy:
Components of treatment for PTSD
Most treatment programs involve a comprehensive approach, including several modalities:
Education for patient and family about PTSD
Help for Veterans with PTSD
War-Zone-Related Stress Reactions: What Veterans Need to Know
Resources for U.S. Service Members Returning from Deployment
Returning from the War Zone: A Guide for Military Personnel
When the Letdown Doesn't Let Up
How to Get Back to "Normal"
Beverly J. Anderson, Ph.D., B.C.E.T.S. Help for Officers returning from the war in Iraq.
DVD Living with PTSD: Lessons for Partners, Friends and Supporters
CD "Sage Advice for Trauma Survivors and Caregivers" with Dr. Frank Ochberg
This CD is sensitive, friendly, and informational. It was produced for trauma survivors, their loved ones, and friends. It is a conversation with Dr. Frank Ochberg, the Founder of Gift From Within and a leading expert in the mental health field since the 1960's, and Joyce Boaz, the Executive Director. The discussion is based on questions Joyce has received from trauma survivors, families, and the Gift from Within community. Topics include the description of PTSD for the lay person, types of events that cause PTSD, what should a sufferer of PTSD know about the disorder, post trauma issues, the role of the caregiver, work place issues, the trauma memory system versus the normal memory system, and much more.
Dr. Ochberg is a psychiatrist and former associate director of the National Institute of Mental Health. He is one of the team members who wrote the medical definition for Post Traumatic Stress Disorder and a recipient of a lifetime achievement award from the International Society for Traumatic Stress Studies. 58 minutes. $l5.00.
"Post Traumatic Stress Disorder and Military Families"
Interview with and research by Dr. Frank Ochberg.
Voices from the Field
My name is Stefanie Pelkey and I am a former Captain in the U.S. Army. This testimony is on behalf of my husband, CPT Michael Jon Pelkey, who died on November 5, 2004. Although he was a brave veteran of Operation Iraqi Freedom, he did not die in battle, at least not in Iraq. He died in a battle of his heart and mind. Michael passed away in our home at Ft. Sill, Oklahoma from a self-inflicted gunshot wound to the chest. I feel that my husband is a casualty of this war and to date the Army has not done enough for post-traumatic stress.
Stephanie Pelkey's Congressional Testimony, 2005
There are thousands of soldiers across the country coming home with minds tortured by what they've experienced in Iraq.
An Army study published in The New England Journal of Medicine found that approximately. 19.1% of soldiers and Marines who returned from Iraq met risk criteria for a mental health concern, compared with 11.3% for those deployed to Afghanistan and 8.5% for those sent to other locations. The Army's first study of the mental health of troops who fought in Iraq found that about one in eight reported symptoms of post-traumatic stress disorder.
The Walter Reed Army Institute of Research survey also showed that less than half of those with problems sought help, mostly out of fear of being stigmatized or hurting their careers.
How can couples prepare for the chance that a traumatic combat event may affect the well being of a returning loved one? What happens when dinnertime is quiet or your spouse explodes for no reason. It is a difficult situation. While most service members come home without significant concerns, the ones that do return home hurt need support from their loved ones and from trained professionals.
Dr. Frank Ochberg suggests that sometimes the service member is not ready to see a professional, but recommends that the spouse can reach out and start the process:
|It's usually the wife who wants help and the husband who doesn't. And the husband is either embarrassed or he feels he can't control his temper...and he doesn't want to get himself triggered. Because he knows that's going to make it a whole lot worse. Sometimes what I do is more like shuttle diplomacy. I try to get the guy involved, just seeing me. It usually works out pretty well, 'cause a lot of these guys will say, "I've got an anger management problem." And then you can work on it with them.|
|However, less than fifty percent of affected veterans seek help for trauma related distress. Unfortunately, the primary key to the success of a therapeutic option is the acceptance and willingness of the victim to seek help. If the service member is not ready to reach out, the spouse reaching out for professional support is the best place to start to help build coping mechanisms and a tool box to sustain the family through the time of adjustment.
Frequently Asked Questions (FAQ) With Dr. Frank Ochberg
Q. What happens if my spouse acts out in front of the children? How do I talk to them about PTSD?
A. It may depend on Daddy and on the way it's being manifest. If it's that Daddy is hitting the bottle and behaving in a destructive way, then it could be pretty firm, 'That's your Dad, that's my husband, he did something wrong. Now, we respect him, but we've got to figure out how we're going to help him and it's not going to be easy'.
Q. Should I talk with my husband about what to say to the kids?
A. Yes. If you're the wife, say, 'Charlie, let's face it, you've got PTSD, like a million other people. Now, are you okay with me telling the kids about this? We want to learn about it'. And if Charlie says, "Hell, yes, I'd like you to know', no problem. If Charlie says 'Well, I don't think they're ready for it', that's a different conversation.
If Charlie says, 'No, this is private, I don't want anyone knowing', that's another condition. If you can get it to the point where that it's okay to tell the kids, and to tell family, that is good. My message to the family member or the friend is, you want to be the smartest person on your block about PTSD. You've got PTSD that's affecting someone you love. You get a crash course; you get yourself up to speed.
Q. What should I do if my spouse is having a flashback or night terror, sometimes it scares me a lot to hear my spouse or see him.
A. Fear is a fundamental and helpful human emotion. If you are afraid, do what you need to do to protect yourself. Ask him, when he's not having a flashback, what he would like you to do. Some guys might say, oh, get out of there. Some of them might say, 'Pinch me.' Some might say, 'If you touch me, you'll make it worse.' Some common-sense things that if you think that this perhaps is entering a flashback or a nightmare, do what you can to wake him up, bring him back.
Additional FAQ from the National Center for PTSD
Q. What are the typical patterns of how children respond to a parent with PTSD?
A. Researchers have observed a direct relationship between each of the parent's PTSD symptoms and the children's responses. Researchers also have noticed patterns in the ways children respond to the parent's overall presentation of PTSD. Harkness (1991) described three typical ways these children respond: (1) the over-identified child: the child experiences secondary traumatization and comes to experience many of the symptoms the parent with PTSD is having; (2) the rescuer: the child takes on parental roles and responsibilities to compensate for the parent's difficulties; and (3) the emotionally uninvolved child: this child receives little emotional support, which results in problems at school, depression and anxiety, and relational problems later in life.
These theories certainly do not represent every possible reaction children may have to parents with combat-related PTSD, but they offer some useful ways of understanding how symptoms might develop for these children.
Q. What are the common problems children of veterans with PTSD face?
Social & behavioral problems
Research has shown that there is significantly more violence in families of Vietnam veterans with PTSD than in families of veterans without PTSD, including increased violent behavior of the child. Several studies have examined the effect that fathers' combat-related PTSD and violent behaviors have on their children. Results have generally revealed that children of veterans with PTSD are at higher risk for behavioral, academic, and interpersonal problems. Their parents tend to view them as more depressed, anxious, aggressive, hyperactive, and delinquent compared to children of non-combat Vietnam era veterans (who do not have PTSD). In addition, the children are perceived as having difficulty establishing and maintaining friendships. Chaotic family experiences can make it difficult to establish positive attachments to parents, which can make it difficult for children to create healthy relationships outside the family too. There is also research showing that children may have particular behavioral disturbances if their parent veteran participated in abusive violence (i.e., atrocities) during combat service.
Emotional problems and secondary traumatization
Results have also shown that children of veterans with PTSD are at higher risk for being depressed and anxious than non-combat Vietnam era veteran's children. Children may start to experience the parent's PTSD symptoms (e.g., start having nightmares about the parent's trauma) or have PTSD symptoms related to witnessing their parent's symptoms (e.g., having difficulty concentrating at school because they're thinking about the parent's difficulties). Some researchers describe the impact that parents' PTSD symptoms have on a child as secondary traumatization. However, because of the increased likelihood that violence occurs in the home of a veteran with PTSD, it is also possible that children develop PTSD symptoms of their own. Having a seemingly unsupportive parent can compound these symptoms.
Q. Can children get PTSD from their parents?
A. It is possible for children to display symptoms of PTSD because they are upset by their parent's symptoms (secondary traumatization). Some researchers have also investigated the notion that trauma and the symptoms associated with it can be passed from one generation to the next. Researchers describe this phenomenon as intergenerational transmission of trauma. Much research has been conducted with victims of the Holocaust and their families (see Kellerman7 for review), and some studies have expanded on these ideas to include families of combat veterans with PTSD.
Ancharoff, Munroe, and Fisher described several ways to understand the mechanisms of intergenerational transmission of trauma. These mechanisms are silence, overdisclosure, identification, and reenactment. When a family silences a child, or teaches him/her to avoid discussions of events, situations, thoughts, or emotions, the child's anxiety tends to increase. He or she may start to worry about provoking the parent's symptoms. Without understanding the reasons for their parent's symptoms, children may create their own ideas about what the parent experienced, which can be even more horrifying than what actually occurred. Overdisclosure can be just as problematic. When children are exposed to graphic details about their parent's traumatic experiences, they can start to experience their own set of PTSD symptoms in response to the horrific images generated. Similarly, children who live with a traumatized parent may start to identify with the parent such that they begin to share in his or her symptoms as a way to connect with the parent. Children may also be pulled to reenact some aspect of the traumatic experience because the traumatized parent has difficulty separating past experiences from present.
Q. What should I do if I feel my or my partner's PTSD is affecting my children?
A. Preventive interventions can be helpful and include explaining to family members the possible impact of intergenerational transmission of trauma, before it happens. Education about the potential impact on children can also be a useful reactive response, when a child is already being affected by his or her parent's trauma history.
An excellent first step in helping children cope with a parent's PTSD is to explain the reasons for the traumatized parent's difficulties, without burdening the child with graphic details. It is important to help children see that the symptoms are not related to them; children need to know they are not to blame. How much a parent says should be influenced by the child's age and maturity level. Some parents may prefer to have help with what they say to their children, and seeking assistance through therapy or written materials can be helpful. The National Center for PTSD's fact sheet below on "Children and Disasters" can help parents talk to children about trauma. This fact sheet also describes how children may react differently, depending on the child's age.
Need to Know
1. Jordan, B. K., Marmar, C. B., Fairbank, J. A., Schlenger, W. E., Kulka, R. A., Hough, R. L., et al. (1992). Problems in families of male Vietnam veterans with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 60, 916-926.
2. Cosgrove, L., Brady, M. E., & Peck, P. (1995). PTSD and the family: Secondary traumatization. In D. K. Rhoades, M. R. Leaveck, & J. C. Hudson (Eds.), The legacy of Vietnam veterans and their families: Survivors of war: catalysts for change (pp. 38-49). Washington: Agent Orange Class Assistance Program.
3. Harkness, L. (1993). Transgenerational transmission of war-related trauma. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 635-643). New York: Plenum Press.
4. Parsons, J., Kehle, T. J., & Owen, S. V. (1990). Incidence of behavior problems among children of Vietnam War veterans. School Psychology International, 11, 253-259.
5. Rosenheck, R., & Fontana, A. (1998). Transgenerational effects of abusive violence on the children of Vietnam combat veterans. Journal of Traumatic Stress, 11, 731-742.
6. Dansby, V. S., & Marinelli, R. P. (1999). Adolescent children of Vietnam combat veteran fathers: A population at risk. Journal of Adolescence, 22, 329-340.
7. Kellerman, N. (2001). Psychopathology in children of Holocaust survivors: A review of the research literature. Israel Journal of Psychiatry and Related Sciences, 38, 36-46.
8. Ancharoff, M. R., Munroe, J. F., & Fisher, L. M. (1998). The legacy of combat trauma: Clinical implications of intergenerational transmission. In Y. Danieli (Ed.), International handbook of multigenerational legacies of trauma (pp. 257-275). New York: Plenum Press.
9. Harkness, L. (1991). The effect of combat-related PTSD on children. National Center for PTSD Clinical Quarterly, 2(1).
Gateway to PTSD Information
Guide for Families from the National Center for PTSD
Down Range: To Iraq and Back (2005).
Courage After Fire: Coping Strategies for Troops Returning from Iraq and Afghanistan and Their Families (2006).
National Center for PTSD
S.A.F.E. Program, Support And Family Education: Mental Health Facts for Families. An 18 session curriculum for people who care about someone who has a mental illness or PTSD. Entire curriculum is available for free download on website. http://w3.ouhsc.edu/Safeprogram/ Courage to Care (Uniformed Services University of the Health Sciences)
Mental Health Self-Assessment Program (DOD sponsored anonymous mental health / alcohol screening and referral program offered to families and service members affected by deployment or mobilization - available online 24/7)
Resources for Working with Military Personnel and Their Families (Ken Pope's website)
VA's Seamless Transition Office
My HealtheVet: The Gateway to Veteran Health and Wellness
Operation: Military Kids
DOD's Military Student Program: The Military Child in Transition and Deployment
Guard Family Youth Website
Operation Healthy Reunions (part of the National Mental Health Association)
PTSD and the Family
Reintegration Fact Sheet for Providers
Talking to Children About Going to War
Parent's Guide for Talking to their Children About War
The Emotional Cycle of Deployment: A Military Family Perspective
Homecoming Preparedness for Veterans and Families: A Self-Help Guide to Ease the Transition from Deployment and the Military to Civilian Life
Becoming a Couple Again: How to Create a Shared Sense of Purpose after Deployment
Being a Couple Again
A Soldier and Family Guide to Redeploying
Coping When a Family Member Has Been Called to War
Helping Children Cope During Deployment
Deployment Guide For Families of Deploying Soldiers. Separation and Reunion Handbook
Returning from the War Zone: A Guide for Families
Welcome Home: How to make a difference in the lives of returning war zone veterans (includes Dr. James Munroe's "Eight Battlefield Skills that Make Life in the Civilian World Challenging")
Helping Children and Youth Cope with the Deployment of a Parent in the Military Reserves (has information for parents, teachers, pediatricians, etc)
Getting Home: All the Way Home
Toolkit from the S.A.F.E. Program
What We'd Like our Family Members and Friends To Know about Living with PTSD
Family Concerns and the PTSD veteran abstracted from the National Center for PTSD
Difficulty managing family roles and responsibilities
Click here to purchase a copy of "Your Military Family Network."
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Please be aware that the materials on this website are intended for educational purposes.
I am very proud of the work he has done in this case. I am hoping that this case will bring forth a nationwide conversation about the women and men in this country who have been abused behind closed doors.
Respectfully, Joyce Boaz, Director.
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