Caregiver Mini Series: 444 Days in the First Year (Series Finale)

“…to this day I still cringe when someone refers to me as a widow.”

The first few days following my husband passing are still very much a blur.  I can remember the flight home, the loneliness that consumed me, and the reality that slowly began to sink in.  I was used to not having my service member home, however knowing I would never hear his voice, feel his touch, or have him hold me was almost too much for my mind to comprehend.

There was so much to do, and I was extremely overwhelmed.  I had plenty of friends and family around me but I still felt very alone.  There was so much to do and I was not quite sure where to start.  My mind raced. My heart pounded.  With every new thought I was once again reminded that I was alone.

No one could have prepared me for the transitional process, or the journey I was about to embark on.  I felt separated from those around me.  I was no longer part of the “active duty” family that I had known for so long, yet I did not quiet feel as though I fit in with the civilian world either.  I felt like an imposter in many ways, simply because I didn’t know what to feel or where I fit in.

My military friends were beginning to welcome their service member’s home, and I was in the beginning processes of “clearing housing.”  I didn’t want to be treated differently and to this day I still cringe when someone refers to me as a “widow.”  My entire world and everything in it was different.

Things moved so quickly that there was no time for me to even process what was going on around me.  Before I knew it, I was packing up our household goods and placing our entire life in boxes.  I was once again saying goodbye to something that I could never get back.  The last home Steve and I shared together would soon be occupied by another family trying to make their way in the uncertain world of the military life–I was to begin mine alone without him.

Grieving for what is Lost

For the military spouse, packing up and moving regularly is part of the military culture. However for a military spouse whose service member has passed away, the familiarity of packing up household goods, and clearing quarters quickly becomes unfamiliar territory.

Typically speaking, when a loved one passes away we are able to choose a little more freely the rate at which we will go through the grieving process.  We are able to reminisce with friends and family as we rummage through our memories, shared experiences, and material belongings or we have the ability to say, “I don’t feel up to this right now.”

When a Service Member passes away however, the entire process seems to be expedited.  Quickly quarters are to be cleared, a new home must be found, and papers must be signed. I remember feeling angry. I felt robbed of the ability to have any time to process what was going on around me, and it was the one time I wanted someone to understand and realize what it was they were asking me to do…I was a widow.

The transitional process that a military family will go through after their service member passes is different in many aspects than that of a civilian. Getting “stuck” in the grieving process is highly possible, especially for those families who never have the opportunity such as I, to be with their loved one during their final hours.

I am so grateful for the many wonderful people who were there during my time of darkness, and there are no words to describe the gratitude I have for those individuals. I realize I am blessed in many ways to have had the opportunities that I did, however I feel as though the need to take a closer look at the transitional process for the wounded family is real. I find myself wondering how many other spouses, children, mothers, fathers, and family members feel as though their ability to grieve has been stunted, or as if they are stuck within the process simply because of the expedited nature.

Missed the beginning of the series? Go to ‘The Phone Call’ to read the first installment of this caregiver series.


Tabitha_FamilyMeet Tabitha…

The caregiving mini-series, 444 Days in the First Year, was written by Tabitha McCoy. Tabitha is a contributor to the MFLN–Military Caregiving concentration team and is a former military caregiver to her husband, SGT Steve McCoy. In this mini-series, Tabitha shares her personal story of caregiving, loss, grieving, and transitioning, as well as insight and advice for both professionals and family caregivers as she recounts the 444 days following her husband’s injuries and then unfortunately his death in June 2008.

Tabitha holds a Bachelor of Science in Psychology, and is currently a graduate student at Valdosta State University where she is pursuing her Master’s degree in Marriage and Family Therapy.

This post was published on the Military Families Learning Network blog on August 29, 2014.

Intimate Partner Violence and Co-Occurring Conditions

Jay Morse and Heidi Radunovich, PhD

Last July and August, we published several blogs about domestic violence. During that month we highlighted definitions of domestic violence, pervasiveness, warning signs, how to differentiate between different types of violence, and work with different types of family violence.

In today’s blog we review Tinney and Gerlock’s (2014) recent article on distinguishing between Intimate Partner Violence (IPV) and violent behaviors associated with mental health issues. The researchers highlight a common combat-related mental health conditions including: post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), substance use disorder (SUD), suicide, and depression.

The researchers make two important distinctions when considering the interaction between IPV and other conditions: First, domestic violence can be present in many forms including coercive violence or resistive violence for instance; and second, the context of the violence (why is it occurring, and what is the impact on the victim) should be considered when making treatment recommendations. Sometimes there are co-occurring conditions, meaning that there could be IPV in addition to a mental health issue. At times it might be difficult to distinguish between what is a mental health-related issue and what is IPV.

According to the authors, “IPV occurs when there has been an act of physical or sexual violence in an intimate relationship and the range of offender behaviors continually remind victims that violence is always a possibility” [1].Tactics might include: intimidation, coercion, threats or other forms of emotional abuse. To distinguish between tactics associated with IPV, and symptoms of co-occurring disorders, the specific symptoms of the specific disorder (e.g., PTSD, TBI, or others) should be considered in relation to the tactics used in IPV (see table below).

It is important to note that these conditions do not occur only within the military, but also occur within the civilian population. In their review, the authors discuss other research studies that relate PTSD to IPV, however, any form of IPV involving military members can occur whether co-occurring conditions such as PTSD are present or not. For instance, a service member returning from combat or a civilian with a trauma history may experience PTSD symptoms including experiencing distressing events or nightmares. It can be difficult to determine whether violent acts associated with a disorder are related to IPV, or simply reflect symptoms of the disorder. Without considering the context, motivation, and possible other symptoms related to the act, the behavior may be indistinguishable. However, the authors note that all violent acts are dangerous, and potentially lethal, so regardless of the cause it is important for family members to have plans for safety in place.

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The Department of Defense offers a wide range of support programs for victims and survivors of domestic abuse through their Family Advocacy Program. The Military Families Learning Network is available to serve military family service professionals.

Information on IPV assessment and tools are available from the Centers for Disease Control and Prevention’s Measuring Intimate Partner Violence Victimization and Perpetration: A Compendium of Assessment Tools [2].

Resources:

1. Tinney, G., & Gerlock, A. A. (2014). Intimate partner violence, military personnel, veterans, and their families. Family Court Review, 52(3), 400-416. doi: 10.1111/fcre.12100

2. Thompson, M. P., Basile, K. C., Hertz, M. F. & Sitterle, D. (2006). Measuring intimate partner violence victimization and perpertration: A compendium of assessment tools. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved from http://www.cdc.gov/ncipc/pub-res/IPV_Compendium.pdf

This post was written by Jay Morse & Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on Twitter, You Tube, and on LinkedIn.

 

 

 

 

 

 

 

 

Parentification in Military Families

Jay Morse & Heidi Radunovich, PhD

In a recent research article, Hooper, Moore & Smith, (2014) provide a review of the research literature on parentification in the context of military family systems and military culture. Parentification is not unique to military families, but may occur in any family where there is a role reversal between the parent and the child.

What is parentification?

The authors define parentification as the disturbance or lack of appropriate boundaries between family subsystems, resulting in functional or emotional role reversal between parents and children in the family [1]. Recently, the term parentification has been used more widely in the military family literature.

Why this is important:

  • An increasing number of individuals on active duty are supporting families with children.
  • Clinical practice should be informed by the military culture – military families face atypical stressors, such as frequent deployments.

Functional vs. Emotional Parentification

The authors distinguish between two forms of parentification: functional and emotional. Examples of functional parentification would be a child taking on additional household tasks and performing specific functions that the deployed parent might have taken care of previously, such as taking out the trash or babysitting. However, emotional parentification refers to the remaining parent using the child inappropriately for emotional support, which leads to increased emotional burden for the child. While it might be necessary and okay for children to help out in the household, and provide functional support, it is inappropriate and damaging for children to provide emotional support to their parents.

The researchers in this article state that far-reaching effects of parentified children can include poor academic performance, an inability to form positive relationships, and feeling overburdened and overwhelmed. Systematic evaluation should be used to identify the extent of parentification. While a good clinical interview should be able to help clinicians determine whether parentification is occurring, some additional tools are available:

The researchers emphasize that clinicians should consider a strength-based approach to treatment, because the child or adolescent may have experienced parentification as positive. Intervention and treatment strategies should be informed by the context and role adopted during the parentification process, according to the authors.

Resources:

[1] Hooper, L. M., Moore, H. M., & Smith, A. K. (2014). Parentification in military families: Overlapping constructs and theoretical explorations in family, clinical, and military psychology. Children and Youth Services Review, 39, 123-134. doi: 10.1016/j.childyouth.2014.02.0030190-7409.

[2] Hooper, L. M. (2009). Parentification Inventory. (Available from L. M. Hooper, Department of Educational Studies in Psychology, Research Methodology, and Counseling. The University of Alabama, Tuscaloosa, AL 35487).

[3] Jurkovic, G. J. & Thirkield, A. (1998). Parentification Questionaire (Available from G. J. Jurkovic, Department of Psychology, Georgia State University, University Plaza, Atlanta, GA 30303).

This post was written by Jay Morse & Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on Twitter, You Tube, and on LinkedIn.

Military Caregiving Educational Course NOW Available!

Caregiver CourseNew military caregiving online course entitled, The Unique Challenges of Military Caregivers, is now available. The course was created under the Texas A&M AgriLife Extension Service – Wounded Warrior Program and provides insight into the life of military caregivers and identifies the many challenges they may face. Emphasis is placed on possible resources and supports that professionals can reference or share when working with military caregivers and families.

To view the course, go to The Unique Challenges of Military Caregivers.

Course Background

Spouses, partners, parents and others become a caregiver of military personnel when they learn their loved one is wounded while serving. These hidden heroes are at the bedside of their service members and with them until they learn to live a “new normal.” Military caregivers focus on their wounded warriors often at the determent of their own health and well-being. Being a military caregiver isn’t easy as they advocate for their warrior, provide medical care and deal with the uncertainty of their future. They do this while also continuing as a parent, employee, spouse or other life roles.

Professionals often don’t recognize the essential role military caregiver’s play in the service member’s healing process. The caregiver provides information to medical staff or other professionals when the wounded warrior can’t remember or doesn’t want to accept the reality of their situation. Since they are a critical part of the service member’s care team, professionals need to understand the trials and tribulations military caregivers face daily.

Upon completion of the course, professionals should be able to recognize a variety of caregiver challenges and identify resources and support services to address each challenge. *The course may take approximately 45-60 minutes to complete.


The Unique Challenges of Military Caregivers course was created by Texas A&M AgriLife Extension Service – Wounded Warrior Program. Course content was developed by Mary Brintnall-Peterson, Ph.D., owner of MBP Consulting, LLC and Professor Emeritus, University of Wisconsin-Extension.

This article was originally published Tuesday, August 19, 2014 on the Military Families Learning Network blog, a part of eXtension.

Passwords and online safety

passwordimage

In early August, the New York Times reported that Russian hackers had “amassed the largest known collection of stolen Internet credentials, including 1.2 billion username and password combinations and more than 500 million email addresses” This report is but the latest in a string of news stories about the credentials of Internet users being compromised. In the past year, there have been many data breaches including Target, Adobe, Michaels and others.

Typically, when a single site is breached, the advice is to change your credentials for that one site, and any others where you use the same credentials. However, in this instance the stolen passwords and usernames were from many websites, and a detailed list of the affected sites is not available.

This incident and similar ones should be the impetus for you to consider how you secure your identity when using websites for communication, banking, purchasing, social networking, and all the activities we do online. Good security requires sacrificing a bit of convenience, but the peace of mind is worth it.

Password Security
 – your responsibility

Most sites require you to login with a username (often an email address) and a password. Since your email address is most likely public, your password is the “secret” that you are using to prove to the website that you are who you say you are. Creating a good password and keeping it secret are vital to online security.

This article about passwords, from the Network Literacy area of the eXtension site provides information on password usage, choosing a good password, remembering passwords, and two-factor authentication.

Some key takeaways

  • Passwords should be long, complex, and different for each site you use
  • Keeping track of passwords is a key barrier to people adopting a strong password policy for themselves
  • Two-factor authentication adds another component to security, making the compromise of a password less harmful

The World Wide Web was originally developed without much thought given to security – it was a model built on trust. Incidents like this make clear that security is necessary, and that each of us is responsible for protecting our identities and credentials.

Authors: Stephen Judd (@sjudd) and Terrence Wolfork (+Terrence Wolfork, @trwolfork )

This article (Passwords and online safety) was originally published Thursday August 14, 2014 on the Military Families Learning Network blog, a part of eXtension.

Creative Commons License This work is licensed under a Creative Commons Attribution 3.0 Unported License.

Resource Discovery: NCTIC’s Manual on Trauma-Informed Care

By Jay Morse & Kacy Mixon, PhD, LMFT

As we’ve highlighted in previous posts, trauma can have adverse effects on the developing brain and can permeate many aspects of personal, work and school life. We’ve also discussed how military personnel and their families are particularly vulnerable to this issue in previous posts. The impact of trauma has also been found to have devastating effects on communities and organizations leading to an increased interest in trauma-informed care [1].

Today’s Resource Discovery features information provided by SAMHSA’s National Center for Trauma-Informed Care (NCTIC) and the Center for Mental Health Services (CMHS). This 2012 manual introduces readers to trauma-informed care by outlining the history, key principles and NCTIC’s role in shaping this treatment approach. Trauma-informed care was first defined and developed by Maxine Harris and Roger Fallot [2]. Developers of this treatment approach believe that everyone can benefit from learning about trauma [1].

Did You Know?

The trauma-informed services movement has its roots in early research on survivors of captivity and war during the 1960’s and 70’s. During the 1080’s, Post Traumatic Stress Disorder (PTSD) diagnosis and treatment were pioneered and the Victims of Crime Act was passed by Congress.  Also in the 1990’s, the Adverse Childhood Experience study documented the prevalence and impact of childhood trauma. During the last two decades, neurological research has documented pathways through which trauma affects the brain, SAMHSA established centers on trauma-specific issues (e.g. child trauma, community disasters) , and national professional associations and media have increased their focus on trauma. [2]

Since their founding in 2005, NCTIC has worked within a wide range of service systems including health and behavioral health, military, justice, housing and homelessness, education and child welfare, women’s services, developmental disabilities, and various advocacy and governmental agencies to help prepare professionals who work with individuals and families affected by trauma.  More detailed information on NCTIC activities, consultants, and products can be found at this webpage.

Professionals working with military families can find this manual especially helpful for providing key principles of trauma-informed care as well as a brief summary of the history of trauma-informed services and key facts about trauma. Below we’ve listed more information on our previous blogs and webinars on trauma.

Webinar:
Blogs: 

Resources:

1. National Center for Trauma-Informed Care (2012). SAMHSA’s National Center for Trauma-Informed Care: changing communities, changing lives. VA: Author.

2. Harris, M. & Fallot, R. (2001) Using Trauma Theory to Design Service Systems, New Directions for Mental Health Services, 89 Spring.

This post was written by Jay Morse and Kacy Mixon, PhD, LMFT. Both are members of the MFLN Family Development (FD) that aims to support the development of professionals working with military families.  Find out more about the Military Families Learning Network  FD concentration on our website, on Facebook, Twitter, and LinkedIn.

 

 

 

 

 

 

AUGUST CAREGIVING WEBINAR: Compassion Fatigue

cover_fatigueMark your calendars for Wednesday, August 20th at 11:00 a.m. EDT as we host our FREE monthly professional development webinar entitled, Caregiver Compassion Fatigue, presented by Brian Bride, Ph.D.

*No registration is required; simply go to https://learn.extension.org/events/1604 the day of the event to join. All interested participants are encouraged to attend. 1.0 National Association of Social Workers (NASW) continuing education credit is available for credentialed participants (pending approval from NASW).

Webinar Background

The negative impact of traumatic events can extend beyond those who directly experienced the trauma to family members and professionals who support the traumatized individual. As such, military caregivers are at risk for a phenomenon called compassion fatigue or secondary traumatic stress.

Compassion fatigue may lead to impairment in social and occupational functioning for many military caregivers. During the webinar, Dr. Bride will introduce participants to the concept of compassion fatigue, describe its symptoms, and discuss strategies to minimize the negative impact of compassion fatigue.

How to Join the Webinar

To connect to this webinar, go to Caregiver Compassion Fatigue the day of the event. Remember, no registration is required to join.

The webinar is hosted by the Department of Defense so you must install security certificates if you are not located on a military installation. Instructions for certificate installation can be found by clicking on DCO Adobe Certificate Installation.

For those who cannot connect to the Adobe site, an alternative viewing of this presentation will be running on Ustream. You can connect to the Adobe webinars using iPhone, iPad, and Droid apps. Search for DCO Connect in the respective stores.


This post was published on the Military Families Learning Network blog on August 8, 2014. 

The Value of Research for Financial Professionals

By Molly C. Herndon

Social Media Strategist 

For financial professionals working with clients in the field, economic research may seem abstract and non-applicable to their daily practice. Our August 12 webinar, Cliffs Notes from the Journal of Financial Planning & Counseling will highlight some of the more relevant articles from the journal and discuss the practical implications and impacts of the research.

Reading by Pedro Ribeiro Simões is licensed Creative Commons. https://creativecommons.org/licenses/by/2.0/legalcode
Reading by Pedro Ribeiro Simões is licensed Creative Commons.

Indeed, measuring outcomes is a significant way we all benefit from academic economic research. The evaluation of the outcomes of projects, programs, and initiatives encourages the improvement of programs to better reach and connect with their audiences. Thus, financial professionals have better access to programs to continue their own education, and a richer well of knowledge to share with clients.

Of course, financial professionals benefit from consuming research as well. By reading journals, financial professionals stay on top of current practices, trends, and can help develop programs that meet the needs of their clients by incorporating empirical evidence.

So make plans to go through some research briefs with Dr. Barbara O’Neill on Tuesday, August 12 at 11 a.m. ET. She will discuss not only the findings of various economic studies, but also the practical application of these findings. More information about this 90-minute webinar is available here. 

This post was published on the Military Families Learning Network blog on August 8, 2014.

What are Dual Trauma Couples?

Rachel Dorman, MS & Heidi Radunovich, PhD

Traumatic events can have long lasting impacts on an individual, and military members returning from deployment could be coping with exposure to multiple traumatic events. Traumatic events can result in PTSD, anxiety, isolation, and depression. Nelson Goff and colleagues (2014) sought to not only learn more about military members coping with traumas but also what happens when their partners have experienced trauma as well.

The researchers specifically sought to learn more about dual trauma couples (DTC) and how having 2 partners coping with trauma impacts the relationship. The study involved 11 married couples, consisting of 11 male soldiers and their female partners (some of whom had a military background). In five of the couples, only the soldier was found to have experienced a high level of traumatic experiences (single trauma couples, or STC); in the other six couples, both members scored as having had a high level of traumatic experience (DTC). Participants had to be 18 years or older, in their relationship for a year or more, and reported no substance abuse or domestic violence during the initial screening. Participants were interviewed separately from their partner, and were also given written measures, which included the Traumatic Events Questionnaire (TEQ), the Purdue Post-Traumatic Stress Disorder Scale – Revised, the Trauma Symptom Checklist-40, and the Dyadic Adjustment Scale.

The researchers found communication problems and trauma triggers to be unique themes to DTC as compared to STC. The researchers found that eleven of the twelve participants in this DTC category reported communication problems, such as not being open and sharing information and the avoidance of conversations related to traumatic events. Trauma related triggers, such as being startled by daily events, were identified by the researchers in nine of the twelve participants in the DTC category. Most of the STC participants described positive couple communication (e.g., staying connected while deployed, perspective taking, and being able to discuss issues openly).

The researchers recommend for clinicians working with military couples who have experienced trauma to evaluate for communication problems, trauma triggers, and issues with relationship roles and intimacy.  The researchers also highlight the importance of practitioners being more aware of DTC, and the fact that when both members of a couple are coping with trauma, this can add additional stress to a couple’s relationship. To learn more about how to help military members dealing with trauma check out our Resource Discovery on Trauma-informed Care , our previous blog on EFT for Couples Affected by Trauma, or our previous blog on Post-traumatic Stress Disorder: Prevalence and Effects on Couples.

Resource:

Nelson Goff, B., Irwin, L., Cox, M., Devine, S., Summers, K., & Schmitz, A. (2014). A qualitative study on single-trauma and dual-trauma military couples. Psychological Trauma: Theory, Research, Practice, and Policy, 6(3), p. 216 – 223. Doi: 10.1037/a0036697

This post was written by Rachel Dorman, M.S. and Heidi Radunovich, PhD. Both are member of the Family Development team that aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network here and on Facebook.

LGB Military Personnel after the Repeal of “Don’t Ask Don’t Tell”

By Rachel Dorman, MS & Heidi Radunovich, PhD

While the creation of the “Don’t Ask Don’t Tell” policy (DADT), made it legal for lesbian, gay, and bisexual (LGB) individuals to serve in the military, it still restrained LGB military members from being able to engage in LGB relationships. With the repeal of DADT, LGB military members now can be open about their relationships without military repercussions. Yet, even with the repeal of DADT there are still risks LGB military members may face in having an open relationship (Johnson, Rosenstein, Buhrke & Haldeman, 2013).

Johnson, Rosenstein, Buhrke, and Haldeman (2013) explain that, due to the military’s historically unaccepting environment to LGB military personnel, there is a stigma that may remain. Such a stigma among military members may create an unwelcoming or hostile environment for those who do not have the same sexual orientation. The researchers explain there may be resistance, homophobia, prejudice, exclusion, and harassment that can flare up against LGB military members in the military environment. These could be legitimate concerns for LGB personnel, and therapists should be willing to listen to the client and follow his or her lead as far as comfort with disclosure. Such stressors, or concern about those potential stressors, could cause LGB military personnel to want continue to conceal their sexual orientation, which can affect their health and well-being. Furthermore, these stressors may result in decreased job satisfaction and commitment to the military, as well as other negative outcomes.

Johnson and colleagues (2013) recommend that mental health providers seek an awareness of the environment and stressors that LGB military members face. It is recommended that practitioners pursue cultural awareness by actively seeking to better understand the negative experiences and stigma clients may have encountered as a result of their sexual orientation, particularly in the military setting. It is also recommended that mental health providers create an environment of acceptance and support when assessing and treating a client. Finally, they stress that those mental health practitioners who do not feel adequately trained to provide care for LGB military personnel to provide appropriate referrals. When providing a referral, seek other mental health providers with an expertise in LGB affirmative treatment, LGB networks for professionals, and local LGB community resources. To learn more about LGB military personnel check out our webinar on “Needs and Supportive Strategies for Professionals Working with LGBT Military Families” or our previous blogs here:

Resources: 

Johnson, B., Rosenstein, J., Buhrke, R., & Haldeman, D. (2013). After “Don’t Ask Don’t Tell”: Competent care of lesbian, gay and bisexual military personnel during the DOD policy transition. Professional Psychology: Research and Practice, 1-9. doi: 10.1037/a0033051

This post was written by Rachel Dorman, M.S. and Heidi Radunovich, PhD. Both are member of the Family Development team that aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network here and on Facebook.