Seamless Transition Committee: A Model for Providing Coordinated Care

Jay Morse & Heidi Radunovich, PhD

Creative Commons [Flickr, Veteran, October 4, 2008]
Creative Commons [Flickr, Veteran, October 4, 2008]
Veterans returning from combat deployment who are seeking health care can be faced with complicated treatment plans. One Veteran’s Affairs health care center has implemented a “Seamless Transition Committee (STC)” which allows for complex cases to be presented to a multi-disciplinary team for feedback and coordination of care. The STC is composed of leaders from a wide range of disciplines and includes: the chief psychologist; program managers; the suicide prevention coordinator; and the medical director of the Post-Deployment Primary Care Clinic. In a typical case, the STC team members would discuss the case background, establish treatment priorities, and agree to treatment recommendations. Review meetings are scheduled for one hour each week at the same time and location.

Results of the program evaluation conducted by Mallen, Schumacher, Leskela, Thuras, and Frenzel [1] suggest that this is a promising model. Over the 3 year study, 149 veteran’s cases were reviewed by the Seamless Transition Committee. Over 50% of the veterans in the STC program had at least 3 mental health diagnoses. The most common diagnoses included: (1) Depressive disorders (77.2%); (2) PTSD (62.4%); (3) Substance abuse (56.4%); (4) Anxiety disorder (44.3%); and (5) Personality disorder (20.1%). Over 40% of the veterans in the program were psychiatric inpatients at some time and over 60% participated in the facility’s Psychiatry Partial Hospitalization program (PPH).

A pre/post study analysis was conducted. Significant changes in service utilization were noted, including a significant decline in psychiatric hospitalization rates. Overall:

  • Visits to mental health clinics increased.
  • PPH utilization remained approximately the same.
  • Inpatient psychiatric hospitalization rates declined from 24.7% to 8.2%.
  • There were no significant changes in emergency room or primary care utilization rates.

The researchers noted that as veterans’ cases were presented at the STC, the veterans utilized outpatient services more often and used inpatient services less. The results of a staff survey indicated that the staff believed that veterans’ care was improved. These changes were attributed to expedited care received through the STC. The STC might provide a good model for other systems of care that wish to enhance collaboration among specialists, and provide more efficient care to patients.

Reference:

[1] Mallen, M., Schumacher, M., Leskela, J., Thuras, P., & Frenzel, M. (2014). Providing coordinated care to veterans of Iraq and Afghanistan wars with complex psychological and social issues in a department of veterans affairs medical center: Formation of seamless transition committee. Professional Psychology-Research and Practice, 45(6), 410-415. doi:10.1037/a0037755

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, YouTube, and on LinkedIn.

Why is Work-Life Balance Important for Professionals?

Work-Life BalanceTrying to balance work, family and life can be a challenge for us all. In a recent professional development webinar, Working to Balance Life, the presenter not only laid the foundation for finding personal work-life balance but she also offered feedback for employers, supervisors and managers who are trying to retain and strengthen their workforce while seeking balance.

When you are feeling unbalanced it may be helpful to do a self-audit of areas and activities where you can get your energy and balance back.  Negotiating balance in the workforce can be essential.

Many businesses and organizations are beginning to implement work-family initiatives into their plan of work so as to perceive a more family-friendly and attractive organization, while reducing burnout and turnover ratios of their employees (Kelly et al., 2008).

Work-family initiatives that many of us are familiar with include:

  • Flex-time
  • Part-time work
  • Job sharing
  • Compressed work week
  • Telework
  • Partially paid family leaves
  • Pre-tax spending accounts for dependent care
  • Information and referral accounts to find care
  • On-site child care

These initiatives vary among organizations and businesses and you may need to do a little research to see what is or is not offered in your professional setting and if your position is eligible for such initiatives.

Management support can be a critical variable in determining if work-life initiatives are actually used within the workforce. Employees are less likely to take advantage of initiatives if there is a lack of management support. When we have the support of supervisors in regards to utilizing work-life initiatives, studies have shown a positive impact in employee’s performances. Such impacts include:

  • Greater work-family balance
  • Lower work-family conflict
  • More perceived success in work and life
  • More loyalty to the organization or business
  • More job satisfaction
  • Lower employee turnover

Professional development training for employers and employees may be helpful to determine what work-life initiatives are available, how to communicate between both parties on finding balance and identifying the best initiative for overall success.

To learn more about work-life balance and how it can affect not only balances in the workforce, but also maintaining balance within your personal life go to, Working to Balance Life, by Sandra B. Morissette, Ph.D.


This MFLN-Military Caregiving concentration blog post was published on March 27, 2015.

Connect with Personal Finance @MFLNPF

By Molly Herndon

Our  team’s presence on Twitter just got a bit easier to find. We’re now tweeting from @MFLNPF. Our team’s tweets, content and details about our upcoming webinars are shared from this handle, so be sure to follow us here to stay up-to-date on all the PF news.

Last summer, our team and the Network Literacy Community of Practice hosted a Twitter cohort for personal finance managers. This two-week learning event was an opportunity for financial professionals to dip their toes into Twitter while working with a group to help newbies become acquainted with the social media space. Check out a recording of the first meeting below. Additional resources for learning about Twitter are available here.

If you’re new to Twitter or an old pro, we’d love to connect with you and grow our network. Share you handle with us and follow us @MFLNPF!

This post was published on the Military Families Learning Network blog on March 23, 2015.

Trauma Therapists and Compassion Satisfaction

Jay Morse & Heidi Radunovich, PhD

Creative Commons [Flickr, Compassion International, March 16, 2008]
Creative Commons [Flickr, Compassion International, March 16, 2008]
Mental health professionals working with traumatized clients can experience excessive amounts of stress that may lead to compassion fatigue and burnout (link “Military Psychologists in a Combat Zone”).  In a recent publication, researchers Craig and Sprang [1] have included an often overlooked idea of compassion satisfaction as a possible outcome in their study of trauma therapists and compassion fatigue and burnout.

What is compassion satisfaction?

Compassion satisfaction is the feeling of gratification that can be derived from helping others or from care giving.  Compassion satisfaction is about helping others and deriving pleasure from knowing that you made a positive contribution to an individual’s well being.

In this study, a national sample of 532 clinical social workers and clinical psychologists who identified themselves as “trauma specialists” completed surveys measuring compassion fatigue, burnout, and compassion satisfaction.  Additionally, the participants responded to a measure of the use of evidence-based therapy practices.  Other variables considered in this study included age, gender, licensure, clinical experience, type of work organization, trauma training, and percentage of PTSD clients.  Gender and age distributions of the sample were comparable to national averages for clinical social workers and psychologists.  The mean age for the sample was 53 years with 23 years of experience.  Only 62% of the social workers and psychologists reported that they had specialized training in treatment of traumatized individuals.  Key findings of the study included:

  • Consistent with previous research, caseloads with a high percentage of traumatized clients may increase the risk for compassion fatigue and burnout.
  • Clinical experience was not a predictor of compassion fatigue (when considering all factors listed above) but was a predictor of compassion satisfaction. Age was not a significant predictor of compassion fatigue or compassion satisfaction.
  • Using evidence-based practices decreases the risk for compassion fatigue. Compassion satisfaction increased with use of evidence-based practices.
  • A lack of training in trauma-specific therapies was associated with burnout in clinicians working with traumatized individuals.

Overall, therapists who work with traumatized clients seem to be less vulnerable to burnout when they have received appropriate training in trauma treatment practices and are able to use them, and when they have a more balanced caseload related to trauma. Compassion satisfaction also seems to be a possible positive outcome among therapists who work with traumatized clients, and is also more likely for those who use evidence-based treatments, and for those who are more experienced practitioners.

References

[1]Craig, C. D., & Sprang, G. (2010). Compassion satisfaction, compassion fatigue, and burnout in a national sample of trauma treatment therapists. Anxiety, Stress, and Coping, 23(3), 319-339. doi:http://dx.doi.org/10.1080/10615800903085818

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.

Welcome to the Early Intervention Team

The Early Intervention Team is excited and honored to be joining the Military Families Learning Network (MFLN)’s Family Development Concentration Area. The goal of the Family Development Early Intervention (EI) team is to enhance the capacity of professionals working with military families who have young children (birth to 5 years old) with or who are at-risk for disabilities and developmental delays.

The inclusion of children with disabilities and their families into child care centers, schools, and communities expresses that each and every child and family is important and a valuable member to society. Successful inclusion of children with disabilities embodies many things including:

  • Providing access to programs, services, and activities for all children and families.
  • Encouraging participation and providing appropriate adaptations for individual children and families, as needed.
  • Providing support to programs and professionals to increase their skills to make inclusion successful and advocate for inclusion in their communities.
  • Using person-first language. Describing “a child with a disability” instead of “a disabled child” recognizes that children with disabilities are children first and more similar to other children than different. Learn more about person-first language here.

Learn more about inclusion from the Division of Early Childhood (DEC) of the Council for Exceptional Children here.

Support for children and families, as well as the professionals and communities that serve them, is necessary for successful inclusion. The EI team will provide information, training, and resources for military family providers such as early intervention providers, teachers, child care providers, new parent support members, and case managers.

Our EI team calls the University of Illinois in Urbana-Champaign home. Amy Santos and Micki Ostrosky are faculty members in the Department of Special Education in the College of Education at Illinois. They serve as the project leaders for the EI team. Kimberly Hile and Jenna Weglarz-Ward are doctoral students in special education with extensive experiences and expertise in programs and services for young children with disabilities and their families.

MFLN Family Development Early Intervention (EI) Team [J. Weglarz-Ward, January 27, 2015]
MFLN Family Development Early Intervention (EI) Team [J. Weglarz-Ward, January 27, 2015]
Collectively, we have accumulated close to 90 years of experience working with children with disabilities and their families. As a team, we have a long history of working together not only on undergraduate and graduate programs in special education and early childhood education but also on various state and national projects. We are all committed to supporting military family providers who can make a positive impact on the lives of young children with disabilities and their families. Collectively, our team brings a broad range of expertise in early childhood education, special education, and early intervention. Our team members have been teachers, administrators, evaluators, trainers and technical assistance providers, and consultants for early childhood programs. We have published peer-reviewed journal articles, book chapters, and in other publications including training modules, monographs, policy briefs, position papers, and guides. We serve on numerous boards, expert panels, commissions, and advisory groups at the local, regional, and national levels. We also present our research at various national, regional, and state conferences, meetings, and symposia. Additionally, we are all parents, with nine children among us ranging in age from 1 to 18 years old. Each of us has experienced the first-hand joys and struggles of parenting, child development, and special education.

In the coming months, military family providers will have access to resources, engage in conversations, and participate in trainings on topics such as:

  • Supporting social and emotional development of young children
  • Early warning signs and interventions for young children with Autism Spectrum Disorder and their families
  • Addressing challenging behaviors
  • Addressing daily and life transitions of young children in military families
  • Recommended practices in early childhood special education and early intervention

We are looking forward to being part of the MLFN community!

This post was written by Jenna Weglarz-Ward & Michaelene Ostrosky, PhD, members of the MFLN FD Early Intervention 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, YouTube, and on LinkedIn.

April Caregiving Webinar: Understanding Narcotic Medications for Service Members

LEARN_Banner

Join the Military Caregiving Concentration for a FREE monthly professional development webinar on, ‘Understanding Narcotic Medications for Service Members.’

Narcotic medications are used for a variety of treatments such as, pain management, anxiety, and sleep disorders. Narcotic prescriptions may be given to augment and extend the effects of medications for service members with acute and chronic pain.

Within the presentation, participants will be able to:

  • Understand the role that professionals play in medication management for service members.
  • Identify various classes of narcotics, their actions and potential dependence it may cause for wounded warriors.
  • Highlight differences in the therapies for acute and chronic pain management, including posttraumatic stress disorder (PTSD).
Presenters

The April caregiving webinar will feature two presenters from West Texas A&M University (WTAMU), Kristen Kuhlmann, Ph.D., and Nancy Turrubiates, MSN, RN.

Dr. Kuhlmann is an Assistant Professor of Nursing at WTAMU with a research interest in exploring what motivates people to begin or maintain a healthy lifestyle, in order to reduce chronic health problems. Nancy Turrubiates is an Instructor of Nursing at WTAMU and is also a direct commissioned officer in the U.S. Army Reserves and was promoted to Captain (CPT) in 2011. Turrubiates currently teaches in the Bachelor of Science Nursing program at WTAMU to senior level students in community health courses.

CEU Credit Available!

The Military Families Learning Network will be providing 1.0 National Association of Social Workers (NASW) continuing education credit to credentialed participants. Certificates of Completion will also be available for training hours as well. For more information on CEU credits go to: NASW Continuing Education Instructions. 

Interested in Joining the Webinar?

*No registration is required; simply go to, Understanding Narcotic Medication for Service Members, the day of the event 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. You can connect to the Adobe webinar using iPhone, iPad, and Droid apps. Search for DCO Connect in the respective stores.

For those who cannot connect to the Adobe site, an alternative viewing of this presentation will be running on Ustream.


This post written by Mikala Whitaker of the MFLN Military Caregiving concentration team and was published on the Military Families Learning Network blog on March 17, 2015.

Changes Coming to the CEU Process

By Molly C. Herndon

Since 2012, more than 6,000 CEUs have been awarded from the MFLN Personal Finance webinars! We are so excited by the strong following these webinars have generated. Our webinar audience is engaged and constantly contributing to the content we develop and shaping the direction in which this project moves. We thank you all! diploma

Starting with our March 17 webinar, Investing with Small Dollar Amounts, we will be introducing a new process for earning Continuing Education Units. After all webinars, both live and recorded, participants will be directed to a brief post-test quiz. Certificates of Completion will be emailed after participants successfully pass the quiz by scoring 80% or higher.

In addition, the March 17 webinar has been approved for not only 1.5 CEUs for AFC-credentialed participants, but also 1.5 general CEUs for FinCert Certified Personal Finance Counselors (CPFC)!

We hope these changes will streamline the process of obtaining CEUs for our loyal audience as well as open our community to new members with the addition of FinCert certified participants.

See you online soon.

– Molly

This post was published on the Military Families Learning Network blog on March 16, 2015.

Trauma Exposure, High Risk Behaviors and Functional Impairment

Jay Morse & Heidi Radunovich, PhD

Creative Commons Licensing [Flickr, Fluorescent Adolescent, November 20, 2010]
Creative Commons Licensing [Flickr, Fluorescent Adolescent, November 20, 2010]
According to recent research, 47% of children and adolescents exposed to trauma and traumatic loss reported attachment problems or functional impairments during adolescence in addition to other high risk behaviors including suicidality (24%), and substance abuse (20%)[1]. Using data collected by the National Child Traumatic Stress Network (NCTSN), Layne and colleagues studied the effects of cumulative exposure of up to 20 different types of trauma on a large group of adolescents [1]. Findings from the study indicated that the probability of 9 types of adolescent high risk behaviors and functional impairment increased incrementally with each type of trauma exposure in childhood and adolescence.

Layne, et al. (2014)

Adapted from Layne, et al. (2014)

A total of 3,785 of 14,088 participants contained in the Core Data Set (CDS) were selected for study. Criteria for selection for the study included: (1) reported at least one confirmed or suspected type of trauma, (2) completed indicators of high-risk behavior and demographic questionnaires, and (3) were between the ages of 13 to 18 years old at baseline. All participants had sought health services through providers associated with NCTSN.

Examining the links between trauma event types and problem behaviors was the primary goal of the study. With each type of trauma or loss exposure, the probability of adolescent high-risk behavior and functional impairment increased. Of particular note, participants in the study had an average of more than 4 types of trauma exposure during childhood and adolescence.

Adolescence is a critical time for development of healthy cognitive and emotional functioning. Identifying childhood trauma, and treating individuals can reduce problems in later life.

Reference

[1] Layne, C., Greeson, J., Ostrowski, S., Kim, S., Reading, S., Vivrette, R., . . . Pynoos, R. (2014). Cumulative trauma exposure and high risk behavior in adolescence: Findings from the national child traumatic stress network core data set. Psychological Trauma-Theory Research Practice and Policy, 6(Suppl 1), S40-S49. doi:10.1037/a0037799

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, YouTube, and on LinkedIn.

Q&A with #eXmilcaregiving: Why is Medicaid an Important Resource for Service Members?

iStock_000000429058LargeMedicaid is an insurance program that provides health coverage for many who are low income or disabled. The program is operated at the state level, using federal and state funding. However, Medicaid programs vary substantially from state to state.

Medicaid can be an important resource because it may provide supplemental or “wrap-around” coverage for services that may have limited coverage under TRICARE or a service member’s primary insurance program. In doing so, it may provide coverage for services that are not otherwise provided under TRICARE or an insurance program. Because of state variability in Medicaid program services and delivery systems, there is a lack of programs and services consistency across the states.

To learn more about Medicaid check out our Medicaid and Military Families: An Introduction training.


Have a question for our military caregiving team? Let us know! We want to hear from you.

As a Professional, How Do You Encourage Caregivers & Service Members to Open Up?

Often times it can be difficult as you work with service members and their families to get them to really open up to you in order to better identify appropriate services to meet their specific needs. In some cases, service members and their families may be reluctant to opening up to you as a professional for fear of their reputation, stigma associated with receiving help, denial about his/her condition(s), or the overall unknown (Brintnall-Peterson, 2014).

We asked a variety of military professionals from Joint Base Lewis-McChord and the Navy Wounded Warrior – Safe Harbor in Washington state, that work with wounded service members and families, on advice they would offer to getting their clients to open up.

Watch and listen as each professional provides key tips and strategies on communicating with their service members and families to get the conversation flowing.

After listening how each individual responds, can you relate to their feedback? What are some strategies that have worked in your profession to getting service members and families to open up? (Insert your response in the comment box below.)


The ‘Professionals Helping Professional’ video series was developed in order to highlight various military service professionals and their work with wounded service members and families throughout the branches of service. The goal of the video series is to enhance the work of military helping professionals and provide educational development to better support our service members and their families.

This post written by Mikala Whitaker of the MFLN Military Caregiving concentration team and was published on the Military Families Learning Network blog on March 9, 2015.