Part III: Adult Learning – Goal-Oriented & Relevancy-Oriented

Adul Learning Series

In life we are often driven forward by our goals and many of our choices are made based on the relevancy of them. As helping professionals you work with clients who are also goal driven, which leads us to our third principle of adult learning: Goal-Oriented and Relevancy-Oriented. Malcolm Knowles, who is often referred to as the pioneer of adult learning, identified four principles of adult learning: (1) Autonomous and Self-Directed, (2) Life Experiences and Knowledge, (3) Goal-Oriented and Relevancy-Oriented and (4) Practical.

Previously we identified principle (1) Autonomous and Self-Directed as well as (2) Life Experiences and Knowledge, where we encouraged military service providers to relate new information back to the life experiences of their clients as well as their clients’ prior knowledge. This month our focus shifts to principle (3) Goal-Oriented and Relevancy-Oriented.

 

Goal-Oriented and Relevancy-Oriented.

Adults are relevancy-oriented, meaning they need to see a reason for learning something. They are also goal-oriented, needing to see the applicability of the experience in order to also see the value. When training adults remember that a theory will need to be related to practical experiences.

As a service provider, when providing education and training to military families be explicit about your goals for the lesson or training. Help you families by explaining the relevancy of the assignments or activities you’ve asked them to participate in. Also, as a service provider, be sure to provide choices for your families, when appropriate, so that they are able to choose what they consider to be the most relevant.


The MFLN Military Caregiving concentration is beginning to wrap up the Adult Learning Series. Next month we will discuss the final principle of adult learning followed by an explanation of adult learning styles. If you missed our previous posts in this series, you can catch up through our Adult Learning Series homepage.

This MFLN-Military Caregiving concentration blog post was published on September 23, 2016.

Project In Sight: The Joys and Challenges of Reintegration after Deployment

Date: October 27, 2016

Time: 12:00 pm-1:00 pm Eastern

Location: https://learn.extension.org/events/2719 (Registration is FREE)

InSight

The MFLN Family Development Team and Family Transitions Team have partnered to provide a brand new programming format for Military Service Professionals. We understand many of the challenges faced in the important work with Military Families. We want to provide you with a private space to discuss those challenges. At each session, we will have a moderated discussion about a topic that is specific to work with military families. We have decided to call each meeting an AIM Session, as we will be offering a chance to Absorb, Ignite, and Maximize through the discussions offered. Materials on a various topics will be given prior to the AIM Session to absorb. On the day of the AIM Session you will join a private chat room with other Military Service Professionals to reflect on thoughts and strategies that we hope will ignite inspiring conversation. After the session, we will provide platforms to share how the AIM Session has maximized your work with military families with others.

Our first AIM session will focus on The Joys and Challenges of Reintegration from Deployment. We will provide you with a short collection of videos capturing some responses from family members who have experienced of deployment before starting the discussion.

Bari Sobelson of the MFLN Family Development Team will be moderating the session. Please feel free to come with resources and information on the topic of reintegration.

We hope you’ll join us on Thursday, October 27, 2016 at 12pm ET. You can learn more and register at our Learn Event page.

 

Measuring Your Financial Health

By Kristyn Jackson, LMFT and Jennifer Hunter, Ph.D., University of Kentucky Cooperative Extension Service

Have you ever heard someone discussing their “financial health?” Financial health refers to how well you are doing financially and is based on a number of factors. Much like you go to your family doctor for yearly check-ups, it is a good idea to perform a financial check-up from time to time.

Unfortunately, many families often find it overwhelming to measure their financial health because of all of the factors included. What further complicates measuring your financial health is the fact that financial advisors and firms often recommend different ways of doing so. You can use more subjective measures of financial health such as your personal satisfaction with your financial status, the amount of financial stress you experience, and how financially independent you feel. However, you can also measure your financial health through more concrete measures.

Capt. Pedro Rodriguez gives two thumbs up while running the 26.2 mile course of the Marine Corps Marathon Forward at Camp Leatherneck, Afghanistan Oct. 27. Rodriguez finished second with a personal record time of 2:47:11. This was Rodriguez's second marathon. (Photo by Sgt. Bobby J. Yarbrough)
Capt. Pedro Rodriguez gives two thumbs up while running the 26.2 mile course of the Marine Corps Marathon Forward. Photo by Sgt. Bobby J. Yarbrough

Provided below is an overview of the various measures that a financial advisor may suggest calculating in order to measure your financial health. It is a good idea to calculate these values on a fairly regular basis, such as the beginning of a new year. If you have questions, do not be afraid to reach out to a professional advisor who can answer them.

  • Liquidity ratio. Liquidity ratio refers to your ability to meet your necessary expenses when you are faced with an emergency such as an unexpected home repair or medical bill. It is recommended that you keep a 3 to 6 month emergency fund, meaning that an ideal ratio is between 3 and 6. To calculate this ratio: LIQUIDITY RATIO = CASH OR CASH EQUIVALENTS ON HAND / MONTHLY COMMITTED EXPENSES
  • Asset-to-debt ratio. This ratio compares your assets to your total existing liabilities. Liabilities include home loans, car loans, credit card debt, etc. It is always desirable to possess more assets than debt. To calculate this ratio: ASSET-TO-DEBT RATIO = TOTAL ASSETS / TOTAL LIABILITIES
  • Current ratio. The current ratio refers to your ability to meet short-term liabilities which include all of your debt repayments to be made in the current year. CURRENT RATIO = CASH OR CASH EQUIVALENTS/SHORT TERM LIABILITIES
  • Debt-service ratio. This ratio refers to the percentage of your income that is designated to debt repayment and the percentage of income remaining for other mandatory household expenses and savings. Lower ratios represent better financial management. DEBT SERVICE RATIO = SHORT TERM LIABILITIES / TOTAL INCOME
  • Saving ratio. The saving ratio is perhaps the easiest to calculate and will provide you with insight as to how well your finances are managed and how likely it is that you can achieve your saving goals. SAVING RATIO = MONTHLY SURPLUS / MONTHLY INCOME
  • Solvency ratio. This ratio refers to your ability to repay all existing debts using your assets in the case of an emergency. You may wish to use a net worth calculator prior to calculating this ratio. SOLVENCY RATIO = NET WORTH/TOTAL ASSETS

Do not worry if these ratios seem complicated. There are numerous resources available to you that can help you to understand what each of these ratios mean. What is important is that you are aware of what you need to be considering when measuring your financial health!

Being aware of your financial health will help you to meet your short-term and long-term financial goals while avoiding unreasonable amounts of debt. Financial experts recommend calculating your financial ratios on a yearly basis and making any adjustments to your spending and saving patterns that you deem necessary.

Contact Jennifer at jhunter@uky.edu

 

Meaning… Less: A Glimpse into Moral Injury

Bari Sobelson, MS, LMFT

Soldier standing by fence

Flickr[DN-ST-91-05864 by Expert Infantry, February 21, 2011, CCO]
Michelle is a wife and a mother of two boys. She has served two tours in Iraq. On the last week of her last tour in Iraq, Michelle encountered a situation that forever changed her life. She was driving and a young boy was riding his bike next to her vehicle. He cut right in front of her and she was unable to stop. She wanted to turn around so badly but she was instructed to keep going, as it was unclear whether or not this was a set up. Michelle constantly thinks about that child and she finds herself consumed by the shame and guilt. She does not like for her boys to go anywhere without her, for fear that someone will do to her children what she did to another woman’s child. She has flashbacks of that moment and replays the scenario in her head to try to figure out how she could have avoided the situation. She doesn’t sleep well.

The above is based on real-life events. However, names and parts of the story have been changed. Although the story has been modified, the trauma of the event has not. A year ago, if I had read this scenario, my first thought would have been that she was suffering from PTSD from the event that changed her life. I would still contend that many of her symptoms fit the diagnosis of PTSD, but there is an added element to her reaction to this event; shame and guilt. Michelle has done something that she may never be able to forgive herself for doing.  It has shaken her entire moral foundation as a human-being, a mother, a wife, and a soldier.

Although the concept is still in its infancy, Moral Injury is gaining more momentum through research and discussion amongst mental health professionals and religious leaders. National Center for PTSD states,

“Military personnel serving in war are confronted with ethical and moral challenges, most of which are navigated successfully because of effective rules of engagement, training, leadership, and the purposefulness and coherence that arise in cohesive units during and after various challenges. However, even in optimal operational contexts, some combat and operational experiences can inevitably transgress deeply held beliefs that undergird a service member’s humanity. Transgressions can arise from individual acts of commission or omission, the behavior of others, or by bearing witness to intense human suffering or the grotesque aftermath of battle. An act of serious transgression that leads to serious inner conflict because the experience is at odds with core ethical and moral beliefs is called moral injury.”

Rev. Rita Brock, PhD, is someone who recognized the need for education on ways professionals can “enable the return to ordinary life of those who experience moral injury.” She states  that “moral injury has a slow burn quality that often takes time to sink in. To be morally injured requires a healthy brain that can experience empathy, create a coherent memory narrative, understand moral reasoning and evaluate behavior. Moral injury is a negative self-judgment based on having transgressed core moral beliefs and values or on feeling betrayed by authorities. It is reflected in the destruction of a moral identity and loss of meaning. Its symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live.”

Soul Repair Center was established in 2012. In addition to offering public education, they are also continuously conducting research on the topic. People, like Michelle who was described at the beginning of this blog, are not alone in their experiences and Rev. Brock and many other professionals see that this is a topic that needs our immediate attention.

If you would like to learn more about Moral Injury and the ways in which it impacts families, please join us for MFLN Family Development Virtual Learning Event 2016 – Strengthening the Family CORE – Session 4 entitled: Exploring the Impact of Moral Injury on Military Families on Septemer 22nd at 11:00am EST. This webinar will be presented by Rev. Brock. It is our hope that you will join us in learning about this incredibly important topic.

References

Maguen, S. & Litz, B. (2012). Moral injury in veterans of war. PTSD Research Quarterly, 23(1), 1050-1835.
Brock, R. & Lettini, G. Soul Repair: Recovering from Moral Injury after War. Boston: Beacon Press, 2012.

This post was written by Bari Sobelson, MS, LMFT, the social media and programming specialist for the MFLN Family Development Team. The Family Development team aims to support the development of professionals working with military families.  Find out more about the Military Families Learning Network Family Development team on our websiteFacebook, and Twitter.

Want to add apps to your Dietetics practise?

Flickr CC Clive Darra ios apps taken Aug 12, 2012
Flickr CC Clive Darra ios apps taken Aug 12, 2012

By Joanna Manero, BS,Research Assistant, Graduate Assistant,Master’s Degree Student

It seems like whatever task you can think of, there’s an App, or mobile Smartphone application, that can do just what you need.  Why wouldn’t there be?  The App industry is huge and positioned to clinch the market of 64% of Americans that own a Smartphone device.

As healthcare professionals, it is our job to evolve and find innovative ways to reach our clients to give them the best and most up to date information.  Incorporating Apps in your current practice may help.  Tune into Justine Karduck and Kirsten DiFilippo’s webinar on Wednesday, September  21st at 11:00 AM EDT to learn about the evidence to support or disprove the use of Apps in nutrition education.  You will also learn how Apps can fit into your current practice, and how to evaluate an App.

If you are new to using Apps in your practice and decide to give it a try, you may be wondering if Apps are regulated in any way.  Apple just launched a strict new set of guidelines for health and medical related Apps.   In addition to the guidelines already in place, the updated guidelines focus on privacy protection, inaccurate data, and preventing harmful behavior.  Apple has put emphasis on Apps that are used to diagnose or treat patients.  These features will now require FDA approval.   To learn more about the guidelines in place, visit the links below.

These guidelines make our job of selecting Apps for practice a little easier. However, an App that works for one person may not work for the others.  It is important to understand your client and their goals.  Tune into the webinar to learn more about this process.

Are you using Apps in your practice?  If so, leave us a comment below and tell us about your experience!

References:

http://mobihealthnews.com/content/apples-updated-app-store-guidelines-place-added-scrutiny-health-medical-apps

http://www.fda.gov/MedicalDevices/DigitalHealth/MobileMedicalApplications/default.htm

http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/

This was posted by Robin Allen, a member of the Military Families Learning Network (MFLN) Nutrition and Wellness team that aims to support the development of professionals working with military families.  Find out more about the MFLN Nutrition and Wellness concentration on our website, on Facebookon Twitterand LinkedIn.

Expert Advice Series: TRICARE® ECHO – Applied Behavioral Analysis (ABA)

Expert Advice Series

In a recent webinar entitled “TRICARE® Extended Care Health Option (ECHO)” participants were able to gather more information about the supplemental services for active duty family members with qualifying mental and physical disabilities provided through TRICARE® ECHO.

Question: I had a couple questions regarding the Applied Behavioral Analysis (ABA) referral process and what type of medical equipment is covered by ECHO and what is not. There seems to be a lack of communication between the child’s Primary Care Manager (PCM) and United Health Care (UHC) when sending in a referral for ABA therapy.  Does the ECHO Case Manager have the correct verbiage and time line to share with the families on what the PCM needs to state on the referral prior to sending to UHC to begin the process for ABA services?  A lot of my clients have shared with me that if the PCM does not write the referral on a prescription pad and if the correct verbiage is not written on the referral  that UHC will kick the referral back.  This causes a lot of confusion for the clients and the process to begin the services for their child with Autism takes longer.

Also, is there a list of medical equipment that ECHO does cover when Tri-care does not?  Such as hearing aids, wheel chairs etc.

 

Advice: The ACD policy requires that prior to coverage of ABA, the beneficiary must be diagnosed with ASD using DSM-5 criteria and issued a referral for ABA by a TRICARE-authorized Physician-Primary Care Manager (P-PCM) or by a specialized ASD diagnosing provider whether they work in the purchased care or direct care system.  The medical record and the referral must contain documentation of the Autism Spectrum Disorder (ASD) diagnosis and documentation of co-morbid psychiatric and medical disorders.  We also require that ASD symptom severity be documented on the referral, but plan to delete this requirement from the referral itself in the next policy update which we expect sometime in FY 2017.

Referrals made for TRICARE Prime beneficiaries from the Direct Care system (the MTF) providers are made electronically in Composite Health Care System (CHCS). These electronic referrals are sent to the regional managed care support contractor for processing. The regional contractor then sends an authorization letter specifying the ABA provider/practice information and the authorization number to each beneficiary.  The Active Duty Family Member (ADFM) parent/caregiver is to call the phone number of the ABA practice on the authorization letter to schedule the appointment for ABA. If the provider cannot see the patient within 28 days, then the ADFM parent/caregiver should directly telephone the regional contractor at the phone number specified in the authorization letter for help getting an appointment with another ABA provider able to see the beneficiary within the 28 day access standard.

For Purchased Care under TRICARE Prime, each regional contractor, in this case UHC, defines their referral requirements. If UHC requires the referral be written on a paper prescription pad, then this is the process that must be followed.  Under TRICARE Standard plans, referrals per se are not used, but rather a prior authorization process if followed. Each regional contractor specifies the process per contractual requirement.  The process may involve filling out a regional contractor online form requesting authorization, faxing in this information on a form or telephoning the regional contractor to request for authorization.  Regardless of each regional contractor’s process, prior authorization is required for ABA services under the ACD. Each authorization is for six months.

I hope this answers your question.  Each regional contractor is available per the phone numbers provided in the presentation to assist family members with the referrals and authorizations. Please encourage the families you assist to call the regional contractor whenever there are problems or challenges accessing ABA through the ACD as we do not want beneficiaries to wait to access ABA services.

 

Expert: Theresa A. Hart, RNC MS, Nurse Consultant/Program Manager, Perinatal, Pediatrics and Special Medical Programs Defense Health Agency Clinical Support Division

For more advice from Ms. Hart, watch and listen to the professional development training on TRICARE® Extended Care Health Option (ECHO) to learn about the ECHO program.


The new blog series provides monthly advice from subject matter experts on issues surrounding military caregiving for service providers and families. We take questions and concerns from military helping professionals and families and provide the necessary feedback from credible experts in the field of study. Whether you are a provider or a caregiver, what questions do you have? We want to hear from you.

 

This MFLN-Military Caregiving concentration blog post was published on September 16, 2016.

 

Virtual Learning Event September 2016-Strengthening the Family CORE – Session 4

VLE 4 | Exploring the Impact of Moral Injury on Military Families

Session 4

Date: September 22nd

Time: 11:00 am-12:30 pm Eastern

Location: https://learn.extension.org/events/2653

VLE 4 Exploring the Impact of Moral Injury on Military Families

This session will be presented by Rev. Rita Nakashima Brock, Ph.D. Dr. Brock is Research Professor of Theology and Culture and Director of the Soul Repair Center. A noted theologian, she has lectured all over the world. During this session,  she will be providing information on the concept of moral injury and ways in which it can impact military service members and their families. Join us on September 22nd at 11:00 am Eastern!

We will offer 1.5 National Association of Social Worker CE credits and CE credits for licensed Marriage and Family Therapists in the state of Georgia for each of our webinars, click here to learn more. MFLN FD Early Intervention will also be providing Early Intervention Training Program (EITP) CE credits, click here to learn more. For more information on future presentations in the 2016 Family Development webinar series, please visit our professional development website or connect with us via social media for announcements: (Facebook & Twitter)

Is there an App for everything? Listen to this audiocast for more information!

Flickr-CC-The-US-Army-The-UOfficial-Army-iPhone-app-Taken-on-January-12-2010.
Flickr-CC-The-US-Army-The-UOfficial-Army-iPhone-app-Taken-on-January-12-2010.
Discover the pros and cons of using nutrition apps in your practice and how to use them effectively.  Tune into this free webinar on September 21, 2016 at 11:00 am EDT.

Mobile Apps for RDNs in Patient Care: What Does the Evidence Say?

To register go to the Learn page at https://learn.extension.org/events/2693
For a preview, listen to this audio chat with our presenters.

Audiocast with Dr. Karen Chapman-Novakofski, Kristin DiFilippo and Justine Karduck

What nutrition apps are you using?

 

This post was written by Robin Allen, a member of the Military Families Learning Network (MFLN) Nutrition and Wellness team that aims to support the development of professionals working with military families.  Find out more about the MFLN Nutrition and Wellness concentration on our website, on Facebookon Twitterand LinkedIn.

 

 

 

 

Off the Shelf: Conversations with Authors of Children’s Books

The Family Development Early Intervention team is always on the look-out for quality children’s books that help address some of the unique needs of military children.

The following is an interview with Brenda Ehrmantraut, author of several children’s books, including Night Catch, a story for military children facing the deployment of a parent.  This interview has been edited for length and clarity.

Night Catch (Published by Bubble Gum Press)
Night Catch (Published by Bubble Gum Press)

What, if any, experiences do you and/or your book’s illustrator have with the military?

I’m a civilian! However, the book was inspired when my brother served in The Army National Guard and was deployed to Iraq in 2004.

What made you decide to write this book? Was there some incident or experience with the military that inspired you?

When a community sends a National Guard Unit off, there is an indescribable feeling of bonding. Everyone wants to step up to help. When my brother deployed, I felt overwhelmed with feelings of fear and helplessness. I wanted to do something, and writing a book was my answer. I was worried about him being away from his family for a year.

What message(s) do you hope that children and families receive as a result of reading your book?

My greatest desire in writing it was to offer comfort and hope to families in times of separation and stress. The book was deliberately designed to have a calming effect. The rhyme is a soothing technique, like a bedtime rock-a-bye. The pictures, and story, play with fantasy a bit, but also are relatable to a child. Here’s a bedroom. Here’s a house with a mother. And even though the star cannot actually be moved, the game of blowing it back and forth each night is a tangible connection for a young child.

Have you received any feedback from military families after they read your book, and if so, what have they said?

I hear from a lot of families who read the story while they are apart. It doesn’t seem to have an age limit. I’ve heard of dads in tears, a 5th grader who carried it around in his school backpack the year his dad was gone, and even parents who have children in the military and they are keeping a copy of the book handy. Connection seems to speak to everyone.

Are there any other books for military children that you would suggest for young children?

The Military Child Education Coalition has a program called, “Tell Me a Story” which promotes reading in military families. Night Catch is one of the books included in their reading list.

This post was edited by Robyn DiPietro-Wells & 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, and YouTube.

How to Overcome Military Family Financial Challenges

By Leslie Tayne, Attorney

With unexpected moves and the possibility of overseas deployment, military families are faced with some interesting obstacles when trying to save money and plan for future expenses. Thankfully, there are some simple strategies both service members and their families can employ to help overcome their financial challenges.

Below I’ve provided some simple tips to help military families boost their cash flow, improve their financial well-being, and keep their financial future looking bright!

For Families

  1. Minimize Your Debt

A Marine may be able to keep his or her calm in a combat zone but on the home front there are still many looming threats, including financial security that can bring even the most iron willed warriors into a stressed environment. Photo by Cpl. Thomas Bricker. CC BY 2.0
Photo by Cpl. Thomas Bricker. CC BY 2.0

Making a strong effort to get out of debt can really help your family. Start out by tracking your spending (for some tips to help you track your spending, visit here). Once you know your spending habits, use that information to create a budget that fits your needs. Once you have a working budget you should be able to free up cash flow and start paying down debt. If you have multiple debts and aren’t quite sure where to start, a good rule of thumb is to focus on the debt with the highest interest rate first; this will save you the most in the long run!

  1. Utilize Discounts and Hunt Down Freebies

Companies offer deals for military families in a variety of categories, such as school supplies, clothing, cars, electronics, and professional services. There are also programs that offer free services to military families. For example, the annual America is Beautiful national parks pass gives military members free access to 2,000 different federal recreation sites. Here are some more freebies and discounts for military families. Don’t forget to also call your utility companies and insurance companies to see if they have any military discounts they can apply to your bill.

  1. Look for Everyday Savings

We’ve all seen those crazy couponers and, while it might be unrealistic for most people to reach that level of dedication, it is very easy to save with coupons and everyday savings. Social media and email are both great ways to find deals on the things you want from the shops you most frequently visit. Subscribe to email newsletters from your favorite stores , so you can be notified of sales and receive exclusive coupons and discounts.

Newspapers and magazines also offer great coupons, as well as sites like coupons.com and afullcup.com. You can also look into Commissionaryshopper.com, which is a coupon site designed specifically for military families!

  1. Consider a Side Hustle

Side hustles are great for spouses of those who serve because they’re fun, can easily be done from home or close to home, and can really help boost your cash flow. From selling photos to tutoring to blogging, there’s bound to be an side hustle out there that’s perfect for you. If you’re not sure where to start though, check out my blog entry on finding the perfect side hustle!

For Veterans

  1. Find A Job That’s Right for You

One of the biggest challenges for veterans is the transition from military service to a civilian job. The lapse of employment that may follow military service can put an additional burden on the families finances, so it’s important to know what options are available to you upon leaving the military. There are numerous organizations and programs, like Hire Heroes USA and the VA’s Make the Connection, that can help vets not only find jobs but network with others who, like them, had to overcome the struggle of reentering civilian life.

  1. Take Advantage of Benefits

There are a variety of organizations out that there dedicated to helping veterans get their post-service lives off to a running start. Volunteers for America helps veterans find affordable housing and offers other helpful services. Your local Housing and Urban Development Plan (HUD) can also provide aid in finding homes. Other opportunities available for veterans and their families include the American Legion (which provides emergency cash grants for children of service members), USA Cares (which helps veterans pay for housing), and Disabled American Veterans (which provides services for disabled veterans). Make sure to inquire with local stores as well as your insurance and utility companies to see if you can qualify for veteran discounts.

While the financial difficulties that military families face are by no means easy to overcome, possessing the right knowledge and adopting good financial habits can help ease the burden significantly. What financial struggles have you faced as a military family? What solutions did you discover? Feel free to share your story in our comments section!

 Leslie H. Tayne has more than a decade of experience in the practice area of consumer and business financial debt-related services. Speaker, Author, Attorney and Founder of the Tayne Law Group, P.C., Leslie is working towards reshaping the debt industry by offering real, proven solutions to help her clients get back on the road to financial freedom. Ms. Tayne will be presenting our September 20 webinar, Credit & Debt Issues for Military Families. Join us at 11 a.m. ET for this great learning opportunity.