Welcome Home: Veterans on Campus · Welcome Home: Veterans on Campus Training David M. Joseph, Ph.D 6 Communicating Less Assertively Adjusting to a less direct communication style

Welcome Home: Veterans on Campus Training

David M. Joseph, Ph.D 1

Welcome Home: Veterans on Campusp

David M. Joseph, Ph.D.Licensed Clinical Psychologist

Team Leader, Oakland Vet Center

Growth of Post 9/11 GI Bill

ENGAGEMENTNational survey of 362,000 first‐year students and seniors attending 564 US colleges and universities by NSSE (2010) found:

– Student Veterans perceived lower levels of campus support than non Veteranssupport than non‐Veterans

– Interacted less with faculty members

– Spent twice as many hours per week working

– Six times as many hours on dependent care

– Twice as likely to report at least one disability

National Survey of Student Engagement (NSSE), 2010



Increasingly Diverse & Complex Military

More ethnic minorities 30% of Armed Services

More women 14% of Active Duty

In relationships 56% marriedIn relationships 56% married

Educated 94% H.S. Diploma/GED

Young & Old

• Active Duty 42% deployed are 17‐25yrs

• Reserve 56% deployed are 30yrs +

DEMOGRAPHICS 2010Profile of the Military Community

Department of Defense

Military Service in U.S.

6%

7%

8%

9%

10%

0%

1%

2%

3%

4%

5%

6%

WWI WWII Korean War Vietnam War

Gulf War Post 9/11

Since Sept. 11, 2001,

2,400,000

How Many Have Served in OIF (OND) & OEF?

American militarypersonnel had been deployed to Iraq, Afghanistan or both*.

http://abcnews.go.com/Politics/us‐veterans‐numbers/story?id=14928136#all*As of August, 2011.



At least 1,000,000 have

deployed more than once.

http://abcnews.go.com/Politics/us‐veterans‐numbers/story?id=14928136#all

Elements of Military Culture

• Chain of command means following orders

• Routine & Structure – what happens when this is gone?g

• Aggression – faster, harder, louder, meaner

• Respect – for authority and for ones self

• Strength – not asking for help

• Honor – used to being trusted

Impact of Deployment

Relationshipwith Children

22 32 44

Positive Impact No Impact Negative Impact

Health

Relationshipwith Spouse

with Children

21

16

38

33

40

48

http://www.pewsocialtrends.org/2011/10/05/war‐and‐sacrifice‐in‐the‐post‐911‐era/2/



72%More Prepared forJob/ Career

Rewards and Burdens of Military ServicePercentage of Post 9/11 Veterans who say that as a result of their service:

96%

93%

90%

0% 20% 40% 60% 80% 100%

Proud of Service

More Mature

Gained Self Confidence

http://www.pewsocialtrends.org/2011/10/05/war‐and‐sacrifice‐in‐the‐post‐911‐era/2/

Coming Home:Transitioning to Civilian LifeTransitioning to Civilian Life

after OIF/OEF



Wounds of War

43% report an “emotionally traumatic or distressing experience.”

16% suffered a serious injury.

o 2x more likely to report “difficulty adjusting”

o 3x more likely to have PTSD

o Less likely to hold full‐time jobs.

• Feeling separate. Vet has changed, and others too

• Managing expectations to be the same as before

L tti d “ d” ll i i ti

Typical Transition Challenges

• Letting down “guard” – allowing intimacy

• Finding employment – choosing a career

• Rebuilding community – connecting to old friends

• Lack of daily structure – what should I do today?

• Finding excitement in every day activities

Communication & Language

Many veterans find it very difficult to explain their experiences, their h h d h ithoughts and their feelings to others who were not there. Many do not have the words to express what they experienced.



Communicating Less Assertively

Adjusting to a less direct communication style can be difficult and take time.

Driving Differently

Combat Zone: Keeping other vehicles at a distance, driving fast, on guard for ambush or

IEDs.

Home: Aggressive driving leads to speeding tickets,

accidents, fatalities.

Common Existential Issues• How can there be a higher power and such bad things happen?

• Why did I live and others died?

• Am I murderer because I killed? Because I let others kill?

• How can I ever get close to someone again?

• I will always feel alone. No one will ever understand me.



Mental Health Challenges for VeteransVeterans

Disorders in OIF & OEF Veterans

• ~18.5% have PTSD or depression

• ~19.5% a traumatic brain injury19.5% a traumatic brain injury

• ~70% have no mental health disorder

Tanielian & Jaycox, 2008

Post Traumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur following exposure tocan occur following exposure to actual or threatened death, serious injury or sexual violence.



Post Traumatic Stress Disorder (PTSD)

A stress disorder that can occur following a traumatic event.• Directly experiencingDirectly experiencing

• Witnessing in person

• Learning that traumatic event occurred to family or close friend (violent)

• Extreme repeated exposure to details.

Post Traumatic Stress Disorder (PTSD)Many people with PTSD naturally get better over time. But for some, PTSD is a chroniccondition that does not improve over time.

Reliving (re‐experiencing symptoms):

If you have PTSD, you might:

• Think about trauma when you don’t want to.

• Have frightening nightmares about the traumaHave frightening nightmares about the trauma

• Disconnect or dissociate such that you experience flashbacks during which you are re‐experiencingthe trauma.

• Feel intense distress when confronted by internalor external cues that remind you of the trauma.



AvoidingIf you have PTSD, you might:

• Avoid situations or that remind you of aspects of traumatic events.

• Avoid talking or thinking about the trauma.

• Avoid situations that trigger a fight or flight alarm response.

HyperarousalIf you have PTSD, you might:

• Feel jittery or stressedmost of the time.

• Be constantly alert and on the lookout for danger

• Feel very uncomfortable with strangers

• Feel suddenly (VERY) angry or irritable

• Have trouble falling or staying asleep

• Find it difficult to concentrate

• Be easily startled by unexpected noises

Thinking and FeelingIf you have PTSD, you might:

• Have profoundly negative thoughts about others: “No one can be trusted”

• Have profoundly negative thoughts about the world: p y g g“The world is completely dangerous – nowhere I go is truly safe.”

• Blame yourself for the trauma: “I should have…”

• Have constant feelings of shame, horror, anger or guilt.

• Feel numb or disconnected from others, unable to experience happiness, satisfaction or loving feelings.



PTSD Affects the Brain

Impaired Fight or Flight Response

PTSD is Affects the Brain


PTSD Affects the Brain




PTSD Affects the BrainImpaired Fight or Flight Response

Common Fight or Flight Triggers

• Someone standing too close

• Strangers

• Feeling cornered trapped or stuck• Feeling cornered, trapped or stuck

• Feeling out of control & overwhelmed

• Reminders or associations (tiger or kitten)

• Disorder – lack of order & chaos

• Being surprised or startled

A Remedy for PTSD

Lack of perceived social support has b f d bbeen found to be a strong predictor of PTSD.

(Brewin et al 2000)



81%

60%

40%50%

60%

70%

80%

90%

Q: WHEN YOU FIRST BECAME A STUDENT AT A COMMUNITY COLLEGE HOW COMFORTABLE WAS IT FOR YOUTO INTERACT WITH OTHER STUDENTS (NON-VETERANS)?

19%

40%

0%

10%

20%

30%

40%

VRC NO VRC

Somewhat or very comfortable with non‐veterans

Not comfortable with non‐veterans

Traumatic Brain Injury

The “signature wound” of the current conflicts

What is Traumatic Brain Injury?

Caused by a bump, blow, blast or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.

• Umbrella terms that spans wide variety of symptoms.

• 80% of combat head injuries are “mild concussions”

• Blast injuries resulting from IED’s are common cause.




• Often unknown to the veteran

• Could be diffuse symptoms – difficult to pinpoint or understandpinpoint or understand.

• May be in conjunction with PTSD

• May be the result of multiple injuries


• May impair learning in multiple ways

• Memory

• Concentration• Concentration

• Information processing (audio, visual or both)

• Slowed executive functions

– Problem solving

– Planning

– Insight / awareness

Cognitive Problems

• Memory

• Concentration & attention

Affective / Behavioral Problems

• Frustration or irritability

• Depression

• Anxiety

Somatic Complaints

• Headache

• Fatigue

• Poor balance

Common Symptoms – mTBI & PTSD

• Learning Difficulties

• Following complicated directions

• Language problems

• Impulse control

• Slowed or cloudy thinking

• Reduced tolerance for stress

• Sleep problems

• Numbing out or flipping out

• Inflexibility

• Feeling guilty

• Denial of problems

• Social appropriateness

• Dizziness

• Changes in vision, hearing, or touch

• Sexual problems



mTBIWhat you might not see:

Chronicle/Darren Breen

Common PTSD Triggers & Challenges

On Campusp

Parking



Noises and Distractions

Timed Tests

Class Assignments



Group Assignments

Campus Crowds & Crowded Classrooms

Managing Bureaucracies



Managing Bureaucracies



Recommendations

Review

• Cultural, mental health & physical issues can make it difficult for veterans to adapt to the requirements of campus life.

• Many veterans are new to navigating their disabilities – or seeing themselves as disabled. Many will struggle with asking for help.

How to Help a Veterans Help Themselves

“This is not a handout, it’s your civil right, that you defended”

“Stay focused on the mission – to succeed in school”

“No one is going to do the work for you – don’t worry, that’s still on you”



Recommendations

• Be specific and methodical when giving instruction.

• Use outcome specific language• Use outcome specific language.

• Refer for treatment and/or assessment

• Consider adding reasonable accommodation text to every syllabus.

Recommendations

• Give direct and honest feedback.

• Don’t be intimidated by receiving directand honest feedback.

• Be sensitive to the limitations of the VA and to the student’s ability to interact with VA clinicians – offer direct contact if appropriate.

Recommendations

• Warm handoffs make a HUGE difference. Whenever possible, make personal and specific referralsspecific referrals.



Recommendations

• Have a contact person on campus who is familiar with veteran related issues. Know how to reach that personKnow how to reach that person.

Recommendations

• If you don’t know the answer, try to find out. If you don’t know where to ask, chances are the veteran won’t knowchances are the veteran won t know either.

How Veterans Enhance Your Campus

• Resiliency and Strength

• Alternative perspectives & life experiences& life experiences

= DIVERSITY

• Motivation & determination

• Leadership

• Maturity



Remember, when you are not sure what to say to a veteran,

just say…

Welcome Home.

Thank You

[email protected]

Documents

Welcome Home: Veterans on Campus · Welcome Home: Veterans on Campus Training David M. Joseph, Ph.D 6 Communicating Less Assertively Adjusting to a less direct communication style