Grants Post Award Conference St. Louis, MO

“The best thing about the future, is that it comes only one day at a time.”

A. Lincoln

Buddies/Cohesion vs. WithdrawalAccountability vs. Controlling Targeted Aggression vs.

Inappropriate AggressionTactical Awareness vs.

HypervigilanceLethally Armed vs. “Locked and

Loaded”

Emotional Control vs. Anger /Detachment

Mission Operational Security vs. Secretiveness

Individual Responsibility vs. GuiltNon-Defensive (combat) Driving vs.

Aggressive DrivingDiscipline and Ordering vs. Conflict

Two times the amputations of any previous war

11-28 % identified with TBI22% diagnosed with PTSD, could reach 30%

Many undiagnosed for many years

Two times the amputations of any previous war

11-28 % identified with TBI22% diagnosed with PTSD, could reach 30%

Many undiagnosed for many years

Exposure to an event that causes intense horror, terror or fear of death. After the event the person persistently re-experiences the event, attempts to avoid memory or images of the event and suffers distress or impairment.

Exposure to an event that causes intense horror, terror or fear of death. After the event the person persistently re-experiences the event, attempts to avoid memory or images of the event and suffers distress or impairment.

Sleep problemsRestlessnessOverly watchfulHyper vigilantSocial withdrawalHeadachesAnger OutburstsRisk taking behavior

Socially Disconnected

Emotionally numbDepressed/AnxiousMemory/Attention

SpanFollow throughPoor frustration

toleranceDistrust of Authority

Do not want to be seen as “weak”

Survivor GuiltDo not see own symptomsMajor event will bring to the surface

Whole body/mind disorder

Both open head injury and closed head injuries can vary greatly in degree and resulting damage. A closed injury tends to be more diffuse, from swelling and bleeding and an open injury is more focal to one specific area of the brain. The degree of injury is normally judged by the intensity of the blow.

Physical: headaches, dizziness, balance, nausea, fatigue, sleep disturbance, blurred vision, sensitive to light, hearing difficulties or loss, sensitivity to noise, seizures, numbness, tingling, loss of taste

Weakness in one or more limbs, facial muscles, or one side of body. Difficulty finding words, or understanding the speech of others, slurred or slow speech.

Cognitive Behavioral/Emotional

Depression, Anxiety,, agitation, irritability, impulsivity, aggressiveness, Nervous, difficulty controlling urges, (uninhibited), inappropriate laughter.

Attention span, concentration, memory, speed of processing, judgment, executive control

Majority are mild and gone in 3 monthsNo two brain injuries are ever the sameEffects are complex and vary from person

to personIn combat TBI can be either from a direct

blow to the head orAs a result of an IEDA closed brain injury is often undetected

until later

Possible Job accommodations“Do what you can, With what you have,Where you are” T. Roosevelt

Reduce distractionsProvide private spaceEnsure adequate lightingDivide large assignments into smaller

piecesPlan uninterrupted work timeProvide disability awareness to co-

workersCombine breaks into one long break

Encourage employees to walk awayAssign a mentorProvide the availability or closed door

spaceAllows calls to counselors and doctors and

the time to make up the workAllow a place for relaxation techniques

during breaksProvide written as well as verbal

instructions

Table 10 – Employer concerns about hiringCosts More = 58.1%Lack skills and experience = 49.4%Not as Safe and Productive = 45.7&Supervisors/disciplinary action = 44.3%

Supervisors/Evaluate = 40.7%

Table 12 – Helpful Hiring StrategiesEmployer tax credit and incentives =

69.2%Disability awareness training = 64.3%Visible top management commit = 64.2%Mentoring = 63.4%Assistive Technology = 61.1%A specialized Recruiting force = 60%Flexible work schedule = 60%Train Existing Staff = 57.9%

Success is not final, Failure is not fatal: It is the

courage to continue that counts

W. Churchill

4/09 VHA states “1/5 of the veteran population was homeless prior to incarceration

National Center for PTSD….PTSD can indirectly lead to criminal behavior, i.e. self medication and hyper vigilance.

Psychiatric services studied 129 veteran inmates and 50 tested positive for PTSD.

2008 conference of Mayors committed to the idea of veteran court systems and training of first responders.

Self-conceptSelf-knowledgeSelf-efficacyInternal locus of controlNegative beliefs or attitudePlanning and decision making

Prepare a master applicationHave a social security number and card

Have a permanent addressRecord an appropriate message on your phone or answering machine

Have resources for faxes and e-mails

Do Not Lie!

Letter of Explanation

ImmaturityIrresponsiblenessSelf-centerednessLittle concern for othersLack of remorseAbility to “talk” themselves out of

anythingModel prisoner

Adults make mistakes

Listen to Input

Confront the Offender

Know your authorityDo not threatenState clear consequencesBe clear about observations and

perceptionsMonitor results for accountabilitySay no and follow through

Substance Abuse 68%Transportation 63%Lack of understanding workplace culture 34%

Lack of meaningful support 29%

In most cases needs permission in writingArrests during last 7 yearsConvictions (no matter when it

occurred)Do not have to report any records that

have been legally erased

Employers in 2001 44% always check and 18% sometimes check. Some occupations are required to check.

“Don’t let what you can’t do Stop you from what you can

do.”

J. Wooden

What is Case ManagementCase management is the facilitation and coordination of services at the community level. The purpose of case management is to provide individuals with specific resources to take control of his/her life. It requires the case manager to focus on the long and short term goals an individual has and empower him/her to make educated decisions about their future.

1. Case management is comprehensive and client centered

2. The case manager and the client are partners

3.There is mutual respect between clients and case managers

4. A client has only one IDP.

5. Case management relates client’s actions to outcomes.

6. Case management involves creative problem solving.

8. The case manager and the system are accountable.

9. Case management requires partnership at the system level

7. Case management relies on a network of services and support.

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WholePerson

Concept

Four Step Goal Setting Process

Change the problem statement into goal statements

Brainstorm solutions and options; Balance options with reality

Four Step Goal Setting Process

Choose one or more options

Sequence services and options on the IDP and establish responsibility

Criteria for Goals

SpecificMeasurableAttainableRealisticTrackable

~Date anything that is written

~Quote statements exactly as stated

~Recognize pertinent information

~Write in specific, observable and measurable terms

~If something is an opinion, say so

Case

Notes

Reviewing IDPs

Summary of the assessment information

State specific goals

Reviewing IDPs

In 2 weeks, I will have…

State who is

Reviewing IDPs

Dates each step will be accomplished

Reviewing IDPs

Client’s and case managers

Reviewing IDPs

Signature

Client should be given a copy

Reviewing IDPs

Reviewed and updated regularly

Reviewing IDPs

Can notes be deciphered

Reviewing IDPs