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Understanding a Veteran with PTSD

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This time of year, we remember with gratitude the many joys that our families, friends, clients, and neighbors have brought us, and we especially remember the sacrifices of those who have served our country. The Outreach Team at Maryville University has asked us to share this article with you, so that as attorneys, we might have a heightened understanding regarding the challenges that so many veterans face.

– Article courtesy of Maryville University.  See the original article here: https://online.maryville.edu/online-bachelors-degrees/psychology/understanding-a-veteran-with-ptsd/

Servicemen and women oftentimes face unique challenges when leaving active duty and readjusting to civilian life.

As explained by U.S. Veterans Magazine, these challenges include

  • discovering ways to re-establish their roles within the family,
  • having to find and obtain a civilian job (sometimes for the first time ever, such as when enlisting after graduating from high school),
  • and adjusting to a life that involves making their own choices versus being told what to do, how to do it, and when.

However, sometimes soldiers also return home with challenges related to their mental wellbeing as a result of what they’ve witnessed while on active duty. And one of the most common mental challenges is post-traumatic stress disorder (commonly known as PTSD).

PTSD and the Military

The National Institute of Mental Health (NIMH) explains that PTSD is “a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.” In the case of military personnel specifically, these types of events typically occur during times of war when soldiers find themselves face-to-face with not only their own mortality, but that of their fellow comrades as well.

In fact, PTSD is more common for military personnel than for the general population. According to the U.S. Department of Veterans Affairs, approximately 7 to 8 percent of the population will experience PTSD at some time in their lives. Yet, this rate is much higher for military veterans, and the exact amount depends largely on which conflict they endured.

For instance, those serving in operations Iraqi Freedom and Enduring Freedom have somewhere between an 11 and 20 percent chance of developing PTSD. However, it is estimated that approximately 30 percent of Vietnam War veterans developed or will develop this particular mental health condition. So, what is it like for veterans who are living with PTSD?

Living with PTSD

The NIMH says that individuals suffering from PTSD often have flashbacks of the traumatic event, bad dreams, and other frightening thoughts. They may also develop avoidance symptoms whereby they purposely stay away from anything that reminds them of the experience. This can mean avoiding certain places and objects that serve as a reminder of what they’ve experienced.

With PTSD also often comes what the NIMH refers to as arousal and reactivity symptoms. These include being easily startled, feeling on edge, and displaying angry outbursts. Trouble sleeping is also common with PTSD. According to the National Sleep Foundation, this is generally due to the individual feeling like they need to be alert, which is a result of the anxiety that sometimes comes with the nighttime and subsequent darkness, or the nightmares the person seeks to avoid.

Veterans with PTSD may notice cognitive and mood changes as well. For instance, they may find it difficult to remember the entire traumatic event or feel guilt associated with their part in it. Sometimes, they have negative feelings toward themselves or the world at large, or they lose interest in activities they used to enjoy.

These are all trademarks of PTSD and all of these types of responses must be present on some level for a professional to render a diagnosis. But why do some military personnel develop PTSD where others don’t, even if they’ve witnessed the exact same event?

PTSD Risk Factors

Many studies have been conducted on this very topic. One meta-analysis published in PLOS One reports that after reviewing 32 different pieces of research (21 retrospective studies, 4 prospective studies, and 7 cross-sectional studies), there are many factors that stand out as strong predictors of whether or not combat-involved military personnel will develop PTSD.

They include:

  • Previous exposure to adverse life events: Being exposed to troubling life experiences (such as sexual abuse or assault) prior to joining the military can increase the risk of PTSD, partially because the event’s negative impact creates other psychological issues.
  • Witnessing injury or death: If a servicemember witnesses an injury or death, or discharged his or her weapon during active duty, there is a higher risk of developing PTSD than a servicemember who has not experienced these circumstances.
  • Various military characteristics: Military rank and occupation, branch of service, length and number of deployments have all been found to contribute to PTSD risk, because each factor determines how likely it is the soldier will be part of active combat.
  • Deployment stressors: Being exposed to excessive temperatures, a lack of privacy in the unit, and worrying about family can all increase a vet’s risk of PTSD.
  • Gender: Female veterans develop PTSD more often than their male counterparts, possibly due to reasons associated with being more susceptible to depression, experiencing less cohesion in the military unit, and being more sensitive to threats.
  • Race: Minorities have been found to be more susceptible to PTSD than non-minority military personnel. However, it’s unclear if this is because this demographic tends to have more of the other risk factors, or if they are assigned to military roles that see combat more often.
  • Level of education: The lower a serviceman or woman’s educational level, the higher the risk of PTSD, potentially due to not having learned effective coping skills or limited access to helpful resources.

PTSD and Post-Deployment Risks

PLOS One’s research also found that PTSD risk can rise after returning home and is often based on various post-deployment factors.

One factor is social support, and their study found that “a positive recovery environment after trauma exposure may serve as a protective factor” for PTSD. In other words, the more the servicemember’s family and friends are there to offer support after duty is complete, the less likely it is that PTSD will develop. That’s because this level of support gives the servicemember the self-reliance and self-security needed to fend off this condition.

Work status after employment is a potential risk factor as well. Specifically, if the veteran comes back and is unemployed, and therefore unable to provide financially for the family unit, this may instigate PTSD.

These types of situations can occur long after the combat ends, but they can still affect the soldier psychologically, making PTSD a threat even after returning home. Knowing all of this, how can you best help a veteran with PTSD?

Helping Veterans with PTSD

The first step involves educating yourself about how someone with PTSD typically reacts. According to the National Center for PTSD, a person with this mental health condition may appear angry, tense, or worried. They may also come across as numb, distant, or detached.

Veterans with PTSD may also be easily irritated, jumpy, or nervous, while being more demanding or protective at the same time. Intimacy issues are not uncommon with PTSD either.

All of these responses can affect family and friends, who may feel hurt, dejected, angry, or sad, especially if they don’t recognize these patterns as being normal reactions to PTSD. So, creating a positive response first requires that you understand these responses enough to know they are a normal way of dealing with this condition.

The second step is to get the veteran the outside help he or she needs. This may involve counseling-type therapy sessions (either one-on-one, group, or both), or even family therapy so the everyone involved can work through the PTSD together. In this case, it helps to find a professional who specializes in the disorder.

If possible, ask local military veterans for their recommendations. Alternatively, you can do an internet search. For instance, Psychology Today offers the ability to do a quick search based on your geographic location. Just enter your city or zip code and all local therapists with this specialty are provided. This site even provides other necessary information to help make a more informed decision as to whether to hire them, such as:

  • a brief bio, along with qualifications and credentials
  • specialties, issues covered, and treatment approaches
  • cost per session and insurance plans accepted
  • contact information for setting up an introductory meeting

VA Specific Services

The National Center for PTSD also offers The Guide to VA Mental Health Services for Veterans and Families, which shares the types of treatments that are available through Department of Veterans Affairs (VA) and what happens when you request help.

For instance, for PTSD specifically, there are various medications that can sometimes help when treating depression, anxiety, mood disorders, and sleep disorders related to PTSD. There are also various talk therapies and residential care if long-term, intensive treatment is needed.

Eligibility for these types of services is based on a number of factors, but it generally involves completing active military service in one of the U.S. branches of military, being honorably discharged, or being a National Guard member or Reservist who served in a combat zone. If they determine that you qualify, you will likely be referred to a local VA facility for treatment to begin.

There are nearly 2,000 facilities, and you can use the online locator if you want to find the closest ones to you. Simply enter your location (either your full address or zip code), what type of facility you’re searching for, and how close the facility is (you can search based on a certain mile radius or request the 5, 10, or 25 closest centers to you). The results give you the facility name, its address and phone number, and how many miles it is from your home.

The Vet Center Program is one of the options available to any active or veteran military member who has served in a combat zone or area of hostility, has experienced military sexual trauma, or has provided emergent medical care or mortuary services. Services offered at these facilities include counseling, outreach and education, substance abuse assessment and referral, employment assessment and referral, explanation of VBA benefits, and screening and referral for other issues, such as traumatic brain injury (TBI) and depression.

The more you know about and understand PTSD, the easier it is to see the impact this condition can have on the military veteran individually and the family unit as a whole. Educating yourself about treatment options helps as well, and provides you with the tools you need to help yourself or a loved one overcome this sometimes debilitating condition.


Why It Is Worth the Time to Forge Relationships with Allied Professionals—Yes, You Can Develop Profitable Referrals!

ThinkstockPhotos-480331331To a large extent, your success is determined by how well you manage your leads and vital relationships, especially referral relationships with allied professionals. Unfortunately, forging and maintaining profitable referral relationships is one of the greatest challenges facing most law firms.

In the coming weeks, we’re going to discuss proven strategies for building a strong referral network. We’ll talk about how to get started on the right foot, the questions you need to ask to qualify your referral sources and properly set expectations, how to track your results, and more.

At the very least, we hope these emails help you understand the importance of the following two concepts:

Contrary to what some potential referral sources would have you believe, your value is not in the referrals you send back. Your value goes far beyond that.

Your goal is not simply to have good meetings with allied professionals. Rather, your goal is to turn meetings into revenue.

Logically enough, building profitable relationships with allied professionals begins with knowing precisely which professionals you should be meeting with. We’ll talk about that next time.


Use the Proper Software and System to Build a More Efficient Team

ThinkstockPhotos-200342113-001Using state-of-the-art software within an effective system allows you to build a highly efficient team and firm. Each workflow is comprised of a series of steps with a defined set of tasks to be completed at each step. Many of the steps are designed to do things automatically, like assign tasks to staff, send emails to update your clients on progress, and much more. Your staff can easily see the work assigned to them and what they need to do next, while you get a crystal clear picture of the workflow throughout your whole firm. You will see every matter’s progress, who is working on what, the steps that need to be taken next, and what might be holding things up. Armed with information like this, you’ll be able to better hold members of your team accountable and improve overall efficiency.

As we have seen, leading-edge software allows you to generate accurate, customized planning documents following a single client interview. Over time, and with proper training, you may even be able to turn this task over to a paralegal. And in the process, free up more time to pursue new clients and generate new revenue, or to simply work less and live more. The possibilities are limited only by your priorities.


From Efficiency to Proficiency: Automatic Alerts about Potential Planning Mistakes

GettyImages-915387342State-of-the-art asset protection software can alert you to potential problems. Case in point: During the interview, LWP software will display “light bulb” icons offering built-in practice tips and pointers that provide background and help you make informed choices. For example, there is a light bulb that displays information about required minimum distributions, which can help you select the best option for how to treat income from retirement accounts. These practice tips can include the language that would appear in your documents based on the selection you choose, references to case law or other legal authority, and sometimes just a simple explanation of the legal concept to help you make the proper selection for a particular client’s needs.

Light bulbs are just one of the safety nets you’ll find in LWP’s cloud-based software. A big, bold warning appears if one of your selections could impact your client’s Medicaid eligibility. It reminds you to use your best judgment to determine whether the warning applies in your jurisdiction and in your client’s particular situation.


Create Customized Estate Plans with Greater Efficiency

ThinkstockPhotos-879813798The process of creating a customized estate plan begins with the client interview. State-of-the-art software uses a single-entry system; as you work through the interview, you only have to enter information once. That information is later reused in the interview and replicated in the assembled documents.

Another benefit of a single-entry system is that it allows you to easily update necessary information. For example, if you need to change Bob Sample’s name to Robert P. Sample (or make a change considerably more complex), you only have to correct it once. The change will automatically be adopted throughout the interview, and ultimately, across every document included in this particular estate plan.

Additionally, the data collection tools within the software and workflows are designed to make it easier for you to gather the information you need to draft your clients’ documents. For example, when your legal assistant or client services coordinator enters a client’s information into a matter within the workflow, the information will populate and pre-fill some of the choices within the software interview.

Next time: Discover the power of Dynamic Interviews


Time Is Money, Make More of Both

Cloud-based-workflowLWP cloud-based workflows and the Color-Coded Planning System can help you manage time efficiently, monitor cash flow, hold your team accountable, and ultimately, realize your firm’s full profit potential. The more you work with the focusers and your calendar, the better you will get at reading them and pinpointing the areas that must be improved to achieve your goals. As always, if you have questions about these tools, or any of LWP’s systems and processes, we invite you to reach out to us.

Always cheering you on,

Your LWP Team


Meet Your Clients’ Needs During Green Time. They’ll Love (and Pay) You For It

Green-timeGreen time is the time you spend on serving your clients to provide the value for which they hired you. This requires working with your team, utilizing systems and processes to create consistent quality, and ultimately, reducing the amount of time YOU work every week, every month, every year.

Green time encompasses all of the following:

  • Working on client tasks, both products and services (light green)
  • Meetings with clients that deliver work/product (dark green)
  • Time with coworkers on work/product (light green)
  • Review of work/product (light green)

Ideally, 40 percent of your week should be devoted to green time.