Table of Contents

Wiley PracticePlanners® Series

Title Page

Dedication

Wiley PracticePlanners® Series Preface

Preface

About the Authors

Section I: Adjustment to Killing

Normal Reactions to Killing

EXERCISE I.A Normal Reactions to Killing

When Killing is Necessary

EXERCISE I.B When Killing is Necessary

Section II: Adjustment to the Military Culture

How Did I Imagine My Life in the Military?

EXERCISE II.A How Did I Imagine My Life in the Military?

All for One and One for All

EXERCISE II.B All for One and One for All

Section III: Amputation, Loss of Mobility, Disfigurement

Mourning and Acceptance

EXERCISE III.A Mourning and Acceptance

What Makes Me Who I Am?

EXERCISE III.B What Makes Me Who I Am?

Section IV: Anger Management and Domestic Violence

Anger as a Drug

EXERCISE IV.A Anger as a Drug

Being Who I Want To Be

EXERCISE IV.B Being Who I Want To Be

Section V: Antisocial Behavior in the Military

What was I Thinking?

EXERCISE V.A What was I Thinking?

Mentorship and Respect

EXERCISE V.B Mentorship and Respect

Section VI: Anxiety

Action, Coping Skills, and Acceptance

EXERCISE VI.A Action, Coping Skills, and Acceptance

Getting Away from Catastrophizing

EXERCISE VI.B Getting Away from Catastrophizing

Section VII: Attention and Concentration Deficits

Staying Focused

EXERCISE VII.A Staying Focused

Structuring My Life

EXERCISE VII.B Structuring My Life

Section VIII: Bereavement Due to the Loss of a Comrade

Commemorating Lost Friends and Family

EXERCISE VIII.A Commemorating Lost Friends and Family

How Do I Want to be Remembered?

EXERCISE VIII.B How Do I Want to be Remembered?

Section IX: Borderline Personality

Am I Comparing My Insides with Other People's Outsides?

EXERCISE IX.A Am I Comparing My Insides with Other People's Outsides?

I Can't Believe Everything I Think

EXERCISE IX.B I Can't Believe Everything I Think

Section X: Brief Reactive Psychotic Episode

Staying in Touch with Reality

EXERCISE X.A Staying in Touch with Reality

Reality Checks

EXERCISE X.B Reality Checks

Section XI: Chronic Pain After Injury

Alternative Methods for Managing Pain

EXERCISE XI.A Alternative Methods for Managing Pain

Coping with Addiction and Chronic Pain

EXERCISE XI.B Coping with Addiction and Chronic Pain

Helping Myself By Helping Others

EXERCISE XI.C Helping Myself By Helping Others

Section XII: Combat and Operational Stress Reaction

Normal Reactions in Extreme Situations

EXERCISE XII.A Normal Reactions in Extreme Situations

Healthy Ways to Handle Stress Fast

EXERCISE XII.B Healthy Ways to Handle Stress Fast

Section XIII: Conflict With Comrades

Communication and Conflict Management Skills

EXERCISE XIII.A Communication and Conflict Management Skills

Understanding Sources Of Conflict

EXERCISE XIII.B Understanding Sources Of Conflict

Section XIV: Depression

Challenging Depressive Illusions

EXERCISE XIV.A Challenging Depressive Illusions

From Acceptance to Appreciation

EXERCISE XIV.B From Acceptance to Appreciation

Section XV: Diversity Acceptance

Different People, Different Strengths

EXERCISE XV.A Different People, Different Strengths

We're More Alike than We Look: Seeing Past the Surface

EXERCISE XV.B We're More Alike than We Look: Seeing Past the Surface

Section XVI: Financial Difficulties

Money Management Skills

EXERCISE XVI.A Money Management Skills

Spending as a Drug

EXERCISE XVI.B Spending as a Drug

Section XVII: Homesickness/Loneliness

Making the Best of Wherever I am

EXERCISE XVII.A Making the Best of Wherever I am

This, too, Shall Pass: Taking it One Day at a Time

EXERCISE XVII.B This, Too, Shall Pass: Taking it One Day at a Time

Section XVIII: Insomnia

Why Can't I Sleep?

EXERCISE XVIII.A Why Can't I Sleep?

Sleep Management

EXERCISE XVIII.B Sleep Management

Section XIX: Mild Traumatic Brain Injury

Adapting to a Brain Injury

EXERCISE XIX.A Adapting to a Brain Injury

Helping My Family and Friends Help Me

EXERCISE XIX.B Helping My Family and Friends Help Me

Section XX: Nightmares

What are My Dreams Telling Me? Keeping a Dream Journal

EXERCISE XX.A What Are My Dreams Telling Me? Keeping A Dream Journal

Avoiding and Coping with Nightmares

EXERCISE XX.B Avoiding and Coping with Nightmares

Section XXI: Opioid Dependence

Near-Term and Long-Term Effects of Opioid Dependence and Withdrawal

EXERCISE XXI.A Near-Term and Long-Term Effects of Opioid Dependence and Withdrawal

Safe and Healthy Alternatives: Ways to Cope with Pain and Anxiety without Drugs

EXERCISE XXI.B Safe and Healthy Alternatives: Ways to Cope with Pain and Anxiety Without Drugs

Section XXII: Panic/Agoraphobia

Working with Fear

EXERCISE XXII.A Working with Fear

Preventing Panic in Myself and Others

EXERCISE XXII.B Preventing Panic in Myself and Others

Section XXIII: Parenting Problems Related to Deployment

How Will I Explain this Deployment to My Children?

EXERCISE XXIII.A How Will I Explain this Deployment To My Children?

How Will I Stay in Touch With My Children?

EXERCISE XXIII.B How Will I Stay in Touch With My Children?

Section XXIV: Performance-Enhancing Supplement Use

Near-Term and Long-Term Effects Of Stimulant Dependence and Withdrawal

EXERCISE XXIV.A Near-Term and Long-Term Effects of Stimulant Dependence and Withdrawal

Near-Term and Long-Term Effects of Anabolic Steroid Dependence and Withdrawal

EXERCISE XXIV.B Near-Term and Long-Term Effects of Anabolic Steroid Dependence and Withdrawal

Section XXV: Phobia

Useful and Useless Fear

EXERCISE XXV.A Useful and Useless Fear

Understanding and Overcoming Phobias

EXERCISE XXV.B Understanding and Overcoming Phobias

Section XXVI: Physiological Stress Response—Acute

Quick Strategies for Coping with Intense Stress Response

EXERCISE XXVI.A Quick Strategies for Coping with Intense Stress Response

Safe and Peaceful Place Meditation

EXERCISE XXVI.B Safe and Peaceful Place Meditation

Section XXVII: Post-Deployment Reintegration Problems

Why Am I Having Trouble Now?

EXERCISE XXVII.A Why Am I Having Trouble Now?

What's Different and How Will I Adapt?

EXERCISE XXVII.B What's Different and How will I Adapt

Section XXVIII: Posttraumatic Stress Disorder (PTSD)

I am a Survivor, Not a Victim—PTSD as Life Saving Adaptation

EXERCISE XXVIII.A I am a Survivor, Not a Victim—PTSD as Lifesaving Adaptation

Identifying and Avoiding or Coping with PTSD Triggers

EXERCISE XXVIII.B Identifying and Avoiding or Coping with PTSD Triggers

Section XXIX: Pre-Deployment Stress

Am I Ready for Deployment?

EXERCISE XXIX.A Am I Ready for Deployment?

Helping My Family Prepare for My Deployment

EXERCISE XXIX.B Helping My Family Prepare for My Deployment

Section XXX: Separation and Divorce

Getting Through the Loss of a Relationship

EXERCISE XXX.A Getting Through the Loss of a Relationship

Avoiding Rebounds, Replays, and Resentments: Identifying and Changing Patterns that Aren't Working

EXERCISE XXX.B Avoiding Rebounds, Replays, and Resentments: Identifying and Changing Patterns that Aren't Working

Section XXXI: Sexual Assault by Another Service Member

Taking Care of Myself Physically and Emotionally after a Sexual Assault

EXERCISE XXXI.A Taking Care of Myself Physically and Emotionally after a Sexual Assault

Healing and Claiming My Identity as a Survivor

EXERCISE XXXI.B Healing and Claiming My Identity as a Survivor

Section XXXII: Shift Work Sleep Disorder

Alternative Sleep Scheduling

EXERCISE XXXII.A Alternative Sleep Scheduling

Establishing a Shift Work Sleep Environment

EXERCISE XXXII.B Establishing a Shift Work Sleep Environment

Section XXXIII: Social Discomfort

Getting More Comfortable in Social Situations

EXERCISE XXXIII.A Getting More Comfortable in Social Situations

Finding a Social Niche and Friendships

EXERCISE XXXIII.B Finding a Social Niche and Friendships

Section XXXIV: Spiritual and Religious Issues

Understanding Spirituality

EXERCISE XXXIV.A Understanding Spirituality

What Do I Believe in?

EXERCISE XXXIV.B What Do I Believe in?

Section XXXV: Substance Abuse/Dependence

What Does Addiction Mean to me?

EXERCISE XXXV.A What Does Addiction Mean to me?

Problem Identification

EXERCISE XXXV.B Problem Identification

Personal Recovery Planning

EXERCISE XXXV.C Personal Recovery Planning

Section XXXVI: Suicidal Ideation

What Do I Have to Offer to Others?

EXERCISE XXXVI.A What Do I Have to Offer to Others?

Finding Emotional Relief and Support

EXERCISE XXXVI.B Finding Emotional Relief and Support

Section XXXVII: Survivor's Guilt

Corresponding with Fallen Friends

EXERCISE XXXVII.A Corresponding with Fallen Friends

Carrying the Legacy

EXERCISE XXXVII.B Carrying the Legacy

Section XXXVIII: Tobacco Use

Avoiding Nicotine Relapse Triggers

EXERCISE XXXVIII.A Avoiding Nicotine Relapse Triggers

Use of Affirmations for Change

EXERCISE XXXVIII.B Use of Affirmations for Change

Appendix: Additional Assignments for Presenting Problems

About the Downloadable Assignments

Download CD/DVD Content

End User License Agreement

Wiley PracticePlanners® Series

The Couples Psychotherapy Treatment Planner, with DSM-5 Updates, Second Edition

The Older Adult Psychotherapy treatment Planner with DSM-5 Updates, Second Edition

The Severe and Persistent Mental Illness Treatment Planner, with DSM-5 Updates, Second Edition

The Crisis Counseling and Traumatic Events Treatments Planner, with DSM-5 Updates, Second Edition

The School Counseling and School Social Work Treatment Planner, with DSM-5 Updates, Second Edition

The Veterans and Active Duty Military Psychotherapy Treatment Planner, with DSM-5 Updates

The Severe and Persistent Mental Illness Progress Notes Planner, Second Edition

Wiley PracticePlanners®

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The veterans and active duty military psychotherapy homework planner / James R. Finley, Bret A. Moore.

ISBN 978-1-119-38482-3 (paper); 978-1-119-38483-0 (ePub); 978-1-119-38498-4 (ePDF)

This book is dedicated to our loved ones, without whose support and encouragement we could not do what we do; to the many colleagues, mentors, and clients who have shared their lives and their wisdom with us through the years; and finally to the brave, skilled, and dedicated men and women in uniform who have been our brothers and sisters in arms past, present, and future.

Accountability is an important dimension of the practice of psychotherapy. Treatment programs, public agencies, clinics, and practitioners must justify and document their treatment plans to outside review entities in order to be reimbursed for services. The books and software in the Wiley PracticePlanners® series are designed to help practitioners fulfill these documentation requirements efficiently and professionally.

The Wiley PracticePlanners® series includes a wide array of treatment planning books including not only the original Complete Adult Psychotherapy Treatment Planner, Child Psychotherapy Treatment Planner, and Adolescent Psychotherapy Treatment Planner, all now in their fourth editions, but also Treatment Planners targeted to specialty areas of practice, including:

In addition, there are three branches of companion books which can be used in conjunction with the Treatment Planners, or on their own:

Adjunctive books, such as The Psychotherapy Documentation Primer and The Clinical Documentation Sourcebook, contain forms and resources to aid the clinician in mental health practice management.

The goal of our series is to provide practitioners with the resources they need in order to provide high quality care in the era of accountability. To put it simply: We seek to help you spend more time on patients, and less time on paperwork.

Preface

Today there is a large and growing population of veterans and active duty military personnel with some unique psychotherapeutic needs. They range from those who are still in their teens to some of their great grandparents who served in World War II and Korea. They are men and women from every sector of society, and they come to us to help them cope with issues such as building new lives with physical disabilities more extensive than ever before, because medicine has advanced so far that doctors can save the lives of Soldiers, Sailors, Airmen, Marines, and Coast Guardsmen who would have died of their wounds in any previous era. Other issues involve their families and the strains of having one and sometimes both parents going overseas multiple times. At the same time, there aren't nearly enough treatment resources to meet the need as well as we wish we could.

The use of therapeutic homework assignments to augment face-to-face sessions with a therapist, social worker, psychologist, or psychiatrist offers great advantages. It serves as a “force multiplier” enabling the clinician to engage the veteran or service member with whom he or she is working in the therapy process every day, rather than only on days they can meet. This allows each professional to help several times as many clients as would be possible if all the work were being done in session. It keeps the therapeutic process in the forefront of the lives of veterans and service members both by engaging their attention and energy daily and potentially in all spheres of their lives. They are able to take the work of therapy into the arenas in life that challenge them, practice what they're learning on the spot, and process the lessons learned when they meet with their clinicians. They are also able to involve their families in their therapy more easily, as they do the homework on their schedule, at the place that works for them.

The homework assignments are provided online as well as printed in the Planner, enabling clinicians to modify them, tailoring each assignment to the situation, coping resources, stages of readiness and insight, and other specifics of each client. They are uniformly cognitive-behavioral in structure, the approach research shows is most effective for psychotherapy in general, with many also containing strong elements of solution-focused brief therapy.

As with other Homework Planners in the Wiley PracticePlanners series, the assignments are closely integrated with the corresponding Treatment Planner, Progress Notes Planner, and TheraScribe module, being built on the same problem areas. This Homework Planner contains 78 homework assignments covering 38 problem areas, with a Therapist's Overview for each assignment. In many cases the Overviews also offer videotherapy recommendations tapping into another Wiley resource, Rent Two Films and Let's Talk in the Morning, 2nd ed., by John W. Hesley and Jan G. Hesley.

A final note: Both of us are not only clinicians, we are veterans. We've based a lot of this book on our own experiences on active duty in the U.S. Army and Marine Corps. We have done our best to produce a work that would do as much good for our brothers and sisters in arms as we possibly could. If you have suggestions for ways we can make it better, please contact us via John Wiley & Sons, Inc. We appreciate all the feedback we can get.

About the Authors

James R. Finley, MA, LMHC, is a psychotherapist with experience as a therapist, clinical supervisor, and program manager in a variety of military, community, and correctional settings—outpatient and inpatient. He is the author of Integrating the 12 Steps into Addiction Therapy and coauthor with Brenda S. Lenz of The Addiction Counselor's Documentation Sourcebook, 2nd ed. and The Addiction Treatment Homework Planner, 4th Edition, also published by John Wiley & Sons. He is a retired Marine and disabled veteran.

Bret A. Moore, PsyD, ABPP, is a clinical psychologist in San Antonio, Texas. In 2008, he left active duty service in the U.S. Army, where he served as a captain and a clinical psychologist with the 85th Combat Stress Control (CSC) unit based in Fort Hood, Texas. He has extensive experience treating veterans, including two tours of duty in Iraq as an Officer in Charge of Preventive Services and Officer in Charge of Clinical Operations. He is coauthor of The Veterans and Active Duty Military Psychotherapy Treatment Planner and Wheels Down: Adjusting to Life after Deployment. He is coeditor of Living and Surviving in Harm's Way: A Psychological Treatment Handbook for Pre- and Post-Deployment of Military Personnel and Pharmacotherapy for Psychologists: Prescribing and Collaborative Roles. He also writes a bi-weekly column for Military Times titled Kevlar for the Mind, which deals with mental health issues specific to veterans and service members.

Section I: Adjustment to Killing

Normal Reactions to Killing

Goals of the Exercise

1. Resolve cognitive and emotional conflicts surrounding killing another human.

2. Facilitate reconciliation of spiritual and moral conflicts with killing.

3. Replace negative ruminations with more adaptive thoughts.

4. Reduce anxiety and prepare emotionally for future combat/training missions.

5. Understand how killing another human can impact the mind and create temporary changes in the body's physiology.

Additional Problems for which this Exercise may be Useful

Adjustment to the Military Culture
Combat and Operational Stress Reaction
Nightmares
Posttraumatic Stress Disorder (PTSD)
Spiritual and Religious Issues

Suggestions for Processing this Exercise with Veteran/Service Member

The “Normal Reactions to Killing” activity is designed for use with veterans/service members who are experiencing guilt and self-condemnation after combat experiences in which they killed other people, particularly when those emotions are based on conflicts between the act of killing and religious or other moral training received earlier in their lives. Alternately, it may also be useful with veterans/service members who feel “less than” among peers because they (the veterans/service members) perceive themselves as having more trouble making this adjustment than others. The activity seeks to normalize common thoughts and emotions experienced by many people in combat and other situations in which they must kill other human beings, and to help these veterans/service members gain reassurance by seeing that their reactions are healthy and normal. Follow-up for this exercise could include reporting back to the therapist on thoughts and feelings about this assignment and their outcome, as well as bibliotherapy using books suggested in Appendix A of The Veterans and Active Duty Military Psychotherapy Treatment Planner.

EXERCISE I.A Normal Reactions to Killing

What is a normal reaction to killing another person? What thoughts and emotions are typical for military men and women in this situation?

First, it's important to realize that there is no one normal reaction. Your response, and anyone else's, is shaped by a combination of childhood lessons about right and wrong, cultural messages, expectations about the experience of fighting and killing, and the specific circumstances in which the experience of killing takes place. There are some common tendencies, though. For many of us, it means we're doing the opposite of what we've been taught, and often of what our instincts tell us. It's also common to find that neither the experience of combat nor our feelings at the time are what we anticipated.

This exercise will help you think through this issue and, hopefully, make more sense of your experience in combat and of your thoughts and emotions about that experience.

1. To start with, what beliefs and values related to killing did you have going into combat, and how do you think those beliefs and values affected your reaction?

_____

2. Some of the common reactions many people have to killing include feeling sick, feeling regret, feeling guilty or ashamed, and other negative emotions. On the other hand, some people feel elated and glad to be alive, and some just feel a sense of satisfaction that they didn't let the other people in their unit down. It doesn't mean there's anything wrong with a person if he or she feels any of these things, or even goes back and forth between some of them. Before your experience of combat and killing, how did you think you would feel, and what did you consider a normal reaction?

_____

3. Now think of a leader you respect deeply, someone you consider both good at accomplishing the mission and a good person in terms of character. How do you suppose that person felt after his or her first experience of combat, death, and killing? Have you talked with him or her about it, and if not, how do you believe that person would respond if you wanted to have that kind of talk?

_____

4. Although some people are surprised, perhaps even worried about themselves or ashamed, by their reactions to their first experiences of killing, some others are more bothered by the way their feelings about it change with more experience; they may find themselves caring less, feeling hardened, and wondering whether this means they are becoming people with no conscience. Have you experienced anything like this? If you have, please use this space to briefly describe the changes in your feelings and what you think they mean.

_____

5. Now, consider this: Would people who really were without conscience be worried about it, or even think about it at all? In fact, this process of becoming somewhat numb to the experiences of danger, of killing, perhaps of seeing friends killed or wounded, is usually the mind's way of taking care of itself, enabling a person to keep functioning in a harsh environment. We are very adaptable by nature, and human beings have survived in all kinds of extreme situations, in part by adapting mentally. This is a normal and healthy reaction under these extreme and unhealthy conditions, too. What do you think might happen to a person who had to stay in a combat environment and was unable to develop this kind of mental toughness?

_____

6. Finally, people sometimes look at the ways they've reacted to combat and killing and wonder whether they'll be able to readjust to normal life when they return to it. Have you had this concern? If so, what parts of your reaction to war worry you the most?

_____

7. This is a normal concern shared by many people, too; however, most of them make the readjustment to “real world” life successfully, and there are many resources you can go to for information and other tools to help you in the readjustment process. Please use this space to list three things you can do to make that readjustment as successful as possible for yourself.

_____

Be sure to bring this handout back to your next session with your therapist, and be prepared to discuss your thoughts and feelings about the exercise.

When Killing is Necessary

Goals of the Exercise

1. Resolve cognitive and emotional conflicts surrounding killing another human.

2. Facilitate reconciliation of spiritual and moral conflicts with killing.

3. Replace negative ruminations with more adaptive thoughts.

4. Reduce anxiety and prepare emotionally for future combat/training missions.

Additional Problems for which this Exercise may be Useful

Adjustment to the Military Culture
Combat and Operational Stress Reaction
Posttraumatic Stress Disorder (PTSD)
Spiritual and Religious Issues

Suggestions for Processing this Exercise with Veteran/Service Member

The “When Killing Is Necessary” activity is designed for use with veterans/service members who are experiencing moral, ethical, and/or spiritual conflict between normal societal values prohibiting killing of other people and the necessity to kill in combat. This activity is best suited for use with veterans/service members who are motivated by spiritual training and concerns about leading socially responsible and ethical lives and are troubled by this conflict, or who respond with feelings of guilt and cognitive dissonance when they find themselves engaged in, preparing to engage in, or remembering combat. Follow-up for this exercise could include reporting back to the therapist/therapy group on thoughts and feelings about this assignment, as well as bibliotherapy using books suggested in Appendix A of The Veterans and Active Duty Military Psychotherapy Treatment Planner.

EXERCISE I.B When Killing is Necessary

Is killing ever right, and if so, when? That may seem like an unrealistic question, but even for some people who have experienced combat and killing, it's hard to answer. However, many people throughout history have struggled with this issue. Each of us must find our own solution, but there are some common realizations that many have found and shared. This exercise will help you think through this question and, hopefully, come to a resolution that truly makes sense for you.

Sometimes it's useful to look at the differences between the situations in which our “normal” values are meant to guide our actions, and the very different situations encountered in combat. Warfare has always created some very hard questions for people who want to do what is right, and it's wise to think through those questions in a calmer situation and, if possible, answer them for yourself before you have to act on your choices. The rest of this assignment will bring up some of those hard questions and ask you to think them through and answer them for yourself now.

1. A useful place to begin is with what we already know or believe. What have you been taught about violence against other people, up to and including killing?

_____

2. What situations have you learned or been taught justified violence against other people, if any—self-defense, defense of another person, and so on?

_____

3. Some people believe killing is always wrong no matter what. That sounds simple and clear, but it doesn't offer an answer when someone is likely to die no matter what you do, and it becomes a choice of who will die—you and your friends, or the enemies you're fighting. If you've held the belief that killing is wrong, period, what do you think the people who taught you that would want you to do when you have to choose between killing to defend yourself and the people depending on you, or failing to do so and having that result in the deaths of yourself and others in your unit?

_____

4. It's fairly common in some kinds of warfare to encounter situations in which you are confronted with enemies who are not attacking or threatening you at that moment, or not directly, but who will represent a threat if left alone. If a close friend asked your advice, would you tell him or her that killing those enemies was justified—self-defense against a future threat rather than one in the present—and if not, what would you advise your friend to do?

_____

5. Finally, people who have never experienced it may not be able to understand the chaos, confusion, and stress that surround a person making life-and-death decisions in split-seconds in combat; even a belief in the right to self-defense against a clear threat may not guide you when a situation is not clear and failure to act may cause the wounding or death of yourself or other people in your unit, but taking forceful action may cause the deaths of noncombatants due to the confusion and chaos of the moment. Thinking about it now, if that close friend asked your advice again, would you tell him or her that forceful action was justified? If not, what would you recommend that your friend do?

_____

Most people would agree that all you can ask of anyone is that they would do their best in any situation, within the limits of what's going on around them; their mental, emotional, and physical state; and what information they have to act on. Do you agree with that philosophy, and if you do, is that a standard you can meet? If so, as long as you do your best, you'll be making the best of the situation even when none of the possible outcomes are what you might have wished they were. That's not to say you won't be troubled—you may be, depending on what situations you've met in the past or meet in the future. But if you can honestly tell yourself you made the best choices you could given the stressors and time pressure you were under and the limited knowledge of the situation you may have had, you've done all anyone has the right to ask of you. Try to remember not to judge yourself by a higher standard than you'd impose on a friend.

Be sure to bring this handout back to your next session with your therapist, and be prepared to discuss your thoughts and feelings about the exercise.

Section II: Adjustment to the Military Culture

How Did I Imagine My Life in the Military?

Goals of the Exercise

1. Enhance ability to adapt to the structure, expectations, and hierarchical organization of the military.

2. Develop adaptive means for dealing with the physical and mental stress of military service.

3. Identify positive aspects of serving in the military.

4. Develop a trusting and open relationship with a superior within the chain of command.

Additional Problems for which this Exercise may be Useful

Antisocial Behavior in the Military
Conflict with Comrades
Diversity Acceptance
Homesickness/Loneliness

Suggestions for Processing this Exercise with Service Member

Adjusting to military life can be difficult, even for the most well-adjusted individual. The differences between the way service members pictured it before joining and the day-to-day reality of military life can create feelings of disillusionment. Learning to navigate the many sometimes arbitrary, confusing, and counterintuitive rules, customs, and traditions can dampen the spirit of newly minted service members. This exercise allows the service member to develop a greater appreciation for the positive aspects of being in the military as well as identify negative thoughts that may be reinforcing the negative aspects of being in the military. Be mindful that reassurance, patience, and compassion will go a long way in helping service members become accustomed to their new lifestyle. Follow-up for this exercise could include reporting back to the therapist/therapy group on actions related to this assignment and their outcomes, as well as bibliotherapy using books suggested in Appendix A of The Veterans and Active Duty Military Psychotherapy Treatment Planner and/or videotherapy using films on the topics of “Friends and Support Systems” and/or “Vocational and Work-Related Issues” recommended in Rent Two Films and Let's Talk in the Morning, 2nd ed., by John W. Hesley and Jan G. Hesley, also published by John Wiley & Sons.

EXERCISE II.A How Did I Imagine My Life in the Military?

It's normal to second-guess your choice of joining the military. Nearly every service member has been there at some point. At times, things seem unfair—your life is micromanaged by people you hardly know and you have to ask permission to do the most basic things. But things are not all bad. There are many benefits to being in the military, though it's easy to lose sight of this fact. This exercise will help you focus on the positive aspects of being in the military and get you thinking about ways to overcome the negatives.

1. Most of us find that some parts of military life are not what we expected. We may have pictured it with more drama and glamour, and less stress and boredom. We have become disappointed with this new environment that confronts us with an endless supply of rules, customs, and traditions that are sometimes confusing and don't seem to make sense. If you've found differences between what you expected and what you've experienced, describe those differences here:

_____

2. If you are completing this exercise, it's likely that you are already well-aware of the cons (negatives) of being in the military. Please list some pros (positives) of being in the military:

a. _____

b. _____

c. _____

d. _____

e. _____

f. _____

g. _____

h. _____

i. _____

j. _____

k. _____

l. _____

3. Choose three of the pros from above and write about why they are important to you. Use three 5 × 7 note cards and fill up at least the front of each card. Once you've finished them, place the cards in your pocket and review them at least once each day.

4. Now, list three cons of being in the military. List one negative thought that may reinforce negative views of why a “con” situation exists; then list thoughts that explain these situations in more positive ways. (Example: [con] My NCO is always correcting me. [negative thought] He doesn't respect me—he thinks I'm an idiot. [positive thought] He sees my potential and is setting high standards for me because he believes I can meet them.)

A. Three cons of being in the military

1. _____

2. _____

3. _____

B. Negative thoughts (negative explanations for situation in each con)

1. _____

2. _____

3. _____

C. Positive thoughts (positive explanations for situation in each con)

1. _____

2. _____

3. _____

5. Does looking at these “cons” in both negative and positive ways make it easier for you to go through the day in a more positive mood than if you were only thinking about the negatives? Does it make adjusting to military life more manageable? If so, please briefly describe the difference this is making for you:

_____

Be sure to bring this handout back to your next session with your therapist, and be prepared to discuss your thoughts and feelings about the exercise.

All for One and One for All

Goals of the Exercise

1. Identify and implement changes that will reduce the negative emotions brought on by adjustment to military life.

2. Identify and develop activities outside of the military that provide a sense of pleasure and self-worth.

3. Develop friendships with others with similar interests.

4. Use existing supports within the military that assist with the challenges of adjusting to military life.

5. Develop new, or engage in existing, hobbies that are non-military related.

Additional Problems for which this Exercise may be Useful

Adjustment to the Military Culture
Conflict with Comrades
Diversity Acceptance
Homesickness/Loneliness

Suggestions for Processing this Exercise with Veteran/Service Member

Joining the military is the first big life decision for many service members. Leaving home and being shipped off to an unfamiliar part of the country or to a foreign land can be intimidating. For many young service members, withdrawal and seclusion are normal reactions to being surrounded by unfamiliar people, places, and things. This exercise will help the service member expand his/her interests and strengthen already existing social supports. It will also help him/her develop new non-military related activities and interests. Follow-up for this exercise could include reporting back to the therapist/therapy group on actions related to this assignment and their outcome, as well as bibliotherapy using books suggested in Appendix A of The Veterans and Active Duty Military Psychotherapy Treatment Planner and/or videotherapy using films on the topic of “Friends and Support Systems” recommended in Rent Two Films and Let's Talk in the Morning, 2nd ed., by John W. Hesley and Jan G. Hesley, also published by John Wiley & Sons.

EXERCISE II.B All for One and One for All

For most of us, part of the appeal of military service was the idea of being a member of a tight-knit group—all for one and one for all, as expressed in The Three Musketeers. However, when we're uncomfortable with a major life change, we may tend to withdraw from our surroundings. Unfortunately, this limits our interaction with others and keeps us from enjoying places and activities, putting that camaraderie out of reach. In this exercise, list three activities that you enjoy but haven't engaged in since joining the military, and make a plan for how you will get involved in each activity again. In addition to having fun, this is a great way to find friends who share your interests. After you've done that, identify at least five new potential sources of support and friendship that you can explore (e.g., church, singles group, amateur sports team, hobby club, military mentor).

1. Activity #1

What is the activity? _____

Plan for getting active in the activity again:

_____

2. Activity #2

What is the activity? _____

Plan for getting active in the activity again:

_____

3. Activity #3

What is the activity? _____

Plan for getting active in the activity again:

_____

4. List five new potential sources of support and friendship and when you'll try them out.

a. _____

b. _____

c. _____

d. _____

e. _____

Be sure to bring this handout back to your next session with your therapist, and be prepared to discuss your thoughts and feelings about the exercise.