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VISN 6 MIRECC > Education > Readjustment Challenges

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Military personnel are deeply affected by their war experiences. Adjustment difficulties are common. These are normal reactions to abnormal experiences.

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For Veterans & Families
*updated*  Improve Your Sleep: A Self-Guided Approach for Veterans with Insomnia V2

Dr. Christi Ulmer (HSR&D Center of Innovation and MIRECC faculty, Durham site) and Dr. Leah Farrell-Carnahan (MIRECC faculty, Richmond site) are engaged in the creation of self-help options for Veterans with insomnia. In 2011, they were awarded their first MIRECC Clinical Education Grant to support their work. They have now completed translation of cognitive behavioral treatment for insomnia (CBTI) into a self-management workbook format.  

Ulmer CS, Farrell-Carnahan L, Hughes JM, Manber R, Leggett MK, Tatum J, Swinkels C, Beckham JC, and the Mid-Atlantic (VISN 6) Mental Illness Research, Education and Clinical Center (MIRECC). (2018). Improve your Sleep: A Self-Guided Approach for Veterans with Insomnia (Self-Help Workbook). 

This project has also generated development of other innovative approaches. In July of 2014, they were contacted by the National Director of Web Services, Mental Health Informatics Section, about using their draft workbook content to develop a web-based self-help course. Drs. Ulmer and Farrell-Carnahan have since served as subject matter experts for the “Path to Better Sleep” course, which is now available at

In 2016, Drs. Ulmer and Farrell-Carnahan were awarded a second MIRECC Clinical Education Grant to create a 6 session telehealth-supported self-help CBTI ntervention. In “Tele-Self CBTI”, a VA healthcare provider contacts the Veteran by phone on a weekly basis to support their self-help CBTI efforts. Funding is being used to create both Provider and Veteran manuals for use with this intervention. HSR&D-funded research is underway to assess the feasibility of Tele-Self CBTI, and findings will be used to support research funding applications to test the efficacy of the intervention. 

These brochures provide information about common readjustment challenges and some possible coping strategies.

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For Employers
TTIWW: Employee Assistance in the Civilian Workforce - This free web course provides an introduction to the impact of the military culture, and the deployment cycle, on the civilian workplace experience of military affiliated individuals. It includes case studies of how specific issues ranging from physical disabilities, to behavioral health issues, to work/military/family life balance might be addressed in an employee assistance setting.
To attend this free web course on Post Deployment Issues, follow this link -
Register, then select the course you want to view.

For Community Providers
This series of free web courses is designed to familiarize healthcare providers with some of the unique issues of Veterans and their families.
Treating the Invisible Wounds of War (TTIWW)(English and Spanish editions) - This course is designed to help behavioral health providers and clinicians in all disciplines who may see a Veteran or family member on an unrelated issue develop a better understanding of the culture in which Veterans and their families live and work, and provide best practices for identifying, assessing and treating mental health disorders that result from the trauma of war.
TTIWW: A Primary Care Approach - This course is designed from a primary care perspective to help busy providers recognize, diagnose, treat or refer post-deployment mental health issues in military service members and their families.
TTIWW: Issues of Women Returning from Combat - Women military service members returning from deployment to the wars in Iraq and Afghanistan face gender-specific readjustment issues as they transition back to their local communities. This workshop will provide an overview of the health/mental health concerns of women veterans within the context of military culture, gender-specific roles, available support resources and effective treatments.
TTIWW: Recognizing the Signs of mTBI During Routine Eye Examinations - This course will help providers to screen for head trauma signs and includes resources to help providers better serve their military patients.
TTIWW: Understanding Military Family Issues - This course will address common issues of military families and provide resources to support military families and maximize their resiliency.

To attend any of these free web courses on Post Deployment Issues, follow this link -
Register, then select the course you want to view.

For Mental Health Providers - Impulse Control in PTSD Treatment
The goal of this MIRECC-funded clinical education proposal was manualization and dissemination of a PTSD treatment model emphasizing functional and adaptive coping skills. Both the Therapist and Client manuals for group treatment of PTSD were completed, and have been available for several years to other facilities to implement or adapt as needed. The PTSD Recovery Group program described in these manuals has been demonstrated to result in positive improvements in adaptive and symptomatic outcomes. Veterans who completed the 10 week PTSD Recovery Program had significantly reduced PTSD symptom severity and significantly improved psychosocial adjustment. These results support the PTSD Recovery Program as an effective and efficient stand-alone PTSD treatment or as a preliminary step to trauma-focused treatment. Dissemination of both the program itself and the new psychosocial adaptive behavior assessment measure (McGuire Adaptive PTSD Scale-Revised, MAPS-R) that has been developed is on-going. The 3rd Edition of the two manuals were recently released. For more information, contact Dr. Lynch:
PTSD Recovery Group-Therapist Manual 3rd Edition | 
PTSD Recovery Group-Client Manual 3rd Edition