Army Launches Chain Teaching Program for PTSD, MTBI

By Army News ServiceJuly 16, 2007

82nd Airborne Division
Soldiers from the 82nd Airborne Division are ready for the unexpected as they prepare to clear a house in Ar Raqqah, Iraq, July, 6. All Soldiers in combat situations like this suffer stress, but most recover quickly. Those whose symptoms persist may ... (Photo Credit: U.S. Army) VIEW ORIGINAL

WASHINGTON (Army News Service, July 18, 2007) - The Army launched today a "chain-teaching" program to help Soldiers and their Families identify symptoms and seek treatment for those suffering from Post Traumatic Stress Disorder and mild Traumatic Brain Injury.

The chain-teaching program, available at Army Knowledge Online or <a href=""target=_blank></a>, includes a standardized script and supporting audiovisual products that leaders will use to teach Soldiers about the signs and symptoms of these behavioral and mental-health issues.

All active-duty and reserve-component Soldiers will receive the training within 90 days of the launch.

"We emphasize that every commander needs to be able to do an individual assessment of each Soldier," said Col. C. Elspeth Ritchie, psychiatry consultant to the Surgeon General of the Army. "If a Soldier has an issue, that commander needs to be able to reach out and help that Soldier. Soldiers also need to be able to help each other."

A version designed specifically for Family Readiness Groups will be available July 24.

"Combat is inherently brutal and difficult, and it impacts humans in different ways," said Army Chief of Staff Gen. George Casey Jr. "We have made significant improvements in the identification and treatment for PTSD and mild TBI, but we must aggressively work research, prevention and treatment of these injuries and encourage Soldiers and their Families to seek treatment."

All Soldiers in combat suffer stress, but most recover quickly. Those whose symptoms persist may have PTSD.

PTSD and mild TBI are genuine medical and psychological conditions that can negatively impact a Soldier's personal life, professional abilities and health. Soldiers may be affected by only one or both conditions at the same time.

By seeking help, Soldiers can receive professional assessments that direct them toward the right care for their specific conditions.

"It's impossible not to be changed by going to war," said Dr. Deborah Warden, national director for the Defense and Veterans Brain Injury Center, headquartered at Walter Reed Army Medical Center. "Parsing out what parts are a stress reaction and what parts have to do with a previous concussion is difficult."

Previously referred to as "shell shock" or "battle fatigue," PTSD follows a terrifying physical or emotional event, and causes the individual to have persistent, frightening thoughts and memories or flashbacks. Soldiers with PTSD may have any of three kinds of symptoms for weeks or months after the event: re-experiencing the event over and over; avoiding people, places or feelings that remind them of the event; and feeling keyed up or on-edge.

Mild TBI, also known as a concussion, is caused by trauma to the head but may have no physical signs. It is accompanied by loss of consciousness, loss of memory of events immediately before or after the trauma, confusion and disorientation.

TBI and PTSD share such common symptoms as difficulty concentrating, memory problems and irritability, but TBI symptoms can also include headaches, dizziness and balance problems. A person with PTSD may have nightmares and anxiety that worsen.

Soldiers may still suffer from PTSD even if they were not hospitalized or personally injured, just as they may suffer from mild TBI without having been knocked out. In fact, mild TBI is frequently the result of repeated exposure to mild explosions or moderate explosions resulting in significant pressure changes in Humvees, according to health experts.

The chain-teaching program does not replace behavioral-health assessment tools and measures already in effect. Rather, it provides command emphasis and education at unit and Family levels to reinforce the Army's commitment to provide the best health care possible.

The program equips Soldiers to recognize PTSD and mild TBI symptoms in others.

"It is important to remember, although you may not be struggling, your battle buddy may be. We know that combat and operational experiences will impact every Soldier differently," says the chain-teaching script.

The training encourages Soldiers to realize their careers are endangered not when they seek help for their problems, but when they allow a mental-health condition to worsen without proper care.

"This is an attempt to shift the culture," Col. Ritchie said. "We know it will take time, but we need to act now."

"Our Army is doing everything possible to come to grips with a very challenging and complex issue," said Gen. Casey. "This is not just a medical problem; it is an Army problem, and we are going to do all we can to help our Soldiers."

The new program is part of the overall Army Medical Action Plan, the Army's initiative to develop a holistic approach to a sustainable system where Soldiers are supported, treated and vocationally rehabilitated to prepare them for successful return to duty or transition to active citizenship.

More information on the chain-teaching program and other behavioral-health programs is available at <a href=""target=_blank></a>. Check the August issue of "Soldiers" magazine for the story titled "Battling PTSD."

(Information provided by the U.S. Army Medical Command Public Affairs.)

Related Links:

Reducing Stigma Provides Key to Better Mental Health, Officials Say

Military Center Studies Traumatic Brain Injuries

Link to Chain Teaching Program

Army Targets Behavioral Health Issues Using Chain Teaching

Behavioral Health