Consortium for Defense Psychology

By Kristyn Heins, Ph.D.  

The Suicide Prevention and Response Independent Review Committee (SPRIRC) identified a number of recommendations for improving suicide prevention efforts. Some of these included increasing suicide prevention training, improving access to resources, and promoting lethal means safety. The Consortium for Defense Psychology (CDP) has spent the past year targeting a few of these recommendations and increasing the effort to improve suicide prevention services.

One of the most notable efforts was the increase in offered trainings of Cognitive Behavioral Therapy-Suicide Prevention (CBT-SP). The CDP offered 69 CBT-SP trainings over the last 12 months. The two-day immersive training includes education on terms and theory, a specific focus on lethal means safety, and detailed review of the evidence based therapy. Participants engage in polls, small group discussions, and have opportunities to role play these new skills. Once someone has finished the two-day training, they are encouraged to engage in free CBT-SP consultation which is offered twice a week by CDP subject matter experts.

The CDP has also worked to engage adjacent providers, not just training therapists. The suicide prevention training for mental health technicians (MHTs), which is an interactive, instructor-led course, includes role play activities to reinforce learning in each of the key skills. The course provides an overview of the basic components of CBT-SP and how a MHT can support a patient engaged in CBT-SP. Additionally, a separate training tailored to prescribers provides education on the essential skills associated with suicide prevention. This includes safety planning and LMSC, while also providing modules on DOW recommendations and best practices for prescribing medication to patients experiencing increased suicide risk.

The CDP continues to evolve in how we are reaching providers. Over the past year a number of CDP Presents, our monthly webinar series, focused on suicide prevention. Inspiring presentations included navigating suicide in context of romantic relationships, Dialectical Behavioral Therapy for suicide prevention, and prevention of harmful behaviors. One of the most engaging methods of reaching providers is through the Practical for Your Practice podcast. Episodes included topics like navigating multiple presenting problems that contribute to suicide risk, personal experience of suicide loss, and firearm safety.

The CDP considered how various presenting concerns can contribute to suicide risk. Knowing that suicidal thoughts do not develop in a vacuum, we considered what other diagnoses we should be addressing. This year marked the re-launch of CBT for Chronic Pain. There were nine Cognitive Behavioral Therapy-Chronic Pain offerings this past year, each with a substantial number of actively engaged participants. The CDP has also incorporated training on Posttraumatic Stress Disorder evidence based therapies, understanding that traumatic experiences can contribute to the development and maintenance of suicidal thoughts.

We are excited for the next year and our continued push to train providers in evidence based therapies. In addition to our current efforts, we are incorporating a number of alternative learning opportunities including asynchronous training and microlearnings. We look forward to working towards the goal of expanding suicide prevention efforts and supporting our service members and veterans.

Interested in our work? Ready to join the effort? See our training calendar for a complete list of course offerings at https://cdp.usuhs.edu/training-schedule

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.

Kristyn Heins, Ph.D., is a Licensed Professional Counselor serving as a Military Mental Health Counselor for the Consortium for Defense Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. In this role, she supports the CDP’s efforts of training clinicians in evidenced-based practice focused on suicide prevention.

19,000   

The approximate number of child care workers employed by he Department of Defense (DOD), according to a report from the Government Accountability Office (GAO) -- Military Child Care: Services’ Use of Worker Recruitment and Retention Incentives.

These workers care for nearly 172,000 children of service members and DOD civilian employees (as of fiscal year 2024). The military services face challenges recruiting and retaining child care workers, contributing to lengthy waitlists and wait times for child care.

By: Heather Tompkins, Ph.D., MS-ATR, MA, LCMHC

Military life is synonymous with change. While change can be positive, it also can bring stress. The concept of normative military stressors- unique stressors that are an inherent part of military life- is central to military life. A primary example of a normative military stressor are Permanent Change of Station (PCS) moves. Relocation is an anticipated part of military life, with service members and their families moving on average every 2-4 years. Military families move more often and longer distances than civilians. On average, a military family will move 6-9 times between when a child starts kindergarten and graduates from high school. Currently, PCS season is in full swing for many military families (including my own), with peak volume occurring during the summer months from mid-May to mid-September.

A PCS move brings a unique blend of personal, family, and logistical challenges. “Life as usual” consists of managing house packouts, finding childcare/changing schools, career/employment transitions, and adjusting to a new duty station/environment, among other things. As a military spouse who has experienced numerous PCS moves (not counting temporary housing or moves between), I feel fairly versed in the process, the challenges, and the relief the end of each move brings. While moving to a new duty station brings the potential for new personal and professional opportunities, a prolonged or complicated PCS can tax or overwhelm the most adaptable military families. The relocation process presents a dual burden: 

• Logistical Challenges: Managing packing/HHG delivery, travel coordination, housing transitions, expenses, and physical establishment in a new location. 
• Psychological Strain: Exerting cognitive and emotional energy to adapt to new environments, settle into new workplaces or school systems, navigating medical/healthcare, managing loss of local support networks.

Re-establishing and managing a household, career, and family life, while simultaneously absorbing these emotional demands can require substantial physical and mental bandwidth. From my own PCS experiences, I’ve learned a few strategies to help manage the stress and help my family adjust to whatever each new duty station brings.

Three Practical Ways to Manage Stress During Transitions
1. Practice Self-Awareness and Reflection
Self-awareness is the ability to see and understand your own thoughts, feelings, actions, and how you fit into the world. It can be internal (feelings, triggers, core values, and habits) and/or external (how other people see you and how you affect them). Practicing self-awareness allows us to be aware of and manage strong feelings, guides our choices, and helps us to keep how we live in-line with our values. One tool that I frequently use when engaging in self-awareness is metaphor. The water depth metaphor (swimming, treading or sinking) has become my go to when assessing where I am at and how I’m coping amidst military life’s normative stressors.

Normally, I’m swimming along, think Dory (just keep swimming, swimming, swimming), fulfilling my day-to-day personal and professional activities. However, during periods of stress or transition, such as our current PCS, my “normal swimming along” shifts and oscillates between swimming steadily and treading water.

• Swimming: Feeling grounded, moving forward with purpose and on solid footing, comfortably managing and adapting to current demands and challenges.
• Treading Water: Exerting continuous effort to stay in place and keep your head above water to keep up with day-to-day tasks, working hard but not moving (forward or back), “surviving” a busy period, stress, challenges without making progress.
• Sinking: Experiencing acute overwhelm where overlapping stressors feel unmanageable, loss of energy to stay afloat, failing or dropping below the surface.

No matter how prepared, organized, or experienced we are, it is normal for our stress levels to rise as we manage the logistics and psychological strain that come with the transitions of a military move. Engaging in a self-awareness check is a healthy way to gauge where your mental and emotional well-being are during both normal and heightened periods of stress. Likewise, during a prolonged or complicated transition, a simple pause and asking yourself: Am I swimming, treading, or sinking in water? Can provide the opportunity to evaluate whether we are coping and managing these stressors or do we need additional support and resources.

2. Utilize Resources and Supports
I have found over the 15 years of military life, navigating military stressors and transitions does not have to be done in isolation. We each have our supports, whether it is family, friends, neighbors or a combination of that we can turn to during life’s stressors. Likewise, turning to military-informed professionals ensures that the support received is anchored in an understanding of the nuances and realities of military life. Specialized support and resources help bridge gaps in care during times of change, transition, and geographic relocation. As a military family, we are fortunate to have numerous resources both on and off installation that exist to support well-being through every stage of relocation and service. A few examples include (not exhaustive list):

• Star Behavioral Health Providers (SBHP): SBHP helps bridge the gap in specialized behavioral health care by connecting military-connected clients with civilian providers specifically trained in military culture and evidence-based treatments. starproviders.org 
  https://starproviders.org/find-support/
• Military OneSource: A comprehensive 24/7 service offering confidential non-medical counseling, relocation tools, and practical support for every aspect of military life. https://www.militaryonesource.mil/
• inTransition Program: For service members currently receiving mental health care, inTransition provides coaching and support to ensure continuity of care during transitions, PCS moves, or separation from service. https://veteran.com/intransition-program/
• Military Family Life Counselors (MFLC): Provides free and confidential counseling to service members, their families (including children), and survivors on or near installations. In addition, military leaders can request briefings and grief counseling for their units. https://www.militaryonesource.mil/resources/tools/mflc-locator/

These are just a few of the many resources available to military service members and their families that are easily accessible and can provide a variety of support services across the various stressors and stages of transition in military life.

3. Prioritize Re-adjustment, Stability, and Self-Care
PCS impacts the entire family unit. Relocation leads to disruption to routine, stability, and support networks, requiring constant adaptation and flex. Thus, regaining stability after a PCS requires deliberate, structured effort. Military families can foster adjustment and stability by actively prioritizing the following:

• Restoring Routines: Re-establishing predictable household rhythms, daily schedules, and family activities to rebuild a sense of safety and normalcy.
• Connecting with Resources: Securing medical/behavioral healthcare providers, establishing childcare/ school enrollment, identifying both on/off installation supportive resources.
• Building Community: Proactively seeking out local support networks, school/childcare contacts, and peer connections both on and off installation to build your “village”.

Whether you are swimming steadily or working hard to stay afloat, remember that self-awareness is one of the first steps toward well-being. You do not have to endure change, transition, and stress in isolation. There are resources and supports available. As my family’s current PCS comes to an end, my oscillation between swimming steadily and treading water is beginning to move to calmer water. What about you? Take a moment and notice where you are today (swimming, treading, or sinking) and what supports can help bring you back to swimming.

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.

Heather Tompkins, Ph.D., MS-ATR, MA, LCMHC, is a Military Behavioral Health Psychologist with the Consortium for Defense Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. In this role, she provides oversight and fosters collaboration for creative arts related research projects in partnership with the Defense Intrepid Network.