If the idea of chaplains getting together to discuss their interests makes you think of genteel spiritual conversations, consider the topic discussed at the August bimonthly teleconference of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) Chaplain Working Group — combat and killing in relation to posttraumatic stress disorder (PTSD) and spiritual distress.

The Chaplain Working Group routinely delves into spiritual and behavioral conflicts arising from deployment. It’s the nature of their calling that chaplains grapple with difficult issues, and the nature of war that military chaplains must address constructs that deeply challenge common beliefs. One such example is that spiritual health, behavioral health and the use of deadly force are not necessarily mutually exclusive.

Dr. James Bender is a former Army psychologist who deployed to Iraq as the brigade psychologist for the 1st Cavalry Division 4th Brigade Combat Team out of Fort Hood, Texas. During his deployment, he traveled through Southern Iraq, from Basra to Baghdad. He writes a monthly post for the DCoE Blog on psychological health concerns related to deployment and being in the military.

When most people hear the words “psychologist,” “mental health” or “shrink,” they think “mental illness.” After all, why should you talk to those guys unless you have posttraumatic stress disorder (PTSD) or depression? It’s unfortunate that some people think that way, because in addition to helping with serious conditions like PTSD and depression, behavioral health specialists can offer much more. A big part of psychology concerns itself with improving physical performance.

	U.S. Marine Corps photo by Cpl. Preston Reed

Deployment support programs initially focused on the needs of service members in the pre-deployment phase as they trained and prepared for deployment. With the progression of combat operations during the past 11 years, our understanding of deployment-related challenges for service members, veterans and families is better understood, and the importance of the actual deployment and post-deployment phases is also more apparent.

Reintegration is the process of transitioning back into personal and organizational roles after a deployment. It’s often seen as a series of positive events as the service member reunites with family and friends. However, it can also be associated with increased tension and difficulties readjusting to stateside roles, new family routines and changes at work — all of which can affect a service member’s ability to transition smoothly back to home life.

	U.S. Air Force photo by Senior Airman Andrew Lee

Now that you’re back, it’s important that you take time to revisit your financial affairs. Your income and monthly expenses will change since you’re no longer deployed. Evaluating your financial health to make sure your obligations and needs are covered will help you prevent unwanted financial stress during this readjustment period. Consider using the following tips and tools highlighted in the Real Warriors Campaign article, “Planning for Financial Health After Deployment,” to help give you financial peace of mind as you reintegrate to life at home.

Determine financial management roles
While you were away, a spouse, parent or other responsible individual may have served as your financial overseer and managed your financial obligations. Now that you’re home, re-evaluate these roles to establish who will manage your family’s financial responsibilities moving forward.

Jagged debris lacerates the Marine’s face and hands as he dives behind the jeep seeking cover from an improvised explosive device blast 50 meters away. He’s not sure how long it is before the unit corpsman reaches him and finds him conscious with superficial wounds. Things seem a little fuzzy at first but he believes he’s ready to move back to his patrol. The corpsman asks him the first two questions from the Military Acute Concussion Evaluation (MACE) card he carries and that yields a clear decision — the next move for this Marine is a full MACE screening.

This all-too-common scenario illustrates the need for MACE, the Defense Department’s standard for clinical assessment of mild traumatic brain injury (TBI), also known as concussion, in deployed settings. It’s the most widely-used clinical interview tool for early detection of concussion, the most common form of TBI sustained in the military. This year, the Defense Department redesigned MACE and the “Concussion Management in Deployed Settings” clinical algorithms, two critical tools used in conjunction with clinical judgment to help first-tier health care providers—combat medics, corpsmen and initial providers—improve cognitive and symptom screening, and neurological evaluation in theater.