U.S. Army photo by Jasmine Chopra-Degadillo

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.

I spent a few days this month in Orlando, Fla., attending the 127th annual American Psychological Association (APA) Convention, which is the largest gathering of psychologists and psychology students in the world. The convention allows health care providers from all areas of specialization in psychology and from research, practice, education and policy to get together for four days to learn about the latest advances in psychology. For the third year, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) subject matter experts presented at this convention to increase psychologists’ knowledge of the unique needs of the military population, including treatment options for psychological health conditions and traumatic brain injury (TBI).

	Download the Co-occurring Conditions Toolkit mobile app and then share your feedback. (U.S. Army photo by Brian Gebhart)

We want to hear from you! Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) created an easy way for you to share your thoughts on the Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health and corresponding mobile app for smartphones and tablets. Your feedback will help us make improvements to the tool kit and app and other psychological health and traumatic brain injury (TBI) products.

Did the tool kit improve your capacity to manage patients with mild TBI and co-occurring psychological health conditions? Based on your experience with the tool kit, share your thoughts about everything from advantages and disadvantages to recommendations and suggestions for future TBI clinical resources and tools. Take the online survey today—it only takes a few minutes. This survey is voluntary and your responses are anonymous.

	Dr. James P. Kelly, National Intrepid Center of Excellence director, speaks during a recent “Train the Trainer” workshop in Dallas. (Photo by Dr. Lori Millner)

Throughout February and March, I presented signs and symptoms of traumatic brain injury (TBI), in three “Train the Trainer” workshops in Los Angeles, Denver and Dallas, hosted by Area Health Education Centers (AHEC).

I was excited to be a part of this wide-reaching effort to bridge the gap between civilian and military TBI care, because advancing TBI care starts with increasing awareness across both systems.

Military and civilian providers see common TBI-related symptoms: constant headaches; sleep problems; blurred vision; eye-movement abnormalities; and co-occurring conditions, such as post-traumatic stress. Those of us in military medicine collaborate with civilian providers to better understand brain injury and how military individuals may exhibit symptoms differently.

Treating patients with mild traumatic brain injury (TBI) can be challenging because TBI symptoms can sometimes resemble a number of psychological health conditions. Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) developed Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health to provide guidance on the assessment and management of patients with the co-occurring conditions of concussion, post-traumatic stress disorder, pain, depression and substance use disorder.

The tool kit is a user-friendly, comprehensive clinical guidance tool for primary care providers, featuring evidence-based clinical practice guidelines and recommendations from the Departments of Defense and Veterans Affairs. It provides tips for an effective first appointment; guidance on clinical assessment; treatment recommendations; medication information; and patient education websites.

	Marine Sgt. Marshall Kennedy, with his wife Chelsie, received his second Purple Heart Medal for wounds suffered in combat at Walter Reed National Military Medical Center in June 2011. (Photo courtesy of GuardOnline)

At the Military Health System Conference, two recovering service members and their wives sat across from an audience of military health professionals. Typically, the dialogue between the two would be dominated by the latter, as they explain a treatment plan; what to expect during recovery; and how to cope. Yet this time, it was the wounded warriors and their spouses providing important information and openly sharing their personal experiences.

During the “Experiences of Wounded, Ill or Injured Warriors” panel, I listened to Marine Sgt. Marshall Kennedy, his wife Chelsie, Navy Explosive Ordnance Disposal Technician 1st Class Zachary Waskel, and his wife Jamie, share what it was like to sustain an injury during combat and receive treatment, and the spouses’ challenges during that difficult time.

“The flight to [Joint Base] Andrews was the hardest part,” said Kennedy, an amputee who was injured in Afghanistan last year when he stepped on an improvised explosive device (IED). “It was a MAC [Military Airlift Command] flight. There were families on the plane with wounded guys strapped to beds.”