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Brave Choices Blog

Afghanistan, Information From the VA for Veterans

8/18/2021

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Text and information from VA News (veteransaffairs@messages.va.gov)

Veterans from all eras are reacting to the events in Afghanistan, such as the U.S withdrawal and the takeover by the Taliban.

You are not alone.

​Veterans may question the meaning of their service or whether it was worth the sacrifices they made. They may feel more moral distress about experiences they had during their service. It’s normal to feel this way. Talk with your friends and families, reach out to battle buddies, connect with a peer-to-peer network, or sign up for mental health services. Scroll down for a list common reactions and coping advice.

Resources available right now
  • Veterans Crisis Line - If you are having thoughts of suicide, call 1-800-273-8255, then PRESS 1 or visit http://www.veteranscrisisline.net/
    • For emergency mental health care, you can also go directly to your local VA medical center 24/7 regardless of your discharge status or enrollment in other VA health care.
  • Vet Centers - Discuss how you feel with other Veterans in these community-based counseling centers. 70% of Vet Center staff are Veterans. Call 1-877-927-8387 or find one near you.
  • VA Mental Health Services Guide - This guide will help you sign up and access mental health services.
  • MakeTheConnection.net - information, resources, and Veteran to Veteran videos for challenging life events and experiences with mental health issues.
  • RallyPoint - Talk to other Veterans online. Discuss: What are your feelings as the Taliban reclaim Afghanistan after 20 years of US involvement?
  • Download VA's self-help apps - Tools to help deal with common reactions like, stress, sadness, and anxiety. You can also track your symptoms over time.
  • Tragedy Assistance Program for Survivors (TAPS) -  Request a Peer Mentor
  • VA Women Veterans Call Center - Call or text 1-855-829-6636 (M-F 8AM - 10PM & SAT 8AM - 6:30PM ET)
  • VA Caregiver Support Line - Call 1-855-260-3274 (M-F 8AM - 10PM & SAT 8AM - 5PM ET)
  • Together We Served -Find your battle buddies through unit pages
  • George W. Bush Institute - Need help or want to talk? Check In or call:1-630-522-4904 or email: checkin@veteranwellnessalliance.org
  • Elizabeth Dole Foundation Hidden Heroes - Join the Community
  • American Red Cross Military Veteran Caregiver Network - Peer Support and Mentoring
  • Team Red, White & Blue - Hundreds of events weekly. Find a chapter in your area.
  • Student Veterans of America - Find a campus chapter to connect with.
  • Team Rubicon - Find a local support squad.

Common Reactions In reaction to current events in Afghanistan, Veterans may:
  • Feel frustrated, sad, helpless, grief or distressed
  • Feel angry or betrayed
  • Experience an increase in mental health symptoms like symptoms of PTSD or depression
  • Sleep poorly, drink more or use more drugs 
  • Try to avoid all reminders or media or shy away from social situations
  • Have more military and homecoming memories
Veterans may question the meaning of their service or whether it was worth the sacrifices they made. They may feel more moral distress about experiences they had during their service.
Veterans may feel like they need to expect and/or prepare for the worst. For example, they may:
  • Become overly protective, vigilant, and guarded
  • Become preoccupied by danger
  • Feel a need to avoid being shocked by, or unprepared for, what may happen in the future
Feeling distress is a normal reaction to negative events, especially ones that feel personal. It can be helpful to let yourself feel those feelings rather than try to avoid them. Often, these feelings will naturally run their course. If they continue without easing up or if you feel overwhelmed by them, the suggestions below can be helpful.

Strategies for Managing Ongoing DistressAt this moment, it may seem like all is lost, like your service or your sacrifices were for nothing. Consider the ways that your service made a difference, the impact it had on others’ lives or on your own life. Remember that now is just one moment in time and that things will continue to change.

It can be helpful to focus on the present and to engage in the activities that are most meaningful and valuable to you. Is there something you can do today that is important to you?  This can be as an individual, a family member, a parent, or a community member. Something that is meaningful to you in regard to your work or your spirituality? Such activities won’t change the past or the things you can’t control, but they can help life feel meaningful and reduce distress, despite the things you cannot change.
It can also help to consider your thinking. Ask yourself if your thoughts are helpful to you right now. Are there ways you can change your thinking to be more accurate and less distressing? For example, are you using extreme thinking where you see the situation as all bad or all good?  If so, try and think in less extreme terms. For example, rather than thinking “my service in Afghanistan was useless” consider instead “I helped keep Afghanistan safe.”
​
Finally, consider more general coping strategies that you may want to try including:
  • Engage in Positive Activities. Try to engage in positive, healthy, or meaningful activities, even if they are small, simple actions. Doing things that are rewarding, meaningful, or enjoyable, even if you don’t feel like it, can make you feel better.
  • Stay Connected. Spend time with people who give you a sense of security, calm, or happiness, or those who best understand what you are going through.
  • Practice Good Self Care. Look for positive coping strategies that help you manage your emotions. Listening to music, exercising, practicing breathing routines, spending time in nature or with animals, journaling, or reading inspirational text are some simple ways to help manage overwhelming or distressing emotions.
  • Stick to Your Routines. It can be helpful to stick to a schedule for when you sleep, eat, work, and do other day-to-day activities.
  • Limit Media Exposure. Limit how much news you take in if media coverage is increasing your distress.
  • Use a mobile app. Consider one of VA’s self-help apps (see https://www.ptsd.va.gov/appvid/mobile/) such as PTSD Coach which has tools that can help you deal with common reactions like, stress, sadness, and anxiety. You can also track your symptoms over time.
  • PTSD Coach Online. A series of online video coaches will guide you through 17 tools to help you manage stress. PTSD Coach Online is used on a computer, rather than a mobile device, and therefore can offer tools that involve writing.
If you develop your own ways of adapting to ongoing events and situations, you may gain a stronger sense of being able to deal with challenges, a greater sense of meaning or purpose, and an ability to mentor and support others in similar situations.

Afghanistan: How Veterans can reconcile service READ MORE

Afghanistan: How Veterans can learn from Vietnam Veterans READ MORE 

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Mutual Aid & Support Links

3/23/2020

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​Financial support links and mutual aid resources 
(Most of these are local to Minneapolis/St. Paul, Minnesota) 

Minnesota Unemployment Insurance: 
https://www.uimn.org/applicants/needtoknow/news-updates/covid- 19.jsp?fbclid=IwAR1gWVpo-3oIe6hbcn7tuJ1KqPHKT0dmNpksEbyKKDaGBvqOFgPwovuGFmE 

United Way COVID-19 emergency relief fund for rent and other essentials. They are giving funds to local agencies who are distributing them:
Call 1-866-211-9966 and provide your zipcode to be given a list of local agencies to provide assistance 

Minnesota Immigrant Families COVID-19 Fund. This is still fundraising and not ready for disbursement yet but here are current details: https://www.gofundme.com/f/mn-immigrant-families-covid19- fund?utm_source=facebook&utm_medium=social&utm_campaign=p_cp+share- sheet&fbclid=IwAR1MOhxohV6- Qj0NFpRugrCvDENq8tzUwEb8pKBh3fpr_SswoHSesdrhz5M 

Women for political change fund. Applicants need to be people under 30 who identify as a woman, trans person, and/or gender non-conforming person people under 30 who identify as a woman, trans person, and/or gender non-conforming person: https://secure.everyaction.com/sv45KFCFJ0mqutj0dfQzxg2 

Bartender emergency assistance program. You need to have been a bartender for at least a year prior to application (applies to full time and part time). https://www.usbgfoundation.org/beap?fbclid=IwAR2H7xHs9aJluhQAIUcyZ_Kz3rJH- D0QdJW-iliGFLNq1PcFI_Pm0CoIyVA 

Twin Cities Democatic Socialists for America Solidarity Fund: 
https://twincitiesdsa.org/solidarity/?fbclid=IwAR2mtj8ZXIy7QKAI4QwRrDYABBKnWGAy cnvjC3EakYtRY6Mi4J2FtC85F_4 

Resources for Artists and Creative Workers: 
https://springboardforthearts.org/coronavirus/ 

Arts and Culture Leaders of Color Emergency Fund: 
https://docs.google.com/forms/d/e/1FAIpQLSfv4AazvLFVUNAgXoxqBqfZ7jJVkrMroa- CET6Vt6XygR- CaQ/viewform?fbclid=IwAR3EDcf_apyzuFqkxppJNB0UuwI4hShOETA_6tp3863oWjFaZ pfhWI8vOuY 

Sex Workers Harm Reduction Resources: 
https://docs.google.com/document/u/0/d/1GpmUbu7UDCKtbnsBwImFLQtXzHLlZ6FYP Y_NjJvyiFs/mobilebasic?urp=gmail_link 

South Minneapolis Mutual Aid: 
https://docs.google.com/spreadsheets/d/1ZSLDZY4DD85gnGXTAeLtKCxofdOHRcX4z YWAQf7A_GU/edit?fbclid=IwAR3FjUklDE1ThUVfPuL1YFELJo01log5mPURVeZjDqQ0 KYjQj_OgV1Uu4rM#gid=0 

Twin Cities Mutual Aid: Neighbors Supporting Each Other:
https://docs.google.com/document/d/177tyL6xNVsyQWvttbMWg8QE-Gl4-qfnfsd7s4V8QXAM/edit?fbclid=IwAR3fJOIAVd7khnreaLp2QBqaCZVy42GfzMtDoELNlCry8lxhMDT0CPbwvkM

Twin Cities Queer and Trans Mutual Aid: 
https://docs.google.com/forms/d/e/1FAIpQLSdAlOLU9hOKMjwX4W2sQKF69FAF3ow_fSPzjKC67_iyYDRLaQ/viewform

MN Disabled/Elder/Caregiver Mutual Aid 
https://docs.google.com/spreadsheets/d/1oA19f2Idh2UxLZvnx_gT6SikkhQe1i-IHm5W2kCp6-o/edit?fbclid=IwAR1Ohh0Ru1UN5i4WSHNVj85VZUkSjr8QJlynMTJxEtnlD-wb_OPZTgU_yGc#gid=913427466

If you are uninsured (health insurance), there is a special enrollment period that opened up to respond to this emergency: https://www.mnsure.org/news-room/news/index.jsp?id=34- 423931&fbclid=IwAR3Upwk9i7aBzrr95o5pzc3AAQ1xoD9PHqVBF9HKoBBpFs-LAf- BF_wKgaI 

Database of localized resources during COVID-19 outbreak: 
https://docs.google.com/spreadsheets/d/1HEdNpLB5p-sieHVK-CtS8_N7SIUhlMpY6q1e8Je0ToY/edit?fbclid=IwAR3u9jbKNaLfNU5Xet9CcUXQrJKQiilesi4mAgAP47P1eQL5Z_zykWnJK1g#gid=218438926

** Thanks to Alex Iantaffi, PhD, MS, SEP, CST, LMFT at Edges Wellness Center LLC for this information.

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Getting Through Each Day...

3/23/2020

1 Comment

 
I would like to remind you of a few things during this time of physical distancing. 
Please try to: 
  • Keep a regular bedtime and getting up time;
  • Eat regular meals;
  • Drink enough water;
  • Move everyday (remember that breath is movement, and movement does not
  • need to be big! Do whatever feels within your capacity);
  • If you can, spend a little time outside everyday;
  • Connect with people virtually at least a couple of times per week, especially if
  • you live alone.
  • Social distancing is about caring for our community. We can be physically
  • distant, yet emotionally connected. 

** Thanks to Alex Iantaffi, PhD, MS, SEP, CST, LMFT at Edges Wellness Center LLC for this information.
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Telehealth & Additional Resources

3/23/2020

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Best Practices for Telehealth

As we adapt to our new and ever-changing circumstances, we want to share the BEST PRACTICES FOR TELEHEALTH appointments (online/video appointments). 

1. GET READY. Schedule 10 minutes before your session to review instructions and make sure that your connection is working well. Make sure your device is charged and your charger is nearby. Headphones are helpful for the best sound quality and for added privacy.

2. MINIMIZE DISTRACTIONS. Try to find a quiet place to meet. If you live with others, notify them that you will be on a private call. Turn off music and the television so it does not disturb your session.

3. OPTIMIZE THE CONNECTION. Set up your device on a stable and flat surface. This eliminates shakiness in the video. Try to have your face fully in the frame. Close extra tabs in your browser and other applications to optimize your connection.

4. KEEP CALM. Tech issues are normal as everyone adjusts. Keep in touch with your therapist via phone, email or text to sort out connection problems. If a video call stops working, try reconnecting. If the reconnection does not work, text your therapist to get further instructions.

5. GET COMFY. Grab a hot beverage and a comfortable place to sit. Try to stay in one place during your session as you would if you were in the office. 

6. CONNECT AS NORMAL. Look into your therapist’s eyes as you normally would. Try not to look at the camera or your own face. Treat the session just as you would a normal session. Online therapy can feel just as personal as in-person sessions. 

**Adapted from Emma Donovan’s “Tips for Successful Online Therapy Sessions”

Working from Home Mindfully

​Tips for Working from Home Mindfullly: 
7 Key Tips for Working From Home, Mindfully
https://medium.com/@thefatshadow/7-key-tips-for-working-from-home-mindfully-c4b8cd7675f8

Attend an AA Meeting

​Attend an online AA meeting:
https://www.onlinegroupaa.org

On the Frontlines, for Healthcare Professionals

If you know a healthcare professional, first responder, grocery store employee, let them know that there is online therapy available for them at a reduced cost. This is a volunteer created and volunteer run website that connects these first responders with therapists at a reduced cost. https://www.coronavirusonlinetherapy.com

Shopping Hours for Vulnerable Individuals:

SHOPPING:
If you are a high risk individual (Over 60 and/or immunosuppressed) many Twin Cities grocery stores are offering hours for elders, health care providers and immunosuppressed. Here is a list that we have found (Please verify this before going to the store):
Lunds & Byerlys: Daily 7 AM to 8 AM. 
Hy-Vee: Daily, 7 AM to 8 AM
Cub: Daily, 6 AM to 7 AM
Wal-Mart: Seniors Only, Tuesdays, one hour before opening. Pharmacies and Vision Centers are open during this time.
Target: Wednesdays, One hour prior to store opening.
Walgreens: Tuesdays, 8 AM to 9 AM
Whole Foods: One hour prior to store opening.
Costco: Tuesday & Thursday, 9 AM to 10 AM

Please note that many stores offer curbside service when you shop online. ​

Activities:

​There are plenty of ACTIVITIES to do while working/schooling from home. I’ve been calling it pandemic activities:

Good Housekeeping posted:
Bored at Home? Here's a Massive List of Museums, Zoos, and Theme Parks Offering Virtual Tours
https://www.goodhousekeeping.com/life/travel/a31784720/best-virtual-tours/

CNN posted:
All the virtual concerts, plays, museums and other culture you can enjoy from home
https://www.cnn.com/style/article/what-to-do-at-home-streaming-art-museums-concerts-coronavirus-trnd/index.html

Travel and Leisure posted:
Stuck at Home? These 12 Famous Museums Offer Virtual Tours You Can Take on Your Couch
https://www.travelandleisure.com/attractions/museums-galleries/museums-with-virtual-tours

Tour National Parks:
https://crafty.diply.com/121060/you-can-virtually-tour-a-whole-bunch-of-national-parks-from-your?fbclid=IwAR3GMJ2ZPBQnFGBE7JAFXl_fHGi6Ql1wShq0MPJbSbSysaL8XM21JwqjDmE

Amnesty International posted 
6 things to do while at home during COVID-19 pandemic: https://www.amnesty.org/en/latest/campaigns/2020/03/what-to-do-at-home-during-covid-19-pandemic/

USA Today posted 
100 things to do while stuck inside due to a pandemic:
https://www.usatoday.com/story/life/health-wellness/2020/03/16/coronavirus-quarantine-100-things-do-while-trapped-inside/5054632002/

Take a ride on these virtual Disney World rides:
https://www.wmur.com/article/virtual-disney-world-rides/31788233


Coloring Books from 119 Museums:
http://www.openculture.com/2019/02/download-free-coloring-books-from-113-museums.html?fbclid=IwAR0filRECypx22MYiwEykSsLNMurA9A-ktb0HHG5BHgd9EUYV6LnifpzP2A

Additional Activities for Children.

Add links to your resources below. Thanks for your support! 
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Tips for Successful Online Therapy Sessions

3/21/2020

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Telehealth

3/21/2020

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Links to what's been happening on social media from my Facebook Business Page...

11/21/2016

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Signs and Symptoms of Depression

9/16/2016

1 Comment

 
We see and hear a lot about depression. Actually, as I write I see a anti-depressant medication commercial on television. Everyone has ups and downs in mood, but, how do you know that it is depression? Here are some signs of depression:

1. Hopelessness. It's more than the problem at hand. With depression, it's about having a feeling that nothing will get better and there is nothing you can do about it. 

2. Loss of Interest in Daily Activities. Maybe there are activities and/or hobbies that you used to enjoy. Do you still find enjoyment from those activities? Or, have you lost the ability to find enjoyment from those things? If you have a hard time finding enjoyment in activities you once enjoyed, you might be suffering from depression. 

3. Anger and/or Irritability. Feeling angry or irritable is often a symptom of another problem. With depression, your temper could be short and things can easily get on your nerves. Anger and irritability is a symptom of being unhappy.

4. Fatigue. Do you find yourself to be tired and/or physically drained? With depression - normal everyday tasks can be tiring and draining. 

5. Low Self Esteem. If you experience strong feelings of guilt or worthlessness, you may be suffering from depression. If you harshly criticize yourself for a fault or mistake, it could be a sign that something else is going on. 

6. Concentration Problems. Trouble focusing, making decisions or remembering things are all signs of depression. 

7. Appetite Changes. If you notice a significant weight loss or weight gain - it may be due to a change in appetite. 

8. Suicidal Thoughts. If you are thinking about suicide, you likely have depression. 

There's help for depression. I would be happy to see you in my office and help you get the help you need, call and make an appointment: 612.889.7517. If you are reading this and you are not in the Minneapolis-St. Paul Metro Area, you can find a therapist in your area by going to www.psychologytoday.com, click on "Find a Therapist." If you need to talk with someone right now, call 1.800.273.TALK.
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What to Ask Your Insurance Company

8/11/2016

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Health insurance can be confusing. When it comes to therapy, you might need to call you insurance company and find out what is covered. Make sure  you get the answers you need by following this example: (Download this Worksheet)

"My name is ____. I'm interested in going to Brave Choices, Inc. for help with my mental health and I am calling to verify my benefits. First, I would like some general information."

Policy Effective Date: _______
Office Visit Co Pay: ____
Deductible: ____
Out of Pocket Max: ____
Do my deductibles, co-pays and co-insurance apply toward my out of pocket max? ____
How much of my deductible have I spent this year? ____
Do I need a referral to see a mental health/behavioral health therapist? ____
If yes, who needs to refer me? ____
Is Brave Choices, Inc. and/or my provider is in-network? ____
If not, how does my insurance work if Brave Choices, Inc. and/or my provider is out of network? ____

Individual Therapy
The clinic usually uses CPT codes 90834 and 90837 for these services. 
What's my co-pay/co-insurance? ____
Is there a limit on the number of sessions per year? ____
If so, how many individual therapy sessions per year? ____
Is authorization required for individual therapy? ____

Lastly, ask for the representative's name: ____
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    Heather Holt,
    ​MSW, LICSW

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Brave Choices, Inc. is a Twin Cities counseling practice located on Očhéthi Šakówiŋ and Wahpekute land at
1575  7th St. W. Ste. 104, Saint Paul, MN 55102, 612.889.7517

This practice believes that BLACK LIVES MATTER.
​We are inclusive and all are welcome.


​Heather Holt, MSW, LICSW offers mental health counseling for individuals and families at this location. 
St. Paul, MN skyline painting print was produced by Katie Swanson. Used with permission. Image is copyrighted.
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