The medical, surgical, and psychiatric casualties of Operation Iraqi Freedom will receive care from a broad group of clinicians working in diverse clinical settings. Although most service members will initially be treated in military treatment facilities, many may find themselves returning to the United States with conditions that are treated in military facilities, VA Hospitals, civilian treatment centers, or all of these as they move through their recovery. As a result, some clinicians involved in treating casualties ...
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The medical, surgical, and psychiatric casualties of Operation Iraqi Freedom will receive care from a broad group of clinicians working in diverse clinical settings. Although most service members will initially be treated in military treatment facilities, many may find themselves returning to the United States with conditions that are treated in military facilities, VA Hospitals, civilian treatment centers, or all of these as they move through their recovery. As a result, some clinicians involved in treating casualties returning from Iraq may not have an understanding of the experiences of the military patient, the military system in which he or she serves, the military medical services available, or the potential impact of medical decisions on the service member's future military career. It is essential that all health care professionals-civilian or military-who care for casualties from Operation Iraqi Freedom have at least rudimentary and relevant military knowledge. A variety of factors including personal and cultural characteristics, orientation toward coping with stressors and painful emotions, pre-deployment training, military-related experiences, and postdeployment environment will shape responses to Operation Iraqi Freedom. Furthermore, psychological responses to deployment experiences can be expected to change over time. The absence of immediate symptoms following exposure to a traumatic event is not necessarily predictive of a long-term positive adjustment. Depending on a variety of factors, veterans may appear to be functioning at a reasonable level immediately upon their return home particularly given their relief at having survived the war-zone and returned to family and friends. However, as life circumstances change, symptoms of distress may increase to a level worthy of clinical intervention. Even among those veterans who will need psychological services post-deployment, acute stress disorder and posttraumatic stress disorder (PTSD) represent only two of a myriad of psychological presentations that are likely. Veterans of Operation Iraqi Freedom are likely to have been exposed to a wide variety of war-zone related stressors that can impact psychological functioning in a number of ways. It is important for clinicians to recognize that the skills and experience that they have developed in working with veterans with chronic PTSD will serve them well with service members returning from Iraq. Clinicians' experience in talking about trauma, educating patients and families about traumatic stress reactions, teaching skills of anxiety and anger management, facilitating mutual support among groups of veterans, and working with trauma-related guilt, will all be useful and applicable.
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