Reservists face challenges returning to work

Reservists returning to their civilian jobs following U.S. military service in Iraq or Afghanistan often face difficulties adjusting to their previous lives, and experts say employers must be alert to potential problems.

Returning reservists face issues ranging from relatively minor problems, such as readjusting to the slower pace of everyday life vs. service in a combat zone, to post-traumatic stress disorder with symptoms that can include anger, depression, nightmares, extreme reactions to noise, oversensitivity to criticism, difficulty concentrating, drug and alcohol abuse, and marital problems.

Reincorporating returning workers will be a challenge many employers face. According to the U.S. Department of Defense, 110,500 National Guard and reserve personnel were mobilized as of August.

While many returning soldiers are just fine, the National Center for Post-Traumatic Stress Disorder, which is part of the Department of Veterans Affairs, cites a 2004 study that estimates the risk of post-traumatic stress disorder is 18% from service in the war in Iraq and 11% from Afghanistan.

However, observers say these estimates may be low. Denise Curran, a clinical therapist for Chicago-based ComPsych Corp., an employee assistance program provider, estimates that 30% of returning soldiers will have PTSD, increasing up to 70% for those returning from second tours of duty.

There are steps that employers can take to address the situation (see story, page 27) even though they generally do not have specific programs aimed at reservists and usually address such needs through their regular EAPs, observers say.

Employers also should encourage reservists to contact the federal Department of Veterans Affairs, which can provide returning soldiers with support groups that include their peers, said Ms. Curran. "They're so much better at being able to provide this for the soldiers," she said.

Spouses and families members can encounter problems as well, say observers. When a woman, for instance, is left to take care of all the family chores herself, "there's probably some anger, she's feeling deserted, she's feeling abandoned. She's feeling like all the work's falling on her" while her husband is "getting some glory for what he's doing," said Ann D. Clark, chief executive officer of San Diego-based ACI Specialty Benefits Corp.

Generally, family members of employees are also covered under EAPs.

"It's sort of a very individual response," said Kristine Brennan, executive director of Continuum Employee Assistance, Training, Consulting, a Lincoln, Neb.-based EAP provider.

At Lakeland, Fla.-based Publix Super Markets Inc., referrals are made through the chain's internal EAP program, said a spokeswoman. For issues such as depression, "there are a lot of different options, with a lot of different possibilities. Our EAP assists them to try to find the right person" to address their needs, said the spokeswoman.

Employers overall are concerned about the issue, said Rich Paul, vp of health and performance solutions at Norfolk, Va.-based ValueOptions Inc., an EAP provider. Employers recognize "the importance of playing a role in the successful adjustment of someone returning from military service," he said.

But problems nonetheless may emerge, experts say. "I think the biggest problem there is, is the rapid shift from one culture to another," said Ms. Clark.

After coming from a highly emotional environment, where they feel "very bonded to the people around them," veterans "may feel isolated, may feel disoriented, may feel like they're not part of their own families anymore. They probably feel like people don't understand," said Ms. Clark.

Whereas overseas they may have felt they had a "real purpose" and a structured existence, they may come home and find their work boring or unimportant, said Teresa Zahren, a clinical social worker with Continuum. Their job just "doesn't seem like a big deal in the scheme of life," said Ms. Zahren.

The swiftness of change from military to civilian life may be a factor. Somebody can be in a war zone one day and be back in their own bed at home less than 24 hours later, said Richard Seidel, director of clinical programs at Roanoke, Va.-based Carilion Behavioral Health, which operates Carilion EAP.

That leaves little time to decompress, said Mr. Seidel. "It takes time for the nervous system to recalibrate itself," but some people have trouble doing so. "It's like your nervous system gets stuck on high alert," he said.

Returning reservists "may have difficulty concentrating or remembering the tasks they have to complete, or in making decisions," said Mr. Paul. "We also see some anxiety. Certainly, there may be feelings of anger or irritability, where someone becomes very sensitive to comments and perhaps more explosive than normal."

Reservists also may self-medicate with alcohol or drugs, said Isabelle Duguay, a counselor with Bensinger, DuPont & Associates in Chicago. "Those are very common dual diagnoses you would encounter" with PTSD sufferers, she said.

If an employee shows PTSD symptoms, "Do not be alarmed," said Ms. Duguay. "Understand that everybody adjusts in a different time frame, and sometimes just patience is enough and they'll go back to being normal."

Observers, warn also, however, that problems may not be immediately apparent. Soldiers are "taught to suck it up, so to speak, and to be strong," said Pat Gilligan, ACI's clinical director and himself a veteran of combat in Vietnam.

Furthermore, PTSD "sometimes doesn't show up for years" and then "it will hit them," said Mr. Gilligan.

While it is normal to relive the trauma of, for instance, seeing someone killed, this should eventually fade away, said Ms. Duguay. But people with PTSD may start reliving the situation six months later. This means employers must remain alert for PTSD symptoms "even though you have an employee coming back who seems to be functioning normally," she said.

"I think probably the best thing that an employer can do is plan and prepare for the transition of the individual back into the workplace," said Mr. Paul.

"They need to hear from us, 'Welcome home.' They need to hear, 'Thank-you for your service to your country,' not, 'You've been gone for six months, your work's piled up and, yeah, welcome back,"' said Jodi Aronson Prohofsky, senior vp of operations for Eden Prairie, Minn.-based CIGNA Behavioral Health, which plans to start a dedicated support line for returning veterans in November.

"It's important for employers to communicate clearly with their returning soldiers what the expectations are around their job," Mr. Paul said. "Let them know kind of clearly what is happening with respect to office procedures, department dynamics, how has the work changed and what are the work expectations, and sort of make sure they recognize there may be some training that's required to bring the person up to speed," he said.

Employers "can help the employee adjust by recognizing that everyone kind of adjusts or reintegrates back into the workplace differently," he said. There is no "right way or a wrong way with respect to how quickly someone is able to assimilate back into the workplace," Mr. Paul said.

If problems do emerge, employers should refer employees to their EAPs and not try to solve his personal issues themselves, Mr. Gilligan stressed.

Focus on "what's required of them at work" and "don't give them any sort of special treatment," he said. "Hold them accountable."

An EAP is "critical at this time," Ms. Clark said. It can provide easy access to counselors as well as a variety of guidelines to managers "to help ease the transition" for veterans, she said.