Guard Units Embed Counselors to Ease Trauma

In California, the National Guard is taking an innovative approach to dealing with post-traumatic stress disorder. To head off PTSD problems during and after combat tours in Iraq, the Guard is embedding counselors with its troops.

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A couple of weeks ago, we featured a report about an Army base where soldiers seeking help with the psychological consequences of combat in Iraq appear to have been ignored or penalized. But that is not the case everywhere in the American military. Today we have the story of an experimental program in a few California National Guard units. It is designed to detect problems such as posttraumatic stress disorder early by embedding psychologists in Guard units.

NPR's John McChesney reports.

JOHN MCCHESNEY: National Guard soldiers in camouflage uniforms are blasting away at popup targets on this rifle range in the tawny hills of Central California. They're here for their weekend drill. But two men stand out in bold relief against the camo-suited crowd because they're wearing civvies, civilian clothing. They are the unit's embedded psychologists here to listen to the soldiers and to observe behavior.

Darrel Lions, an avuncular man with a shock of white hair says his embed includes being a player in the weekend drill.

Mr. DARREL LIONS (National Guard Psychologist): I will be firing if we have enough time after the soldiers go through. I hope to fire both on the qual(ph) range and down on the popup range.

MCCHESNEY: Lions is part of an experimental program instituted by the California National Guard.

Mr. LIONS: Part of the work really for us as embedded in the National Guard Unit is really to break stigma. So I'm not necessarily going to be direct line dealing with trauma as much as helping that person to have an experience with a mental health professional that allows them then to break through and go get treatment.

MCCHESNEY: This is the 579th Engineering Battalion. Some of them had a rough time in Iraq. One company suffered three dead and 17 wounded out of 93 soldiers, a casualty rate of one in five.

Bob Dizelle(ph) is the other embedded psychologist out here for weekend drill.

Mr. BOB DIZELLE (Psychologist): I've had some real hard stories told to me, and sometimes it starts with just the real innocuous, oh, how you doing? Where you been? And it will quickly kind of evolve into them really doing some processing.

I had one guy, I just said, hi, how you doing? And he came and sat down and in about 10 minutes he got the saddest expression in his eyes. And he said, my girlfriend tells me I don't care about anything anymore. He says, sometimes I fake it and I pretend I care but, he said, inside I don't. I don't care about anything anymore.

MCCHESNEY: Colonel Walter Goodwater is the commander of the 579th. It was his decision to participate in this pilot counseling program. He tells the story of a Sergeant T, an equipment operator who was a master at finding and disarming roadside bombs in Iraq.

Colonel WALTER GOODWATER (National Guard): But after he got back, he was in his civilian job, he saw something that triggered events in Iraq and he told me, he physically had to get out of the vehicle and he sat down along the edge of the road and just started shaking and sweating. The difference is on a drill weekend, I've got somebody sitting here. There's no one to help him there. So that's the huge difference.

MCCHESNEY: That huge difference is between active duty troops who report everyday to their unit where their behavior can be observed and Guard troops who are isolated from their units most of the time. Soldiers from the 579th are scattered all across Northern California, from the Oregon border all the way down to San Francisco. Some armories are out in rural areas.

Colonel GOODWATER: When they go home, any of those trigger events could happen and there's no battle buddy sitting there next to them most of the time. And that's what this embedded program is trying to help, because a soldier can pick the phone up then and call the embedded person that's working with them for some immediate intervention.

MCCHESNEY: Well, not always. Again, embedded counselor Bob Dizelle.

Mr. DIZELLE: They don't have my phone number. If they're in a crisis situation and they want to contact me they can do that via the command of the unit.

MCCHESNEY: But that loss of anonymity could discourage soldiers from coming forward. Seeking psychological counseling can be seen as a career stifling admission of weakness or instability.

Try West, the contractor directing the pilot program, insists that they are now permitting more direct contact between soldiers and counselors, bypassing the command structure.

So how is the program playing with the rank and file? Well, this is no scientific sample but if the two men we did talk with are typical, then the embed program managers have some work to do.

Corporal DENVER CORTEZ (National Guard): Honestly, I think it's a waste of money.

MCCHESNEY: Corporal Denver Cortez was in Iraq. He wasn't wounded but he had friends who were. He says the psychologist embed program is awkward and intrusive.

Corporal CORTEZ: Every time we come back to drill, they always want to try to get in your head and talk to you. Tell me what you're feeling, what your feelings are and how does it make you feel?

Well, I don't want to keep thinking about it. You know, I'm quite happy discussing it with people that know what I'm talking about. Our embedded counselor, she wasn't in Iraq. Why would I talk to her about stuff that I saw when she can't relate?

Staff Sergeant MICHAEL GILMORE (National Guard): Actually, it's made a lot of people uncomfortable because it's just a civilian walking around watching your psyche as you're training.

MCCHESNEY: Staff Sergeant Michael Gilmore lost part of his arm from a roadside bomb in Iraq and he's having some readjustment problems, which may be associated with PTSD or post traumatic stress disorder.

Sergeant GILMORE: A couple weeks ago, I was at a stoplight and ran the light to stop traffic. That was one of things we used to do overseas was, you know, lead vehicle would run out there and stop traffic through. And I don't know what triggered me. I think my arm was hurting and my brain started triggering back and I come up to the stoplight and right out in the middle of the intersection to stop traffic.

MCCHESNEY: Sergeant Gilmore remains ambivalent about the embed program. He doesn't believe the embedded counselors are familiar enough with PTSD. He's been in therapy for a while at the Veteran's Administration where he feels confident that they know what they're talking about. But at the same time, he hopes the embedded psychologist will help breakdown the stigma about seeking help. And even skeptic Corporal Cortez tries to be more positive at the end of our interview.

Corporal CORTEZ: Regardless of what my feelings are, as long as this program helps one soldier, it's worth it. It doesn't work for me. It doesn't work for a lot of guys. But if it does help that one soldier that needs it, then it's totally worth the money.

MCCHESNEY: The Try West pilot effort is funded until next spring. The contractor is applying to the Defense Department to expand the program.

John McChesney, NPR News.

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