Special Issue: Social Work With the Military: Current Practice Challenges and Approaches to Care
Jose E. Coll PhD*, Eugenia L. Weiss PsyD, LCSW & Jeffrey S. Yarvis PhD, LCSW, BCD, LTC. (2011). No One Leaves Unchanged: Insights for Civilian Mental Health Care Professionals Into the Military Experience and Culture. Social Work in Health Care Volume 50, Issue 7, pages 487-500.
This article aims to elucidate an understanding of military culture and experience, so as to better frame the services offered by civilian clinicians. Service members indoctrinated into such an influential culture can experience adjustment problems upon reentry into the larger society, and thus professional counselors and social workers must be ready to address the reintegration process with veteran clients. Furthermore, this article highlights a few of the major mental health concerns that are prevalent in combat veterans, especially for those returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), and presents a brief overview of treatment modalities implemented both within and outside of the military. Practical therapeutic suggestions for clinicians with little or no knowledge of the military are discussed. The objective is to educate and prepare civilian mental health practitioners to administer culturally sensitive prevention and intervention services to meet the unique needs of this population.
Recent Research (2011)
Kelley, M. L, Jouriles, E.N. (2011). An introduction to the special section on U.S. Military operations: Effects on military members' partners and children. J Fam Psychol. 2011 Aug;25(4):459-60.
The deployment of U.S. military personnel to global hot spots, whether as combatants or as peacekeepers, has increased attention to the psychological well-being of military personnel and their family members. Despite the growing awareness that deployments have reverberating effects on all family members, theoretical explanations and empirical research on the impact of deployment on couple, family, and child adjustment, factors that serve to protect families from the demands of military employment, and effective methods of treating the mental health needs of military families are needed. The seven papers in this section increase our understanding of how the demands of U.S. military operations impact couples, family functioning, parenting, and child psychological adjustment and provide an additional resource for mental health professionals who work with these families. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
>Verdeli, H., Baily, C., et al. (2011). "The Case for Treating Depression in Military Spouses." Journal of Family Psychology 25(4): 488-496.
The increased operational tempo associated with current deployments to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) is placing considerable strain on military families. Among other sequelae of OIF and OEF deployment, findings from recent studies suggest high rates of depression in spouses of service members. This review presents a rationale for targeting depression among military spouses. It examines how stressors relating to the deployment cycle may contribute to depression in spouses and outlines the effects of spousal depression on the mental health of service members and their children. Mental health services currently available to military spouses as well as barriers to their care are also described. Considerations for the adaptation of treatment to their unique circumstances and needs are discussed., (C) 2011 by the American Psychological Association
Du Rocher Schudlich, T. D., L. M. Papp, et al. (2011). "Relations Between Spouses' Depressive Symptoms and Marital Conflict: A Longitudinal Investigation of the Role of Conflict Resolution Styles." Journal of Family Psychology 25(4): 531-540.
This study investigated longitudinal relations between spouses' depressive symptoms and styles of conflict resolution displayed by husbands and wives in marital conflict, including angry, depressive, and constructive patterns of expression. Behavioral observations were made from a community sample of 276 couples during marital conflict resolution tasks once a year for 3 years. Couples were observed engaging in a major and minor conflict resolution task. Constructive, angry, and depressive conflict resolution styles were derived from the behavioral observation coding. Couples self-reported on depressive symptoms and marital dissatisfaction. Path analyses provided support for an extension of the marital discord model of depression ( Beach, Sandeen, & O'Leary, 1990). Specifically, angry, depressive, and constructive styles of conflict each mediated the link between marital dissatisfaction and depressive symptoms. Significant cross-spouse effects were found. Implications for the treatment of depressed and/or relationally discordant couples are discussed., (C) 2011 by the American Psychological Association
Burns, M.S. Mahalik, J.R. (2011). Suicide and dominant masculinity norms among current and former United States military servicemen. Professional Psychology: Research and Practice. doi: 10.1037/a0025163
Recent statistics suggest current and former United States military personnel are at a greater risk for suicide than ever before. Indeed, approximately 300 active-duty servicemen died by suicide in 2009, a population-adjusted death rate exceeding that of civilians (U.S. Department of Defense, 2010). Despite a growing body of literature highlighting the adverse consequences of men's adherence to traditional masculine norms on their physical and emotional health, little attention has been paid to the contributions of compliance with these norms on current and former male military personnel's risk for suicide. The present manuscript highlights the need for greater consideration of servicemen's adherence to norms of masculinity to better understand their suicide risk. To organize this presentation, the authors discuss how current and former servicemen's adherence to social and military injunctions for masculine behavior may contribute to an unwillingness to utilize mental health services that, in turn, exacerbates their mental health and may contribute to their risk for suicide. The authors also provide specific recommendations for gender-sensitive treatment interventions and future research.
Rudd, M.D., Goulding, J., & Bryan, C. J. (2011). Student veterans: A national survey exploring psychological symptoms and suicide risk.
Professional Psychology: Research and Practice, doi: 10.1037/a0025164
The current study explored psychological symptoms, symptom severity, and suicide risk in a national sample (N = 628) of student veterans. We hypothesized that the rates, types, and severity of problems experienced by student veterans on campus would in many ways mirror those reported by active duty service members as well as the Operation Iraqi Freedom/Operation Enduring Freedom veteran population. Almost 35% of the sample experienced “severe anxiety,” 24% experienced “severe depression,” and almost 46% experienced significant symptoms of posttraumatic stress disorder. Of particular concern, there were significant numbers of participants thinking about suicide (46%), with 20% having a plan, 10.4% thinking about suicide “often or very often,” 7.7% making an attempt, and 3.8% believing that suicide is either “likely” or “very likely.” Implications of the findings are discussed, with a particular focus on college and university campuses.
For more information about the NCTSN Military Families Learning Community and Seminar Series, please contact Pat Martinez, MSN, MPH, Child and Family Program, Center for the Study of Traumatic Stress Uniformed Services University at Patricia.Martinez.CTR@usuhs.mil or Gregory Leskin, Ph.D., Director, Military Families Initiatives, National Center for Child Traumatic Stress, UCLA at firstname.lastname@example.org.
Building Bridges to Suypport Military and Veterans Families: Health Care Providers Resource Guide* is a substantive guide created by the DCoE to assist medical and mental health providers with their work in helping service members,veterans and their families maintain health and positive family functioning.
The Center for Deployment Psychology has five interactive online courses designed for clinicians caring for military service members, veterans and family members. The goal of these courses is to provide psychological health (PH) professionals with knowledge of military culture to improve communication, understanding and overall interaction with warriors and their families.
CDP developed the following courses in collaboration with Essential Learning and Magellan Health Services. Each course includes background information and a series of interactive links, which allow you to control the pace of learning. At this time, these courses are offered as information only — you will not be able to access the final test or to get continuing education (CE) credit. For updates on when the courses are available for CE credit, continue to check the _CDP Web site_ <http://www.deploymentpsych.org>.
The names (links to) courses are:
1) Military Cultural Competence introduces you to the military world. Topics cover military structure, ranks and insignia, common stressors, demographic characteristics and deployment-related terminology.
2) Working with Service Members and Veterans with PTSD delves into the psychiatric syndrome that can develop following exposure to trauma. The course begins with an introduction that covers the Civil War and follows up to present day. It is broken into five sections that include lessons on Prevalence of Trauma and Development of PTSD, Trauma Exposure and Emotional Reactions During OIF/OEF Deployments, Assessing PTSD and Common Co-morbidities and Treatment of PTSD.
3) Prolonged Exposure Therapy for the Treatment of PTSD reviews one of the most effective treatments for individuals who have PTSD, “Prolonged Exposure Therapy” (PE). This workshop is an introduction to PE and provides a brief overview of techniques and procedures. This course is not intended to replace the in-depth training needed to employ this treatment. More information on how to obtain thorough training, in person or through self-study, is available at the end of the course.
4) Cognitive Processing Therapy for PTSD in Veterans and Military Personnel is a course designed to introduce students to this evidence-based, short-term treatment for PTSD. The Cognitive Processing Therapy protocol may be used for both individuals and groups. Currently, this course is not intended to replace the in-depth training needed to employ this treatment. More information on how to obtain thorough training, in person or through self-study, is available at the end of the course.
*5) A one-week course, “Addressing the Psychological Health Needs of Service Members and their Families” is offered across the United States and is geared toward training civilian providers who are new to working with the military or who are interested in working with service members and their families. _A schedule of upcoming trainings and registration is available online.
This intensive course, which is comprised of four modules, will train civilian mental health providers to better address the behavioral health needs of military personnel and their family members throughout the deployment cycle.
*6) Two-Week Courses, “Topics in Deployment Psychology" In addition to online courses, CDP runs free intensive two-week courses four to six times per year. These courses cover topics military mental health professionals actively providing care find important and helpful. Attendees include active duty, reserve and civilian behavioral health professionals and other professionals in training.