Social Work with Military Populations

Diane Scott is a Professor in the Department of Social Work and Associate Dean of the College of Education and Professional Studies at the University of West Florida. Prior to joining the social work faculty at UWF, Dr. Scott worked as a social worker for Department of Defense serving military service members and their families. Dr. Scott authored the chapter “War-related deaths in the family” in N. Webb’s book, “Helping Bereaved Children” (2010) published by Guilford Press. Dr. Scott has received grant funding and has numerous journal publications for veteran related project.  James Whitworth is the Associate Dean of the School of Education and Social Services at Saint Leo University. He has taught graduate clinical social work courses at Saint Leo since 2011. Dr. Whitworth has provided extensive private practice counseling for military members, veterans, and their families with depression, anxiety, Post Traumatic Stress Disorder (PTSD). Lt Colonel (Ret) Whitworth served as a clinical social worker and mental health officer in the US Air Force for 21 years. He is the former Chief of Air Force Family Research at the Pentagon and also worked three years as the Chief of Air Force Family Advocacy Operations and Research. Dr. Whitworth taught behavioral medicine and research to Family Medicine Residents at Eglin Air Force base for six years.  Joseph Herzog is an Associate Professor in the Department of Social Work at the University of West Florida.  He has 10 years of experience working with military families as a clinical social worker at a non-profit counseling center located near Ft. Stewart, Ga. Dr. Herzog received a PhD from the University of South Carolina and his dissertation research was on secondary trauma in military families. He continues to be involved military family research and is currently evaluating Veterans’ Treatment Courts in the West Florida area.

• Chapter 1 Working with Military Personnel 1 Case Study Army Private Shane Westcoat 2 Case Study Army Master Sergeant Daniel Yost 3 Military Culture and Lifestyle 3 Military Populations 3 Learning the Military Culture 4 The Environment 6 Social Interaction 8 Children and Family Members 9 Fostering Resiliency/Strength-based Perspective 10 Interventions and Resources 10 Understanding and Managing Ethical Challenges 11 A Systematic Process for Responding to Ethical Challenges 13 Case Study Continued: Army Private Shane Westcoat 15 Case Study Continued: Army Master Sergeant Daniel Yost 16 Summary 16   Chapter 2 Working with Veterans 19 Transitioning from the Military 19 Retiring, Separating Voluntarily or Involuntarily 20 Case Study Marine Corps Sergeant (E-5) Troy Franklin 20 Differing Eras for Veterans 22 Financial Implications 23 The Military Life Cycle (MLC) Model and Life Stages 24 U.S. Department of Veterans Affairs 25 Health 26 Burials and Memorials 26 Vet Centers 26 The Disability Process 27 Current Issues Involving Veterans 28 Homelessness 29 Vet Court 29 Resources/Organizations For Veterans 30 TRICARE/Military OneSource 30 Veteran Service Organizations 30 Case Study Continued: Marine Corps Sergeant (E-5) Troy Franklin 31 Summary 31 Chapter 3 Deployment 34 Deployment 35 Tempo and Types of Deployments 35 Case Study Air Force Staff Sergeant (SSgt) Steven Callaghan 36 Deployment Cycles 37 Protective and Risk Factors: What Helps and What Hinders Service Member and Family Adjustment to Deployments? 39 Protective Factors 40 Risk Factors 40 The Importance of Military Member and Family Resiliency 41 Recommendations for Building Resiliency 42 Interventions and Strategies 43 Predeployment 43 During Deployment 44 Post-Deployment/Redeployment 47 Community Interventions 48 Case Study Your Treatment Plan for SSgt Callaghan and His Family 49 Summary 49 Chapter 4 Severe and Chronic Service-Related Injuries 54 The VA Health Initiative 55 Severe and Chronic Injuries Common to First Gulf War, OEF, and OIF Veterans and Active Duty Service Members 55 Post-Traumatic Stress Disorder (PTSD) 55 Case Study Army Specialist (SPC) James Wilks 56 Traumatic Brain Injury (TBI) 57 Traumatic Amputation 58 Spinal Cord Injury 58 Southwest Asian Infectious Diseases 58 First Gulf War: Injuries and Chronic Illnesses 60 Severe and Chronic Injuries Common to Vietnam and Korean War Veterans 61 Agent Orange 61 Prisoner of War Status: Injuries and Chronic Illnesses 61 Cold Injury 62 Severe and Chronic Injuries Common to Older Veterans 62 Hearing Impairment 62 Visual Impairment 63 Chemical, Biological, and Radiological Weapons 63 Case Study Continued: Army Specialist (SPC) James Wilks 64 The Wounded Warrior Project 65 Summary 65 Chapter 5 Assessment and Treatment of Deployment-Related Trauma Responses 69 Social Work Role with Returning Warriors 70 Case Study Marine Corporal (Cpl) Brandon Williams 71 The Nature of Trauma Responses Among Military Members 72 What Happens in the Brain and Body When Humans Are Exposed to Threats? 72 Warrior Benefits, Consequences, and Other Impacts of the Alarm Stage 74 The Differences Between a Functional “Normal” Response to Deployment-Related Trauma and Post-Traumatic Stress Disorder 74 Assessment of Trauma Responses 77 Helping Warriors Recover from Trauma 79 Initial Responses and Psychoeducation 79 Clinical Interventions 80 Prolonged Exposure (PE) Therapy 81 Cognitive Processing Therapy (CPT) 84 Eye Movement Desensitization and Reprocessing (EMDR) 85 Accelerated Resolution Therapy (ART) 87 Case Study Continued: Assessment and Intervention with Cpl Williams 87 Summary 88 Chapter 6 Social Work Practice with LGBT Military Members and Veterans 92 Case Study Navy Petty Officer 2nd Class Jenna Sinclair 93 Looking Back at Life in the Military for LGBT Persons as Polices Changed 94 Remedy for Discharge Under DADT 95 Estimates of LGBT Military Personnel 95 Clinical Issues and Assessment with LGBT Military Personnel 96 Interventions and Resources for LGBT Service Members and Veterans 98 Case Study Continued: Navy Petty Officer 2nd Class Jenna Sinclair 98 Summary 99 Chapter 7 Sexual Assault: Response and Treatment 102 Case Study Army Sergeant Elena Fuentes 103 Sexual Assault and Sexual Harassment 103 Sexual Assault and Sexual Harassment = Military Sexual Trauma 104 Prevalence 104 Military Culture 105 Programs and Interventions 108 Reporting Sexual Assault 109 Treatment Issues 109 Treatment Approaches 110 Case Study Continued: Assessment and Intervention with SGT Fuentes 111 Case Study Your Treatment Plan for SGT Fuentes 112 Summary 112 Chapter 8 Suicide Prevention, Assessment, and Response 116 Case Study Seaman Apprentice (SA) William Scott 118 Potential Causes for Increased Military-Related Suicides and What Social Workers Can Do to Address Them 119 Suicide Prevention: A Population Health Model 120 Suicide Assessment 120 Suicide Behavior Definitions 120 The Importance of Building a Trusting Relationship and Understanding the Military Culture 121 Three Direct Warning Signs of Suicide Risk and Significance of Client’s Crises 123 Risk Factors 124 Impulsivity and Substance Abuse 127 Protective Factors 127 The Absolute Need for Collaborative Suicide Assessment 127 Use of Formal Assessment Tools 128 Military SAFE-T (Suicide Assessment Five-Step Evaluation and Triage) 129 Initial Management and Safety Planning with Suicidal Veterans and Military Members 133 Safety Planning 134 Special Considerations for Managing Suicidal Military Members Within Their Units 138 Clinical Responses: Treating Suicidal Military Members and Veterans 138 Key Elements for Treating Suicidal Clients 138 Research-Supported Interventions to Decrease Suicide Risk 139 CBT-Based Interventions 140 Dialectical Behavioral Therapy (DBT) 141 Interpersonal Therapy (IPT) 142 Case Study Continued: SA Scott 142 Summary 143 Chapter 9 Substance Abuse Prevention, Assessment, and Response 148 Case Study Vietnam Veteran PFC Tanchi 149 The Consequences of Substance Abuse 150 Physical 150 Family 150 Occupational 150 Homelessness 151 Assessment and Treatment 151 Prevention 151 Assessment 154 Interventions 155 Relapse Prevention 158 Case Study Continued: Vietnam Veteran PFC Tanchi 159 The Impaired Professional 159 Summary 160 Chapter 10 Families with Secondary Trauma 164 Secondary Trauma 165 Case Study Rob 166 Origins 167 Transmission of Trauma 168 The Impact on Military Families 169 Family Functioning 169 Spouses 169 Children 171 Assessment and Treatment 171 Assessing Secondary Trauma in Individuals 171 Play Therapy with Children 172 Couple’s Counseling 172 Secondary Trauma in the Person of the Therapist 173 Case Study Continued: Rob 174 Self-Care 175 Summary 175 Chapter 11 Military Family Maltreatment Prevention, Assessment, and Management 179 Prevention is Primary 180 Case Study Petty Officer 2nd Class (PO2) Michael Johnson 181 New Parent Support Program 182 Secondary Prevention Services for Families at Risk 183 Prevalence and Risk/Protective Factors for Family and Relationship Maltreatment 183 Assessment and Response to Family and Relational Maltreatment 184 Family Advocacy Programs 184 Definitions of Family and Relationship Maltreatment 186 Assessment of Family Maltreatment Allegations 189 Safety First! 190 Special Role of Victim Advocates 191 Intimate Partner Violence Victim Reporting Options: Restricted versus Unrestricted 192 Management of Child and Spouse Maltreatment Cases Within the Military 196 Family Advocacy Committees 198 Interventions with Families Where Maltreatment Has Occurred 198 Developments in Military Family Maltreatment Response and the Defense Task Force on Domestic Violence 203 Case Study Continued: PO2 Michael Johnson, Amanda, and Family 203 Summary 204 Chapter 12 Building and Sustaining the Military Community 209 Systems Thinking with Warriors and Their Families 210 Case Study Joint Base America 210 Introduction to the Community Capacity Model: A Tale of Two Communities 212 Community Alpha 213 Community Bravo 214 The Community Capacity Model as a Guiding Framework 214 What Is Community Capacity? 215 The Importance of Building Connections 217 Examples of How Social Workers Can Promote Community Capacity by Building Informal Connectedness 218