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171_15.pptxSWU 171 Intro to social work dr. Hilary Haseley, phd, msw, acue
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Military Social Work
Nearly all social workers will likely assist service members in some capacity and context
Multiple health, mental health, and social challenges for service members
US Department of Veterans Affairs is the largest employer of MSWs in the United States
Service member: Preferred term instead of soldier; universal term for those currently serving in the armed forces
Increasing behavioral health care from social workers following World War II
Programs offered by the Department of Veterans Affairs (VA)
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military social work
Conscription: forced military service
Or draft
US military has been all-volunteer since 1973
Educational benefits subsidy as large as $60,000, Post 9/11 GI Bill, for 4 years
More interventions and long-term care for service members
Author, Title and Edition. © 20XX SAGE Publishing.
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Deployment
Deployment: Action of systematically stationing military persons or forces over an area or moving forces within an area of military operation
Can be difficult on the service member along with their families
Deployment lengths: usually between 6 and 12 months
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Reintegration
Reintegration: Resumption of age, gender, and culturally appropriate roles in the family, community, and workplace
May be a time of difficulty and personal stress
Support is needed for military service members during reintegration
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military Culture
Incorporates unity, a sense of purpose and direction, and values
Uniform Code of Military Justice governs military behavior and morality
Department of Defense (DoD): HQ of all six branches of the military
Hierarchy and bureaucracy are the norm
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military Culture
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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15-2 Understand military culture, values, and beliefs.
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Military Culture
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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15-2 Understand military culture, values, and beliefs.
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Military Culture
Four distinct pillars of military culture
Strict discipline
Loyalty and self-sacrifice
Ceremonies and rituals used to solidify common identities
Emphasis on cohesion
Common reasons for joining
Identification with warrior mentality
Family legacy
Benefits of military life
Escape from difficult situations at home
Exposure to military service during school
Strong predictor of enlistment rates
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military Culture
Veterans: Active duty, discharged, retired, or reserve military members
Status conferred after receiving a general and honorable discharge
Benefits from status
https://benefits.va.gov/benefits/
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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15-2 Understand military culture, values, and beliefs.
Veterans: Active duty, discharged, retired, or reserve military members
Status conferred after receiving a general and honorable discharge
Benefits from status
Title 38 definition
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Military Culture
How War Affects Service Members
Both psychological and physical effects
Operation Enduring Freedom and Operation Iraqi Freedom have been extended military operations/conflicts
Three factors considered essential for success: Secrecy, stoicism, denial
Common effects of war are PTSD, shame, survivors’ guilt, helplessness
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military Culture
Veterans’ relationships, careers, education, and physical independence often suffer from their service
VA hospitals and TRICARE military insurance were designed to meet these needs
DoD and VA have separate funding and information streams
TRICARE benefits
Health care
Housing
Life insurance
Job training and help
Retirement
Military families also suffer considerable stress from both separation and reunification
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military Culture
Behavioral Health Problems Affecting Service Members and Veterans
PTSD and other mental health issues
Wounds from IEDs
Moral injury
Emergent clinical concern examining mental health outcomes among current and former military personnel
Requires an act of transgression that abruptly and seriously contradicts an armed service member’s expectation about behavior either during an event or afterward
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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15-3 Identify issues that affect service members, veterans, and their family members.
PTSD and other mental health issues
Wounds from IEDs
Moral injury
Emergent clinical concern examining mental health outcomes among current and former military personnel
Requires an act of transgression that abruptly and seriously contradicts an armed service member’s expectation about behavior either during an event or afterward
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Military Culture
Behavioral Health Problems Affecting Service Members and Veterans
Traumatic brain injury (TBI)
Ranges in severity from mild to severe; often from blast exposure
Complicates adjustment to civilian life post-service
Symptoms can include headache, fatigue, sleep issues, vomiting, seizures, speaking problems, limb weakness, poor coordination, confusion, and so on
Posttraumatic stress disorder (PTSD)
One in five veterans qualifies for PTSD diagnosis
Combat PTSD is more chronic and complex than civilian PTSD
Vietnam vets have a greater occurrence of panic disorder, earlier average onset of alcoholism
May relive traumatic experiences through flashbacks, nightmares, trigger responses
May avoid crowds, driving, war movies if they’re reminded of combat
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military Culture
Substance use disorders
Problems in combat settings and after discharge
Prevention efforts have stepped up, as with the Air Force’s community capacity model
Shared responsibility: one is concerned
Collective competence: one is motivated and will act
Veterans active in process of healing may be less likely to abuse substances
Author, Title and Edition. © 20XX SAGE Publishing.
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Military culture
Suicide
Highest suicide rate occurs among those who have gone to war
Three biggest risk factors: Relationship, legal, and financial troubles
Veteran suicide as a serious public health issue
Successful prevention efforts have focused on mind–body framework
Medical, environmental, psychological, nutritional, behavior, social, physical, spiritual and family fitness
The goal is to enhance resilience through getting fit in these spheres
https://www.va.gov/health-care/health-needs-conditions/mental-health/suicide-prevention/
Author, Title and Edition. © 20XX SAGE Publishing.
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Military Culture
Issues Affecting Wounded Veterans
Most wounded service members survive.
Social workers work to help them adjust to their new circumstances.
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Military Culture
Deployment strains military families
Spouses become lonely and stressed with additional responsibilities
Especially vulnerable: younger families, families with young children, families with pregnancy, families where the service member is deployed to a new and unfamiliar place
Reservists also have this uncertainty, as they may be called into active service at any time; income for families often decreases during deployment
Post deployment role negotiation can be a challenge for reunited families
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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15-3 Identify issues that affect service members, veterans, and their family members.
Deployment strains military families
Spouses become lonely and stressed with additional responsibilities
Especially vulnerable: younger families, families with young children, families with pregnancy, families where the service member is deployed to a new and unfamiliar place
Aging military veterans are at risk for social exclusion
Reservists also have this uncertainty, as they may be called into active service at any time; income for families often decreases during deployment
Post deployment role negotiation can be a challenge for reunited families
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Military Culture
Issues Affecting Military Families
Veterans may resist mental health care due to stigma.
Spouses may also have mental health needs, and children may struggle with (repeated) relocation and separation from a parent
Unemployment may be high and tempt people to reenlist
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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15-3 Identify issues that affect service members, veterans, and their family members.
Vets may resist needed mental health care due to stigma
Spouses may also have mental health needs, and children may struggle with (repeated) relocation and separation from a parent
Unemployment may be high and tempt people to reenlist
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Veteran and Military Service Organizations
Social Work Assessment and Intervention Skills
Must have knowledge of physical injuries
Systems-ecological approach: An approach contending that human development is affected by various environmental systems
Case management, counseling, therapy options, advocacy, medical work, hospice care
Secondary trauma: A term commonly used to refer to “the stress resulting from helping or wanting to help a traumatized of suffering person”
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Veteran and Military Service Organizations
Social Work Assessment and Intervention Skills
Cognitive processing therapy: A 12-session approach to treat PTSD in people who have been sexually assaulted; it combines cognitive therapy and exposure therapy
Cognitive information processing: A theory that comprises multiple theoretical perspectives and attempts to explain human learning as the development of networked memory structures
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Diversity and Military Social Work
Class
Two distinct classes: officers and enlisted—no socialization between the two
Different privileges are afforded and response to services may be quite different between enlisted people and officers
Even kids of enlisted and kids of officers may struggle to socialize comfortably
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Diversity and Military Social Work
Gender and Sexual Orientation
Percentage of women has risen.
Serve in over 90% of military roles 12% are officers.
Women often endure harassment and violence.
At risk for military sexual trauma.
Marines are an exception: only 3% female overall
Navy restricts women from serving on submarines
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Diversity and Military Social Work
Gender and Sexual Orientation
Transgender people are allowed to serve, but not while being recognized as the gender with which they identify
2018 DoD policy eliminated special accommodations for service members who were diagnosed with gender dysphoria
DoD emphasis on gender dysphoria
Gays were prohibited from service until 1993
“Don’t Ask, Don’t Tell, Don’t Pursue” arose in 1993 under President Clinton
Repeal of “Don’t Ask, Don’t Tell” in 2010
Concealment of LGBTQ+ status may increase anxiety, depression, PTSD
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Diversity and Military Social Work
Race and Ethnicity
African American overrepresentation has decreased.
Latino participation up since 1990’s.
Immigrants make up 5% of forces.
Age
Most active service members are 17–24 years old.
Maximum ages designated by each service branch.
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Diversity and Military Social Work
Intersections of Diversity
Sexual harassment can occur to women and men
Forms of sexual harassment
African American men at greater risk for sexual harassment than White men, particularly enlisted African Americans
Latina women in uniform tend to be invisible in media depictions of military
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Advocacy for Service Members, Veterans, and Their Families
Economic and Social Justice
Military needs may trump client needs
Most military social workers must be generalists
Enlistees now have better opportunities for training and careers then in the days of conscription
Retirement with benefits requires 20 years of military service (or injury in service); this is a struggle especially for women who want to have children
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Advocacy for Service Members, Veterans, and Their Families
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Advocacy for Service Members, Veterans, and Their Families
Supportive Environment
Military living can be very internally supportive
Veterans may struggle to get adequate housing after discharge, even being at risk for homelessness (especially veterans of minority races)
Disability from service also impacts later life; VA hospitals’ record of disability treatment has been historically dismal
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Advocacy for Service Members, Veterans, and Their Families
Human Rights and Needs
Rape and sexual violence are common for military women
Women in the military are typically from poor households
Military families have immense needs; divorce is a significant risk, especially for female service members
Families with special-needs members may be aided by the Army’s “exceptional family member” programs
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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Editorial Integra (Q) - AU: Only opening quotation was given for the fourth bullet point in Slide 30, Chapter 15, hence removed. Please check and update if required.
Advocacy for Service Members, Veterans, and Their Families
Political Access
Dual loyalties military feel to “brothers/sisters” and their own families
Society may not understand the military experience
Reintegration can be quite difficult
Military members may have stronger voices than civilians in influencing policymakers
Cox, Introduction to Social Work, 3e. © 2022 SAGE Publishing.
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