Table of Contents

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