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The Need for Veteran-Specific Education & Training

One effect of having an all-volunteer military force has been the separation of many Americans from contact with Service Members and the military culture.  When media coverage of the wars in Iraq and Afghanistan runs at low ebb, civilians also tend to lose track of information about conditions at war, and see few reminders that the war is still in progress.

Although the nation as a whole is welcoming this generation of veterans home in a manner that acknowledges their service and their sacrifice, we tend to lag behind in our education about the realities of Service Members’ and veterans’ lives and experiences.  Even families of Service Members are sometimes unprepared for the new people their loved ones have become, and the new dimensions of their experience (Armstrong, Best, and Domenici, 2006;  Henderson, 2006;  Lighthall, 2008).

Clinicians in the fields of substance use disorder (SUD) treatment, mental health, and other helping fields are no exception.  Those without experience or expertise in post-deployment stress effects, or in the military culture and experience, can bring unintended harm through well intended words, actions, and treatment practices.  The well prepared clinician will have sought and received information and training in:

  • The neurobiology of stress, resilience, and vulnerability to trauma
  • The relationship between trauma and substance use disorders
  • Developmental factors that affect resilience and vulnerability
  • Military factors that affect resilience and vulnerability
  • The experiences of Service Members in Iraq and Afghanistan
  • The range of post-deployment stress effects
  • Considerations for safety and respect in treating veterans
  • Considerations in assessment
  • Considerations in treatment planning
  • Matching evidence-based and promising practices to symptom clusters
  • Helping veterans find meaning and purpose in their experiences
  • Providing help for the family
  • Recovery and self-care

Civilian providers understand the need to tailor their services to veterans’ needs, but many lack more specific information.  Even those who are well schooled in trauma, depression, and SUDs may still need knowledge and training on the military culture, veterans’ experiences, ways of earning veterans’ trust, safe vs. unsafe treatment approaches, the effects of traumatic brain injuries (TBI) on treatment needs, and ways of balancing the pain-management needs of injured veterans with existing or potential dependence on opioid medications.

An added and important benefit of learning more about OIF/OEF veterans’ post-deployment stress effects will be increased effectiveness of services to Vietnam-era veterans whose chronic SUDs and other post-combat effects still bring them into civilian treatment systems.  When they returned from war, our nation knew very little about post-deployment stress effects and the importance of welcoming veterans home and honoring their service.  We can never right that wrong, but we can do our small part to make things better now.

The Need for Clinicians to Educate and Train Veterans and Their Families:  In many ways, the SUD or mental health clinician’s training is also a training of trainers.  These clinicians must be ready to:

  • Educate veterans and families about the neurobiology of resilience, stress, trauma, post-deployment stress effects, substance use disorders, and recovery
  • Train veterans in skills that will help them manage their stress systems and successfully negotiate their experiences and relationships
  • Train family members in skills that will help them manage their own stress responses and support their loved ones’ recovery processes

As returning veterans and their families learn about the development of body’s stress and survival responses, it is important that they learn and remember that:

  • The body’s response to stress and threat is automatic and natural;  it is not a matter of choice, and it is not a matter of character.
  • People with PTSD and/or substance use disorders are not “going crazy.”  These are physical conditions with many remedies.
  • We are much more than our stress systems.  Just as body, mind, spirit, and relationships are all affected by post-deployment effects, so can—and do—resources in all these areas of life contribute to the healing process.
  • People really do recover from, and learn to manage, post-deployment stress effects and substance use disorders.

Next: Effective Treatment Responses


The material on all of the Clinical Pages is taken directly from the clinicians' manual Finding Balance:  Considerations in the Treatment of Post-deployment Stress Effects, published by the Great Lakes Addiction Technology Transfer Center and Human Priorities.  This manual is copyright © 2008, Pamela Woll.  Reprint permission is universally granted, but attribution is requested. Click here for References and Other Resources.
Click the following links for PDFs of materials in the Finding Balance series:   Clinicians' Guide <> Workbook for Service Members and Veterans <> Quick Guide for Service Members and Veterans <> Workbook for Military Families <> Suggestions for Facilitators (Counselors, Trainers, Mentors) using the workbooks

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