As we conclude this Memorial Day, a day that means many things for people across the country: gratitude, grief, or calm remembrance, I wanted to dedicate a post to social work with the military. Many social workers themselves either come from military families (self-disclosure: in my case, my father), or are servicemen and women themselves.

While we often associate social work treatment with a PTSD diagnosis following experiences of loss and trauma abroad, a lot of social work treatment with the military is  systemic. Even though the support looks at the individual and working with where they’re at in their own individual experiences (factors such as resilience, adaptation to civilian life, and relational factors that include spousal and parenting relationships), good social work treatment also looks at the individual in their environment. Just like a general social work intervention, the PIE (person-in-environment) perspective is applied, with the unique factors that affect military personnel.

Dr. Melissa D. Stöppler (n.d.) goes beyond the direct stress of in-combat duty and identifies three stages of combat stress (1)Predeployment, (2)Deployment, and (3) Reunion.

Each of these different stages has its own stressors, ranging from the separation anxiety and expectant fears of predeployment, the experience of physical separation on the soldier’s end and role changes on the home front (deployment phase), and the readjustment and re-attachment of the reunion phase.

When it comes to social work treatment, a couple of things to be aware of:

1. PIE: Person-in-environment. As mentioned above, looking at the stressors that face military personnel both abroad (experience of direct combat) and at home (social isolation and/or spousal relationships).
2. Countertransference: Social workers should be aware of their own beliefs, biases, and personal and historical experiences and have a place to process these (such as supervision). For example, a social worker who has been in the military themselves may be able to tap into their own experiences of being a service member as a way to build the connection and rapport (even without direct self-disclosure), while being aware of and avoiding vicarious traumatization. Also, no matter what one’s private political or worldview beliefs may be, to internally hold these in awareness and build a supportive human relationship with the client.
3. Grounding: Grounding is a word used in much of the PTSD literature. But in addition to gearing a treatment that draws from systems theory, the social work intervention with the military provides a grounding experience, both literally (grounding back home), and psychotherapeutically: a place to pause, stop, and gradually reconnect with the relative safety and differences of civilian life. This invitation to relationship creates a slow detachment to fear, and co-creates the gradual psychic holding environment (à la Winnicott) in which the real progress begins.

References

Stoppler, Melissa C. (n.d.). Wartime Stress and Military Families. Retrieved from http://www.stress.about.com/cs/familymarital/a/aa/032103_p.htm

(No longer active about.com site. Send me a message if anyone is interested in the scanned PDF)