Introduction
Servicemen and veterans face extremely stressful inquiries and factors in military settings, while a post-deployment environment should also be taken into account as the period that is associated with anxiety and tension. Since 2001, 1.5 million troops were deployed in the US, as reported by American Psychological Association Presidential Task Force on Military Deployment Services (Savitsky et al., 2009). As a result of the traumatic experience, poor relationships in the family, and a range of other factors, deployed members of the army may develop substance abuse. Namely, drug and alcohol misuse is expected to facilitate their pain, but, in fact, it leads to both physical and psychological comorbidities. Therefore, social workers should properly evaluate their military clients, conceptualize them, and choose the most relevant strategies for coping with substance use disorders. This paper aims to discuss the social service perspective on working with service members and their families, having substance misuse issues.
Client Conceptualization
Client Evaluation
The changes in the living conditions of a serviceman and his family members in connection with deployment and the transition to a civil society relate to various aspects of life. For example, the geography of service and residence, living conditions, the content of activities, social status, the quality of the expected life, and prospects for further development can be noted as decisive (Stahre et al., 2009; Bray et al., 2010). However, all these changes are, first of all, related to the psychology of the personality of a particular person, who has to adapt to a new environment.
Among the main problems that led to the development of substance abuse, there is a radical change in the entire lifestyle, changing the previous residence, the decline of the financial situation, housing problems, and uncertainty about the possibility of getting it in a new place. Some employment problems and the requirement to organize a life in new realities threaten service members and make them seek a way to escape from the new reality. The review demonstrates that for a noteworthy number of service members and their families, deployment causes the collapse of their established worldview, along with the feelings of loneliness and social isolation (Adams et al., 2012). People who have devoted themselves to difficult military service from a young age find it difficult to adapt to new conditions. A socio-psychological adaptation becomes a difficult process for them: it is critical to master new social roles, shaping a new identity that will allow them to adequately perceive themselves and their environment.
The above factors and concerns lead to the fact that people who made a praiseworthy input to the protection of their country turn out to be a socially-vulnerable population and form a risk group. While evaluating their clients, social workers should pay attention to manifestations of post-traumatic stress disorders (PTSD). The presence of recurring nightmares related to military actions and experience, obsessive memories of traumatic events accompanied by difficult experiences, increased irritability, and unreasoning upsurges of anger are to be clarified. The majority of service members have lost interest in their participation in civilian life. They show less activity in resolving their problems, and, often, they have a lack the ability to understand others and the necessity for spiritual closeness with others and families. The backgrounds of these people are unique and dramatically different from those of non-combatants. The use of the CAGE questions is one of the ways to assess a client based on his or her feelings and thoughts about cutting substance use down, irritation, guilt, and handling hangover (Rubin et al., 2012). Since the credibility of the mentioned method was confirmed empirically, its application seems to be useful.
Environment
The study of the psychological challenges of former military personnel and their families reveals that post-deployment creates painful feelings in all of them. For family members, the key reasons for stress are the lack of work for the spouses, poor housing, substance abuse, problems in raising children, divorces of spouses, and a lack of connections (Beardslee et al., 2013). These factors shape the environment that promotes psychological deviations, such as apathy, fears, and depression in both children and adults. The awareness of these problems makes it possible to identify the content of psychological assistance and the necessary social support for former servicemen. In addition, an important aspect of the work of social workers is a thorough examination of all preceding experiences and personal abilities of a client, taking them into account as much as possible while choosing a suitable copying strategy.
The conceptualization of a client should also involve the evaluation of his or her family relationships and community members. In many cases, social isolation and the inability to engage in society cause additional stress, which strengthens the symptoms of PTSD. Such diseases as schizophrenia and bipolar disorder are two more issues that can be developed because of a lack of social engagement. In general, the environment should be assessed from the point of what can be done to recover the mental condition of the client and his or her family (Acion et al., 2013). In addition, ensuring successful social and psychological adaptation of servicemen is also a state-level problem. The decision of this problem enables people to painlessly switch to new types of activity, allowing society to effectively use trained specialists in the interests of economic development.
Preparing to Work with a Client His / Her Family
Integrated Approach
The preparation for the interaction with clients and their families should start with the thorough conceptualization of their needs and available resources. The key goal of a social worker is to match these two components and contribute to a successful recovery of the service members. The interviews with the clients and assessment tests can be identified as reliable tools to better understand what exactly is needed for a particular person. For instance, the Screening Brief Intervention and Referral to Treatment (SBIRT) can be considered as the option for the early intervention for persons with a high risk of having substance abuse or have its symptoms (Spera et al., 2011). This tool helps in identifying the level of risk and the rigorousness of possible consequences. The brief intervention that can be applied before a wider work can include increasing the awareness of substance misuse, feedback, and motivation to change.
Speaking of the preparation to work with clients and their families, a social worker should also pay attention to professional competencies, namely, knowledge and skills to demonstrate awareness of the given problem and suggest some options to recover. Most importantly, the values, attitudes, and culture of a client should form the basis for both the preparation and intervention (Rubin et al., 2012). Depending on cultural background, the professional choose the strategies that would resonate with a particular situation. Also, the knowledge of affective and cognitive processes along with social and psychological theories is important.
The Role of Faith
The use of an integrated approach to the preparation for working with servicemen should also include a faith factor. The word of God can reach the service members and make an impression on them stronger than everything that they heard. This is why the work from the perspective of faith is important in social work. It is necessary to find a special language in a conversation with clients, especially with those who are not brought up in religious families, who come from the outside (Sayers et al., 2009). Those who sometimes come already tempted by some temptations and who have created some kind of illusions in their heads based on the Christian faith and biblical stories need special attention.
The Gospel does not convey the teachings left to the soldiers by the Savior, but it contains several episodes of communication with Him by the Roman legionaries. A Roman officer who commanded a hundred in Capernaum humbly asks the Lord for the healing of his servant, showing by this both his faith in Christ and his love for his subordinate. Fulfilling the request, the Lord honors him with high praise before the multitude of the people: “Truly, I tell you, with no one in Israel have I found such faith” (Matthew 8.5-10). At the same time, the Lord pointed to the centurion, as the image of the innumerable chosen ones from all nations, who will come and lie down at the feast of faith in the eternal kingdom of Christ. Another centurion stood guard at the Cross of Christ at Calvary and at the hour of His death confessed his faith in the Savior, exclaiming: “Truly He was the Son of God!” (Matthew 27:54). These stories can be used to motivate service members to refer to faith for recovery.
Strategies and Approaches to Interact with a Client
At the initial stage of organizing psychological and social assistance to former military personnel and members of their families, social workers are faced with the task of preventing the standard error of exaggerating the role of test methods and replacing adaptation measures with diagnostic ones. To avoid such a bias in the activities of social workers, their attention is to be focused on the development of programs of diagnostic procedures, which include the necessary number of tests used by specialists at the stage of primary care (Rubin et al., 2012). Therefore, the primary goal of working with clients is a balance between test interpretation and its application to a certain environment.
An important role in the career and personal life guidance of servicemen is assigned to group forms of psychological work. For example, training seminars and group meetings that make it possible to overcome and weaken the effect of social attitudes and stereotypes that hinder adaptation can be noted. The positive outcomes involve reducing some of their inherent rigidity, changing the pessimistic view of their selves and the surrounding reality, and forming a desire for active participation in life in new conditions. Such an approach allows showing possible directions for the application of creative abilities in a new society (Sullivan et al., 2015). Psychological support for the reintegration process is an important component of the socio-psychological adaptation of servicemen since it is aimed at developing the skills of self-regulation and management of their behavior.
To assess the results of the implementation of the programs, various qualitative and quantitative socio-economic, psychological criteria, as well as statistics of authorities can be used. The main criterion for evaluating the program should be the level of stress and destructive behaviors among military personnel. The experience of the US shows that similar programs, after massive reductions in military personnel, have led to positive results (Larson et al., 2013). First of all, the military was ready to recommend reintegration programs to their comrades and, on the whole, quite positively assessed (90% of all participants) assistance for integration into civil life. Second, the participants noted the importance of the moral and psychological impact of such programs – former military personnel switched from a military lifestyle and way of thinking to a civilian understanding of society and their place in it.
One of the most effective forms of preventive and corrective work in military members is social and psychological training. Namely, the training prevents the emergence of conflict situations, relieves emotional stress, and accelerates the process of mastering the skills of effective social behavior, thus contributing to the development of a person’s communicative capabilities (Larson et al., 2012). In addition to spiritually-oriented therapy and educational work with clients, technologies can include role-playing games, art therapy, modeling, and cognitive techniques. One more method of church social work is the use of preventive and informational lectures that can be aimed at preventing negative phenomena in the post-military environment, such as alcoholism, drug abuse, and relationships issues.
Conclusion
To conclude, the range of problems that a social worker has to solve in the course of work with military members who have substance abuse is quite wide. Such activities involve studying the situation in the environment of military personnel and conducting psychological diagnostics, developing optimal solutions, informing and advising on legal issues, and developing skills and knowledge that contribute to the adaptation to civilian life. Faith, cognitive and behavioral therapies, education, and motivational interviewing are discussed as the key methods to help servicemen and their families in successful recovery in the post-deployment period.
References
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