Military Handbook INTRODUCTION Understanding and Intervening with Military Personnel and Their Families

History With each new war, the value of military social workers became increasingly appreciated, and they have been increasingly employed by all of the branches of the armed forces.

Current Military Social Work Roles  All levels of practice  Uniformed and civilian  Vast range of services provided  Wide range of problems addressed  All levels of practice  Uniformed and civilian  Vast range of services provided  Wide range of problems addressed

Unprecedented Problems in the Global War on Terror  Widespread TBI  Lack of a defined frontline  Growing prevalence of PTSD  Greater ratio of survival from devastating injuries  Polytraumatic injuries  More suicide attempts and completions  Multiple deployments  Widespread TBI  Lack of a defined frontline  Growing prevalence of PTSD  Greater ratio of survival from devastating injuries  Polytraumatic injuries  More suicide attempts and completions  Multiple deployments

Impact of Multiple Deployments on Military Families  High prevalence of spousal mental health disorders and child psychological problems  Increased domestic violence  High rate of spousal unemployment  Impact of frequent geographical moves:  Employment difficulties  School transfers and worse academic performance  Mortgage foreclosures  More credit card debt and predatory lending  High prevalence of spousal mental health disorders and child psychological problems  Increased domestic violence  High rate of spousal unemployment  Impact of frequent geographical moves:  Employment difficulties  School transfers and worse academic performance  Mortgage foreclosures  More credit card debt and predatory lending

Lingering Burden After Retirement  Loss of extreme sense of bonding and camaraderie  Seeking to re-experience adrenalin rush, leading to:  Pathological risk taking (substance abuse, other addictions)  More adaptive redirection (cave diving, etc.)  Shame and guilt (deaths of civilians)  Survivor guilt from fallen comrades  Loss of extreme sense of bonding and camaraderie  Seeking to re-experience adrenalin rush, leading to:  Pathological risk taking (substance abuse, other addictions)  More adaptive redirection (cave diving, etc.)  Shame and guilt (deaths of civilians)  Survivor guilt from fallen comrades

Resulting Problems Upon Returning to Civilian Life  Interpersonal estrangement and detachment  Reduced libido and changes in sexual activity  Desire to re-enlist (exacerbated by unemployment and hefty re-enlistment bonuses)  Changing family roles and adaptation  Interpersonal estrangement and detachment  Reduced libido and changes in sexual activity  Desire to re-enlist (exacerbated by unemployment and hefty re-enlistment bonuses)  Changing family roles and adaptation

Implication for Social Workers of Vast Numbers of Service Members Returning at Roughly the Same Point in Time  Greater reliance on civilian social workers to provide services  No longer sufficient to just refer them all to the VA  Social workers as advocates  Greater reliance on civilian social workers to provide services  No longer sufficient to just refer them all to the VA  Social workers as advocates