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Social Work Practice with Veterans
Gary L. Dick, Editor
ISBN: 978-0-87101-453-5. 2014. Item #4535. 352 pages.
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In times of crisis, service members answer the call of duty, making the ultimate sacrifice for their country. When our military service members are called to defend our nation, the entire family system is affected. The families of deployed service members are also called on to serve and sacrifice for their country as they continually accept, adapt, and adjust to the changes that accompany the various stages of the deployment cycle. Social Work Practice with Veterans is a comprehensive, evidence-based social work book that addresses the multiple issues related to working with service members, veterans, and their families.

Service members who return from deployment often face a multitude of physical and mental health issues as they reintegrate back into family life. Social workers serving military service members and veterans need to be competent and knowledgeable about the military culture and informed about the best practices. Social Work Practice with Veterans incorporates all of the 10 Council on Social Work Education Core Competencies and is divided into three major sections.

The book integrates research, practice experience, case studies, theory, and social work values into a single text that covers the entire cycle of deployment and the complicated adjustments associated with posttraumatic stress disorder, suicide, traumatic brain injury, and substance abuse, with special chapters devoted to military fathers, gays in the military, military children, and more.

Social Work Practice with Veterans is an excellent resource for social workers, counselors, and mental health professionals who work with the military community.

Note: eBooks may be purchased online in single quantities only. To purchase multiple eBook copies, please contact naswpress@brightkey.net.
Acknowledgments
About the Editor
About the Contributors

Part 1: Introduction


Chapter 1: Social Work and Veterans: The Call to Serve
Gary L. Dick

Chapter 2: A Brief History of America’s Wars
Jeffrey C. Williams

Chapter 3: Theoretical Perspectives on the Motivation to Enlist
Thomas W. Miller

Chapter 4: The Role of the Social Worker
Gary L. Dick, Bradley J. Schaffer, & Emily Resnik

Part 2: Stressful Transitions


Chapter 5: Deployment: When a Parent Goes to War
Gary L. Dick, Jilian Kuntz, & Nicole Jennings

Chapter 6: Fatherhood and the Military
Gary L. Dick

Chapter 7: Military Children
Gary L. Dick & Donny Marlow

Chapter 8: Gay Individuals in the U.S. Military
Gary L. Dick, Maurice Adkins, Isaac Wright, & Jilian Kuntz

Part 3: Complicated Adjustments


Chapter 9: Adjustment to Civilian Life
Karen Cutright, Allyson M. Wiggins, & Gary L. Dick

Chapter 10: Veterans and Mental Health
Amy L. McMahon & Sophia F. Dziegielewski

Chapter 11: Veterans with Posttraumatic Stress Disorder
Gregory W. Bailey & Susan M. McIlvain

Chapter 12: Veterans and Suicide
Mark Raaker & Emily Resnik

Chapter 13: The Signature Wound: Veterans and Traumatic Brain Injury
Ruth Anne Van Loon, Michelle R. Hubbard, & Rie Aihara

Chapter 14: Veterans and Substance Abuse
Shauna P. Acquavita & Alexa Smith-Osborne

Chapter 15: Homeless Veterans
Bradley J. Schaffer & Gary L. Dick

Chapter 16: War Casualties: When a Service Member Dies
Holly A. Riffe & Rikka C. Bonnette

Chapter 17: Incarcerated Veterans: Social Work in the Criminal Justice System
Bradley J. Schaffer & Gary L. Dick

Chapter 18: Lessons from Those Who Came Before: The Experiences of Vietnam Veterans with Combat-Related Limb Loss
Carrie E. Foote, Regina Pessagno, & Stephen L. Wilson

CSWE Education Policy and Accreditation Standards Core Competencies
Index
Gary L. Dick, PhD, is a professor in the School of Social Work, College of Allied Health Sciences at the University of Cincinnati. Gary received his MSW from the Jane Addams College of Social Work at the University of Illinois, Chicago Circle, and his PhD from The Ohio State University. His research interests are in fatherhood, instrument development, veterans, domestic violence, and self-esteem. His research instrument, the Fatherhood Scale, has been used in over 25 studies around the world and translated into several different languages. In addition to research and publishing, Gary assumes many social work roles including therapist, trainer, college professor, and workshop presenter. His current clinical practice focuses on children and families, adolescents, men in therapy, and fathers.
Compiled and edited by Gary L. Dick (School of Social Work, College of Allied Health Sciences, University of Cincinnati), Social Work Practice with Veterans is comprised of eighteen informed and informative articles (many of them written or co-written with Professor Dick) and cover a wide range of thematically relevant issues ranging from the role of the social worker, to the children of military veterans, to gays in the military, to the problem of veteran suicide rates, to incarcerated veterans, and so much more. Very highly recommended for professional and academic library Psychology/Counseling reference collections, Social Work Practice with Veterans should be considered a 'must read' for social workers, counselors, and mental health professionals who work with the military community.

Michael J. Carson
Reviewer's Bookwatch
Midwest Book Review
January 2015
The profession of social work has been called to serve another generation of U.S. military personnel – those returning service members who served in the Global War on Terrorism. A significant proportion of returning veterans suffer trauma related to the atrocities of this global war. In December 2012, the U.S. Army Office of the Surgeon General reported that there were 103,792 newly diagnosed cases of posttraumatic stress disorder (PTSD) since 2002 (Fischer, 2013). Since 2000, there have been 253,330 diagnosed cases of traumatic brain injury (TBI), 1,715 amputations, 332 deaths resulting from self-inflicted wounds, and 75,817 service members evacuated for medical reasons including battle injuries, disease, and nonbattle injuries (Fischer, 2013). As of June 9, 2014, there were 6,813 casualties (U.S. Department of Defense [DoD], 2013). The race or ethnicity of the majority of the casualties was white (84 percent); there were 8.9 percent African American, 2.2 percent Asian, 1.2 percent Native American/Alaska Native, 1.2 percent multiple races, 0.03 percent Hawaiian/Pacific Islander, and 2.2 percent unknown (Fischer, 2013). As of January 13, 2013, there were 152 women casualties (Fischer, 2013).

Veterans who return with the physical and emotional wounds of war need a variety of evidence-based social work interventions that are guided by clinical wisdom to help them and their families cope with the injuries they sustained and to assist in their adjustment to civilian life. Two features of the Global War on Terrorism that are unique from previous wars are (1) the use of improvised explosive devices and (2) enemy infiltration into the local security forces. The brave men and women of the U.S. Armed Forces have been fighting an enemy who is often invisible, difficult to identify, and difficult to distinguish from the local population. The Taliban has infiltrated into and blended into the Afghanistan security forces, resulting in inside casualties (DoD, 2012).

Of all the wars the United States has fought, the Global War on Terrorism is the longest. In response to the attacks on America on September 11, 2001, President George W. Bush declared the War on Terror, which will be entering its 14th year. The military goal of the War on Terror was to destroy al-Qaeda and the Taliban, both of which were known terrorist groups claiming responsibility for the attacks on America, as well as to remove Saddam Hussein from power in Iraq. Intelligence information indicated that Iraq had weapons of mass destruction. On October 7, 2001, Operation Enduring Freedom began when the U.S. military launched attacks in Afghanistan – the home of the Taliban and the leader of al-Qaeda, Osama bin Laden. On March 20, 2003, Operation Iraqi Freedom began with air and ground strikes on Iraq. Within 21 days, U.S. troops had seized Baghdad. They would remain in Iraq for the next 10 years. Operation New Dawn began on September 1, 2010, when U.S. troop withdrawal began; the mission moved from combat to stability, with a smaller number of U.S. troops remaining in Iraq to advise the Iraqi security forces (DoD, 2013).

These prolonged wars have put enormous strain on the U.S. military, the federal budget, and service members and their families. The impact of the Global War on Terrorism has reverberated throughout the different levels of American society with varying levels of intensity. Entire family systems are called to serve and support the U.S. military when one of their family members is deployed; employers hold jobs open for service members in the National Guard who are called up for duty; the community prays for the safety of those who are in combat and for those who have fallen; universities are called on to develop services that address the complex needs of veterans who are returning to campus after military service; and a multitude of health care professionals collaborate to care for those who are physically and emotionally wounded.

There are four objectives of this introductory chapter. The first is to underline the central role of the evidence-based practice (EBP) framework of this book; we have strived to include clinical wisdom combined with the most recent empirical research related to service members and their families. We conducted interviews to give a voice to those service members and their families whose stories we knew would have an impact on others.

The second purpose of this chapter is to acknowledge how the social work profession has been called to serve and how it is the ethical responsibility of those working with veterans to stay abreast of the emerging issues and the associated research related to veterans. We acknowledge the scope and limitations of research on the subject at hand and accept that we could not include all the topics that are important in social work practice with veterans. For example, most social workers work on multidisciplinary teams alongside nurses, physicians, psychologists, physical therapists, audiologists, occupational therapists, psychiatrists, nutritionists, clergy, and a host of other professionals. We wanted to include a chapter on interdisciplinary teams but were faced with limitations in regard to the size of the book. Other important topics such as domestic violence, female veterans, and sexual assault were deemed important but beyond the page limit of this book.

The third objective is to describe how the historical and social context of the Global War on Terrorism differs from that of the Civil and Vietnam Wars – two wars that divided this country. Throughout the book, the environment in which our country goes to war, the reasons for the conflict, and the impact of war on military service members and their families are critically examined not only within the framework of the values and ethics of the social work profession, but also through the lens of the larger social and historical circumstances that steer events and affect soldiers in varying ways. The fourth objective is to provide a brief introduction to the chapters in the book.

EBP and Clinical Wisdom


Our purpose in writing and editing Social Work Practice with Veterans was to provide a comprehensive evidence-based book by combining research and clinical wisdom to address some of most relevant challenges facing U.S. military veterans. The findings from this research and clinical wisdom can be applied to decision making as it pertains to a number of issues related to veterans. Theoretically, the application of findings from empirical research can have the greatest impact on client outcomes within the shortest time period and with minimal cost. Empirical research, clinical wisdom, and qualitative research, combined under the concept of EBP, can contribute to descriptions and characteristics of at-risk veteran populations, provide a methodology to guide the assessment process, identify which instruments are reliable and valid to measure a particular problem, illuminate which risk factors contribute to further complications, identify which strengths are protective barriers, and provide outcome data on which interventions offer the most promising benefits. Several of the chapters were written by clinical social workers who have extensive expertise in working with veterans through their affiliation with the U.S. Department of Veterans Affairs. They possess expertise on the issues and challenges of returning military service members. Their general professional experience and their clinical wisdom add depth to the chapters they authored and the ones on which they were consulted. In-depth interviews were conducted with veterans who were adjusting to civilian life, with a gay veteran, with a veteran with TBI, with amputee veterans from Vietnam, and with a family who shares their story of the stages of deployment, because their stories provide insight into these issues and military culture.

Drisko and Grady (2012) pointed out that EBP is a decision-making process that most often focuses on decision making in practice but that also has implications for policy, for the administration of social work services, and for research. The focus of this book is on social work practice with individuals, families, and groups; however, the research and clinical knowledge embedded in all of the chapters have implications for policy decisions, administration, and future research.

Social Work Values and Ethics


Social workers have an ethical responsibility to stay abreast of the emerging knowledge related to the populations that they serve. The values underlying the principles of the social work profession – service, social justice, dignity and worth of each person, the importance of human relationships, integrity, and competence – unite all professional social workers within a set of ethical standards that guide practice. To provide standards of practice to guide social workers in their work with veterans and military service members, NASW (2012) heeded the call to serve veterans and their families and issued standards for military practice. In addition, it was important to identify within the chapters where the Council on Social Work Education (CWSE) Educational Policy and Accreditation Core Competencies were operationalized. It is our hope that a combination of these standards, the CSWE Core Competencies, the EBP framework, and the clinicians’ expertise and clinical wisdom can move social workers toward competency in practice as they approach clients from a perspective that enables them to consider the clients’ presenting problem, contextual issues, circumstances, values, cultural beliefs, and preferences.

Peace and Social Justice


In 1990, when the NASW adopted its Peace and Social Justice policy statement, it clearly outlined that peace and social justice were interdependent and that peace not only meant the absence of war, but also the absence of violence within society. The policy statement indicated that lasting peace can only occur through meeting basic human needs and by diverting military spending to meet the social welfare needs of citizens throughout the world. The policy statement addressed military expenditures, called for an international reduction in the production of armaments, and called for the United States to seek nonviolent means to end international conflicts (NASW, 1990). Social workers have different political ideologies concerning the justification of war that may be in conflict with this policy statement. Social workers view war through a personal lens – one that reflects their lived experience, the historical times in which they live out their lives, and the meaning they make of war and peace. At times, those views may be in conflict with the NASW Peace and Social Justice policy statement. However, peace and social justice resonated strongly with public opinion during the Vietnam War, probably more so than any time in the history of America’s wars. To give an historical and social context for the Global War on Terrorism, the following brief discussion compares it with the Vietnam and Civil Wars, highlighting changes in American society that are important for social work practice.

Conscription in the Civil and Vietnam Wars. One of the unique features of the Global War on Terrorism is the fact that it has been fought with an all- voluntary military. Throughout history, military veterans have answered the call to service either by draft or as a volunteer. Drafting citizens into the military has always been controversial. Comparing the Global War on Terrorism with the Civil War and the Vietnam War may help social workers understand the perspective of veterans in historical and motivational terms. This perspective, influenced by economics, socioeconomic status, education, and other contextual factors may raise questions and spur research about the needs of America’s veterans, the reasons why people enlist in the military, and social justice as it relates to veterans.

In 1862, during the Civil War, the South adopted conscription and required white men from the ages of 17 to 55 years to serve in the Confederate army. The Confederacy raised 21 percent of their million-man army through conscription (Perri, 2007). Men who were drafted were required to serve three years in the military, and men who enlisted had their terms extended from one year to three years. At the time, men with certain occupations and within a certain class, such as plantation owners, were exempt from being drafted (Perri, 2007). The following year, in 1863, the North adopted a draft that included men from the ages of 20 to 45 years. Men with money who were drafted could pay to have a substitute serve in their place, and men who were married could not be called up until all the unmarried men had been taken. There was opposition to this class-based system in both the South and the North. Men, whether by their wealth or occupation, could be deferred or avoid entering the military. When wealthy men offered to have a substitute serve in the war for them, it was most likely a poor man who served. These kinds of class exemptions created opposition to mandatory military service beginning in 1863. This opposition lead to riots across the country; in July 1864, riots in New York City resulted in 1,200 deaths (Perri, 2007)

At the height of the Vietnam War, young men reaching the age of 18 years were required by law to register for the draft. Draftees accounted for 25 percent (648,500) of the total armed forces who served in Vietnam. In 1969, 88 percent of the infantrymen in Vietnam were draftees (Perri, 2007). The Vietnam War raged throughout most of the 1960s and was an increasingly unpopular war. In 1968, there were 16,899 service members killed in Vietnam, which was the greatest number of casualties in the war since the Defense Casualty Analysis System of the DoD began keeping statistics on casualties in Vietnam in 1956 (DoD, 2013).

Following his landslide election in 1964, President Johnson’s policies increased the U.S. involvement in Vietnam. President Johnson was under immense pressure to change his war policies; in 1968, he announced that he would not run for a second term as president. The peace movement and the antiwar movement were gaining tremendous energy at this time. The values of patriotism and service to the country were in conflict with the increasingly popular view based on an alternative set of values that the United States was in the wrong war for the wrong reasons and must get out of Vietnam. Young men moved to Canada to avoid the draft. In August 1968, huge antiwar demonstrations were held in Chicago at the 1968 Democratic Convention. For some, these demonstrations may have seemed anti-American, unpatriotic, and a threat to the national security. However, these demonstrations were an example of the basic democratic right in a free American society – the right to freedom of speech. By the time Richard Nixon was elected president in 1968, he was faced with tremendous pressure to end the war. For some young men, draft resistance was seen as the conscionable thing to do; entering the Vietnam War was viewed as morally wrong. As a show of solidarity and resistance, many young men publicly burned their draft cards to demonstrate their opposition to the war. One way to avoid the draft was to register as a conscientious objector. Being a conscientious objector meant that the person held strong, firm, fixed, and sincere objections to war based on religious or personal beliefs and would not participate in war or bear arms (DoD, 2007).

Antiwar demonstrations, sit-ins, rallies, peace movements, and protests were held in cities and on campuses across the country. The antiwar movement, along with the peace movement, demanded an end to the Vietnam War. In 1969, John Lennon’s song "Give Peace a Chance" became the anthem for the antiwar movement in the United States. Two years later, when Joni Mitchell (1971) released "California," she captured the hope of the country and the emerging peace movement when she wrote about the dream of giving peace a chance. At no time in recent history had the United States experienced such an antiwar cultural revolution. Many families were in conflict about their patriotism, especially if they had a family member serving in Vietnam or had lost family member in the war. The opposition to the war was something that each American had to deal with amidst a social and cultural revolution that demanded that peace be given a chance as an alternative to the costly and deadly war.

When President Nixon was elected to office in 1968, he knew he had to end the Vietnam War. In 1969, he began meetings with North Vietnam leaders. These talks became known as the Paris Peace Accords. To address the issue of draft resistance, a lottery system was implemented to randomly select draftees by birthdates. On December 1, 1969, the Selective Service began using a lottery system to call up men for the draft who were born between 1944 and 1950. Birthdates were drawn to determine who should report to duty. Opposition to the war was growing. The Gallup Poll found that, in May 1970, 59 percent of Americans thought that the United States should not have sent troops to Vietnam (Gillespie, 2000). Fifteen years following the end of the Vietnam War, 74 percent of Americans believed that it was a mistake to have sent troops to Vietnam (Gillespie, 2000). During the Vietnam War, students who were in college could get a deferment and avoid the draft, but young men who chose not to go to college or who did not have the means to do so had a higher chance of being drafted and going to war.

On January 23, 1973, under the Nixon administration, Secretary of Defense Melvin R. Laird ended the military draft (DoD, 2013). As the Paris Peace Accords were signed to end the war in Vietnam, the U.S. Armed Services ended conscription and transitioned to an all-volunteer force, which we still have to this day. However, despite the antiwar movement, men and women continued to enlist in the military and served in all branches of the armed forces (army, navy, air force, marine, and coast guard), state army, and air national guards as well as reserve components.

Global War on Terrorism. The social and political context for the Global War on Terrorism was extremely different from that of the Vietnam War. The Vietnam War was fought in southeast Asia to stop the spread of communism. Vietnam had been divided into two countries, North and South Vietnam, based on political ideologies, and the United States was fighting the communist country of North Vietnam. The war was largely localized within this region but expanded somewhat through military excursions into Laos and Cambodia. On September 11, 2001, the United States was attacked when 19 Islamic militants associated with al-Qaeda hijacked four commercial planes and flew them into the Twin Towers in New York City, the Pentagon, and a field in Shanksville, Pennsylvania, killing all on board. The Americans on Flight 93, which crashed in Pennsylvania, stormed the cockpit and diverted the plane from crashing into the White House or the U.S. Capitol building.

When the United States was attacked on September 11, 2001, the country and its allies began a fight against an Islamic extremist group known as the Taliban, which was operating primarily out of Afghanistan. Taliban sleeper cells were spread throughout the Middle East and other parts of the world. The enemy was discreet, anonymous, and devoted to bringing mass destruction to the people of the United States. The ideology driving the Vietnam War was the defense of democracy through stopping the spread of communism. In contrast, the ideology for the Global War on Terrorism was to protect American democracy and defend the United States from future attacks. When the United States declared war on Iraq in 2003, 76 percent of Americans supported the war (Newport, Moore, & Jones, 2003). The collapse of the World Trade Center, the burning of the Pentagon, and the words of Todd Beamer on Flight 93, "Are you guys ready? Let’s roll," are forever etched into the national consciousness of the American people. However, 10 years after the U.S. invasion of Iraq, 53 percent of Americans thought it was a mistake to send troops to Iraq (Dugan, 2013).

Understanding the social, political, and historical context of military conflicts is important for social workers who are working with veterans. We must understand not only the military culture, but also the ecological context of each war. It is possible that the perceptions and the meaning of war for veterans and social workers alike may shift over time and that critical reflection on the part of social workers serving veterans and their families is part of the process of best practices.

Overview of the Book


Social Work Practice with Veterans is divided into three sections: Introduction, Stressful Transitions, and Complicated Adjustments.

In chapter 2, "A Brief History of America’s Wars," Jeffrey C. Williams provides an overview of the historical, political, and social landscape for each of America’s wars. He discusses social work’s response to the veteran population, as well as the reasons behind America’s wars, the distinguishing features of each war, the nation’s attitudes toward veterans, and the number of casualties in each war.

In chapter 3, "Theoretical Perspectives on the Motivation to Enlist," Thomas W. Miller presents the theoretical perspectives on what motivates people to make significant and strategic life decisions, such as joining the military. Miller provides an in-depth analysis into the internal motivation by using content and process theories of motivation to understand the reasons people enlist in the U.S. military.

In chapter 4, "The Role of the Social Worker," Bradley J. Schaffer, Emily Resnik, and I discuss the role of the social worker in working with veterans and their families. Social workers provide a broad array of services in a range of practice settings. Social workers working with soldiers and veterans need to know how to respond to issues such as mental health problems, including the invisible wounds of PTSD and TBI; suicidal ideations or tendencies; physical health issues and war injuries, including the anxiety, depression, sexual assault, loss and grief issues associated with amputations; substance abuse; intimate partner violence; homelessness; criminal involvement and incarceration; economic stress and unemployment; the impact of deployment of the family; and adjustment to civilian life.

Chapter 5, "Deployment: When a Parent Goes to War," begins the section on stressful transitions. Jilian Kuntz, Nicole Jennings, and I discuss the stages of deployment and the tasks associated with predeployment, deployment, and reintegration. We begin to present the impact of deployment on the entire family system. We address the psychological and emotional impact of the service members leaving their family and going to war.

Research on fathers in the military is lacking. In chapter 6, "Fatherhood and the Military," I address this topic and emphasize the need for social workers to understand the impact of deployment on fathers. Fathers play an important role in the lives of their children; this chapter addresses the role conflict and the issues military fathers face while being deployed. It covers the psychological and emotional aspects of fathering for service members and how new challenges are added to the expectations of fatherhood once a service member is deployed. The chapter concludes with a set of guidelines for assessing military fathers.

I felt that it was important to include a separate chapter called "Military Children," because recent research indicates that military children are at increased risk for psychosocial problems when a parent is deployed. In chapter 7, research is presented on the issues associated with children, youths, and adolescents who have a deployed parent. Their reactions are then examined within the context of the psychosocial stages of development.

In chapter 8, "Gay Individuals in the U.S. Military," Maurice Adkins, Isaac Wright, Jilian Kuntz, and I discuss the history of gays serving in the military; the research and work that went into the repeal of Don’t Ask, Don’t Tell (DADT); and the impact of DADT on service members. The chapter includes a case study that illuminates how this policy discriminated and marginalized gay and lesbian service members.

Chapter 9, "Adjustment to Civilian Life," begins the section on complicated adjustments. Karen Cutright, Allyson M. Wiggins, and I present the issues facing some veterans’ adjustment to civilian life. The chapter includes direct quotes of returning service members that give depth and meaning to their experiences with leaving the military. This chapter provides an overview of mental health, polytrauma, employment, and financial issues and issues of particular concern for female veterans.

In chapter 10, "Veterans and Mental Health," Amy McMahon and Sophia Dziegielewski provide an overview of mental health issues related to veterans who have been traumatized by the war. This chapter serves as an overview and an introduction for the chapters that follow, which focus on issues such as PTSD, TBI, suicide, and substance abuse.

In chapter 11, "Veterans with Posttraumatic Stress Disorder," Gregory W. Bailey and Susan M. McIlvain discuss the extent of PTSD in the military, the history of PTSD, criteria for assessing PTSD, instruments to measure PTSD, best treatment practices, and recent issues such as TBI and complex PTSD. The authors also present research that highlights the most promising clinical guidelines.

In chapter 12, "Veterans and Suicide," Mark Raaker and Emily Resnik discuss the extent of suicide in the military, risk factors, protective factors, and a demographic profile of the military suicide casualty. The authors provide a framework for the assessment of suicide, including screening instruments, and discuss a range of interventions.

In chapter 13, "The Signature Wound: Veterans with Traumatic Brain Injury," Ruth Anne Van Loon, Michelle R. Hubbard, and Rie Aihara present the levels of TBI, the scope of the problem, theoretical explanations, and the assessment process for veterans with suspected TBI, including screening, evaluation, and differential diagnosis. A case study is provided, with interventions, policies, and programs that address coping with TBI.

In chapter 14, "Veterans and Substance Abuse," Shauna P. Acquavita and Alexa Smith-Osborne present a comprehensive overview of the issues related to substance abuse with veterans. The authors address the scope of the problem, theories related to substance abuse, and recent research on veterans with substance abuse. They also discuss an assessment model that includes screening instruments, interventions, and substance abuse policies and programs. A case study is provided to illustrate the concepts.

In chapter 15, "Homeless Veterans," Bradley J. Schaffer and I address the micro and macro issues related to the homeless veteran population. We discuss the research on homeless veterans, risk factors for homelessness, how homeless veterans are counted, definitions of homelessness, and the policies and programs that address the issues that homeless veterans face. Case vignettes that explain the ideas and concepts reflected in this chapter are included, as well as a discussion of the role of the social worker in working with this at-risk population.

Holly A. Riffe and Rikka C. Bonnette wrote chapter 16, "War Casualties: When a Service Member Dies." It discusses the DoD’s notification process; the grieving process for war casualties; and how the loss is experienced by fellow service members, parents, spouses, and children of the deceased service member. The grief process, complicated grief, assessment instruments to measure grief, and EBP interventions to deal with grief are presented.

In chapter 17, "Incarcerated Veterans: Social Work in the Criminal Justice System," Bradley J. Schaffer and I discuss the subject of incarcerated veterans. We present the research that describes the risk factors for incarceration, the characteristics of incarcerated veterans and their mental health issues, and two programs that serve veterans in the criminal justice system. A case study is used to illuminate the various roles of social workers who serve incarcerated veterans.

In chapter 18, Carrie E. Foote, Regina Pessagno, and Stephen L. Wilson conducted qualitative interviews with Vietnam veterans who experienced combat-related limb loss and report on their long-term outcomes and their perceptions of coping and adjusting as they reintegrated back into civilian life. The purpose of "Lessons from Those Who Came Before: The Experiences of Vietnam Veterans with Combat-Related Limb Loss" is to use the lessons from these veterans to learn about how to cope and survive, so that their wisdom can improve the experiences of veterans from the Global War on Terrorism.

Conclusion


When working with veterans, it is important to understand the social and historical time period in which they served in the U.S. military. We live in a dynamic, changing, and interdependent global community. We are all moving through time, and we respond to external changes in the world around us as we monitor our internal reactions to those changes. Conceptualizing the context of a veteran’s life from a systems perspective will provide a deeper appreciation of all the forces affecting veterans. The politics and public opinions surrounding the Vietnam War are different from those of the Global War on Terrorism. During the time it took to write this book, America’s views on gays in the military and gay marriage have changed. The country experienced the repeal of the Defense of Marriage Act of 1996, and the Supreme Court ruled to recognize same-sex marriages in states that permitted these marriages. The experiences of gays entering the military following the landmark decisions of June 26, 2013, will be very different from those who went before them. We shall see in the next chapter how social, political, and economic factors leading America to war are as important as the battles that were won or lost. It is possible that international conflicts can be resolved before a nation goes to war and faces the cost of war.