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Ethical Approaches & Competencies in Counseling the Military Community



A presentation to the Military and Government Counseling Association Professional Development Institute. This presentation discusses the need to develop awareness and cultural competence in clinical mental health counseling professionals when working with clients who are military service members, veterans, and their families. The need for cultural competence is demonstrated, a potential framework is proposed, and ways in which a mental health professional can develop cultural competence is provided.

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Ethical Approaches & Competencies in Counseling the Military Community

  1. 1. Ethical Approaches & Competencies in Counseling the Military Community Keynote Address for the Military and Government Counseling Association Professional Development Institute Duane K. L. France, MA, NCC, LPCc 16 March 2017 Suggested Citation: France, D., (2017, March) Ethical Approaches & Competencies in Counseling the Military Community. Presentation at the Military and Government Counseling Association Professional Development Institute, Westminster, CO.
  2. 2. Objectives • Discuss the requirement for counselors to be culturally competent with military & veteran clients • Understand the concept of military service as a separate and distinct culture • Provide an overview and potential lens through which to develop cultural competencies • Identify ways in which counselors can develop cultural competence with this population
  3. 3. Introduction • Licensed Professional Counselor Candidate • 2015 NBCC Foundation military scholar • Recipient of the 2016 NBCC Foundation capacity building grant • Co 4th judicial district veteran trauma court • Active in legislation and advocacy for veteran mental health • Member of the advisory board of Objective Zero and Victory for Veterans • Writing to inform veterans, their families, and communities about veteran mental health • Director of veteran services for family care center, llc. • Executive director of the Colorado veterans health and wellness agency
  4. 4. Introduction • Retired in 2014 after 22 years of service in the united states army • Operation Iraqi freedom oct ‘06-Dec ‘07 • Operation Enduring Freedom ‘09-’10 • Operation enduring freedom ’11-’12 • Flintlock ‘13, Mauritania • Operation joint endeavor, ‘95-’96 • Transportation and logistics
  5. 5. ACA Ethical Requirements According to the 2014 ACA Code of Ethics, Section C.2. (Professional Competence), subsection C.2.a. (Boundaries of Competence) Counselors are “required to gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent counselor” American Counseling Association. (2014). 2014 ACA Code of Ethics. Alexandria, VA: American Counseling Association
  6. 6. Demonstrated Need SAMHSA. (2016, 12 21). Section 223, Demonstration Program for Certified Community Behavioral Health Clinics. Retrieved 03 15, 2017, from SAMHSA Web site:
  7. 7. Demonstrated need Tanielian, T., Farris, C., Batka, C., Farmer, C. M., Robinson, E., Engel, C. C., et al. (2014). Ready to Serve: Community-Based Provider Capacity to Deliver Culturally Competent, Quality Mental Health Care to Veterans and Their Families. Santa Monica, CA: RAND Corporation. 2014 Rand study on the ability for community-based mental health providers to provide culturally competent mental health care to the military and veteran population
  8. 8. Moral Imperative for Cultural Competence Benevolence Nonmalfeasance “do no harm” “do good when possible”
  9. 9. Benevolence in Counseling Veterans • Referring a client to a specialist outside of your clinic in order to receive the best care: “practicing within boundaries of competence” • Refraining from judging or condemning the veteran • Developing an awareness of your reactions to a veteran’s experience • Allowing the veteran to build trust with you at their pace, rather than yours
  10. 10. Nonmalfeasance in Counseling Veterans • Requiring a veteran client to adhere to a particular protocol “because that’s what we do here” • Requiring excessive explanation of basic military terms, which diverts from the critical aspects of the veteran story • Minimizing, dismissing, or discounting a veteran’s experiences • Acting fearful or scared of the veteran
  11. 11. Military Service as a Culture: Webster Definition The integrated pattern of human knowledge, belief, and behavior that depends upon the capacity for learning and transmitting knowledge to succeeding generations The customary beliefs, social forms, and material traits of a…social group, or The characteristic features of everyday existence shared by people in a place or time The set of shared attitudes, values, goals, and practices that characterizes an institution or organization The set of values, conventions, or social practices associated with a particular field, activity, or societal characteristic Culture [Def. 5]. (n.d.). Merriam-Webster Online. In Merriam-Webster. Retrieved March 13, 2017, from http://www.merriam-
  12. 12. Perception and Conventional Wisdom How can you tell the difference between an alligator and a crocodile? One will see you later, and the other will see you in a while! Paradigms are like glasses. When you have incomplete paradigms about yourself or life in general, it's like wearing glasses with the wrong prescription. That lens affects how you see everything else. -Sean Covey Without cultural competence, the providers working with veterans are wearing the wrong prescription, but don’t know it
  13. 13. A Way ahead: Potential Conceptual Framework Shay/ Litz / Maguen Moral Injury CBT / PE / FamilySystems Beck/Seligman Learned Helplessness Stigma Warrior Ethos “Suck It Up and Drive On” Situational and Systematic Causes of behavior Stigma against help-seeking Societal Judgement Peer Judgement Stereotypes: Villain, Victim, Vindicator Barriers to CareFrance, D., (2017, March) Ethical Approaches & Competencies in Counseling the Military Community. Presentation at the Military and Government Counseling Association Professional Development Institute, Westminster, CO.
  14. 14. A Way ahead: Potential Conceptual Framework Grand Unified Theory of Veteran Mental Health Everything but the kitchen sink theory of veteran mental health Culturally competent whole-person approach to veteran mental health
  15. 15. A Way ahead: Potential Conceptual Framework
  16. 16. Prosek, E., Burgin, E., & Wix, K. (2016). Proposing Counselor Competencies for Working with the Military Population [White paper]. The best long- term way to implement this framework is to develop core competencies for working with the military population, as proposed by Prosek, Burgin, and Wix Developing Military Cultural Competence-Long Term
  17. 17. Developing Military Cultural Competence-Short Term Books Blogs Podcasts Movies Training
  18. 18. Books Veteran Mental Health On Combat: The Psychology and Physiology of Deadly Conflict in War and Peace and On Killing: The Psychological Cost of Learning to Kill in War and Society Dave Grossman Vietnam We Were Soldiers Once…and Young: The Battle that Changed the War in Vietnam Hal Moore and Joseph Galloway Persian Gulf War Crusade: The Untold Story of the Persian Gulf War Rick Atkinson Somalia In The Company of Heroes Michael Durant and Steven Hartov Iraq Boots On the Ground: A Month with the 82nd Airborne in the Battle for Iraq Karl Zinsmeister In The Company of Soldiers: A Chronicle of Combat in Iraq Rick Atkinson. Afghanistan Not a Good Day to Die: The Untold Story of Operation Anaconda Sean Naylor. Red Platoon: A True Story of American Valor by Clinton Romesha The Aftermath Lethal Warriors: When the New Band of Brothers Came Home by David Philipps The Invisible Front: Love and Loss in an Era of Endless War by Yochi Dreazen
  19. 19. Blogs Articles about veteran mindset and viewpoint New posts twice to four times weekly Daily articles from a wide range of military, military spouse, and family member authors Established by SF Veteran Scott Faith Quickly becoming the source of news and information for many Post 9/11 Veterans, media company with 16 full-time staff and over 350 contributors on a wide range of military topics
  20. 20. Movies ACRONYM is a gripping, vivid and real account of the invisible trauma war leaves behind. The award winning documentary “Thank You For Your Service” is an in depth exploration of the challenges confronting our military community after nearly two decades of war.— Gary Sinise
  21. 21. Podcasts Justin Nassiri Served as a Submarine Officer from 2002-2007 Byron Chen Served as a USMC MP Officer from 2008-2013 Joe Crane Served as a USMC Helicopter Pilot from 1989-2013 Bennett Tanton USMC ’92-’96 US Army ‘98-’03 Eddie Lazzari US Army ‘96-’05 Jay Knight USMC Infantry Squad Leader from 2004-2008
  22. 22. Training
  23. 23. Conclusion and Contact Vision: To assist veterans in identifying and removing or minimizing barriers to their mental, physical, emotional, spiritual, and behavioral wellness