The Influence of Military Culture and Veteran Worldviews on Mental Health Treatment: Practice Implications for Combat Veteran Help-seeking and Wellness

By Eugenia Weiss, Jose E. Coll and Michael Metal.

Published by The International Journal of Health, Wellness and Society

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The influence of military cultural values consisting of unit cohesion (or the subordination of individual needs over the needs of the collective) the devotion to duty and to the mission, stoicism (emotional restraint) and the importance of adhering to the chain of command become guiding belief systems for military personnel. In fact, military culture has been recognized as a distinct sub-culture of American civilian society. Thus, in order to effectively reach veterans, practitioners need to explore the culturally based constructs of the warrior mentality or worldview. Mental health workers need to consider how military cultural values held by veterans interact with perceptions of trauma and affect their help seeking behaviors in general. Data shows that service personnel tend to under-report their mental health symptoms; are reluctant to seek out mental health services and if they do engage in treatment; they prematurely drop out of services. The reasons for this are complex, from the stigma associated with mental health issues, to the potential for negative work-related repercussions especially for the active duty service personnel (i.e., loss of promotion, medical discharge, or losing security clearance).

However, the authors believe that the reluctance for seeking services has more to do with the veteran’s worldview, than with the other reasons noted. Even though the U.S. military is making a concerted effort to de-stigmatize mental health and is attempting to ensure confidentiality and minimize negative career consequences, the reluctance continues to affect early intervention. The phenomenon described here with regards to treatment participation and compliance parallels the findings from the literature on cultural diversity and seeking therapy. It has been well established, that when working with culturally diverse clients, more than half do not return to therapy for a second session (Sue & Sue, 1999).

The authors have borrowed from Brown and Landum-Brown’s (1995) worldview dimensions to help us understand how worldviews and values (as adapted to military culture and “warrior ethos”) can impact a veteran’s attitude about seeking mental health services. Practical examples will be provided of how this model can be applied to combat veterans as a method of understanding their help seeking behaviors in order to more promote wellness in the veteran client population.

Keywords: Combat-veteran Help-seeking Attitudes, Influence of Military Culture on Mental Health Services

The International Journal of Health, Wellness and Society, Volume 1, Issue 2, pp.75-86. Article: Print (Spiral Bound). Article: Electronic (PDF File; 1.024MB).

Dr. Eugenia Weiss

Clinical Assistant Professor, School of Social Work, University of Southern California, Los Angeles, California, USA

Dr. Eugenia L. Weiss is a California licensed clinical social worker and a licensed psychologist. She received her doctorate from Alliant International University in Clinical Psychology and her Masters from the University of Southern California in Social Work. She is currently Clinical Assistant Professor at the University of Southern California, School of Social Work. Dr. Weiss teaches practice courses in mental health and families and children concentrations. She is core faculty of the Military Social Work Concentration at USC and responsible for developing the clinical practice with military families course and is the lead instructor. Dr. Weiss has maintained a private practice near Camp Pendleton since 1995 working with individuals, couples, families and children/adolescents, with a special emphasis on military families. She is bilingual-bicultural in Spanish. Her areas of expertise include the treatment of trauma, substance abuse and mood disorders. She is also a certified drug and alcohol counselor and is trained in the use of eye movement desensitization reprocessing (EMDR) therapy. Her research interests include military cultural training in social work education and resilience building with military families. She is the author of peer reviewed publications dealing with military social work. Dr. Weiss is co-author of “A Civilian’s Primer for Counseling Veterans” 2nd Edition (Exum, Coll & Weiss, in press

Dr. Jose E. Coll

Clinical Associate Professor, School of Social Work, University of Southern California, Los Angeles, California, USA

Dr. Coll received his doctorate in Counseling Education and Supervision from the University of South Florida and Masters of Social Work at the University of Central Florida. He is currently the Clinical Associate Professor and Director of the San Diego Academic Center and USC Military Social Work Program. Prior to assuming his current position, he served as Chair and Associate Professor of Social Work at Saint Leo University. Dr. Coll has worked as a clinical social worker with adolescents and families of children with Autism, Severely Emotionally Disturbed, and Emotionally Mentally Handicapped. Dr. Coll’s overall research interest focuses on determining development of worldviews and how they influence factors of treatment and clinical outcomes. Moreover, he is actively engaged in research on treatment modalities for suicide prevention among active duty soldiers and their families. He most recently co-authored two books “A Civilian Counselor’s Primer for Counseling Veterans” and “A Developmental Guide to Research: A Student Faculty Handbook”. Dr. Coll has served as a Reconnaissance Marine at Camp Pendleton, Ca. where he was honorably discharged.

Michael Metal

MSW Candidate 2013, School of Social Work, University of Southern California, Los Angeles, California, USA