Disorder during deployments (Rubin, Weiss, & Coll, 2013).


Disorder
or Special Population Group

            More than 1.7 million U.S. military
members have been deployed to Afghanistan and Iraq (Bernhardt, 2009). Posttraumatic
stress disorder (PTSD) has affected many service members in Operation Enduring
Freedom (OEF) and Operation Iraqi Freedom (OIF). According to Moran, Schmidt, & Burker (2013), approximately one in
six service members of the U.S. Army and U.S. Marine Corps meet the criteria for
PTSD. They also meet criteria for generalized anxiety disorder and depression (Moran,
Schmidt, & Burker, 2013). PTSD prevalence rates have gone up in the Army
and National Guard from 20.7% to 30.5% (Moran, Schmidt, & Burker, 2013).
The exposure to combat is directly correlated to the development of PTSD (Moran,
Schmidt, & Burker, 2013). A study found that more than 80% of Army and
Marine service members have been exposed to killing an enemy, been shot at,
handled dead bodies, or known someone that was injured or killed (Moran, Schmidt,
& Burker, 2013). Research suggests that mental health issues after a
deployment, such as PTSD, are associated with a physical injury during
deployments (Rubin, Weiss, & Coll, 2013).

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            According to Clausen, Youngren, Sisante, Billinger, Taylor, &
Aupperle (2016), “Posttraumatic stress disorder is characterized by intrusion,
hypervigilance, negative alteration in mood and cognitions, and avoidance in
response to distressing and/or trauma-related stimuli and situations.” Military
service members are more likely to experience traumatic experiences due to
their combat exposure. This leaves the military population more vulnerable to
developing PTSD. PTSD can be a very debilitating disorder to live with as some
of the symptoms include an altered time sense, confusion, emotional numbing,
impulsivity, and liability of mood (Moran, Schmidt, & Burker, 2013). There
are many effective interventions for treating PTSD such as Cognitive Processing
Therapy (CPT), Prolonged Exposure Therapy (PET), and Brief Eclectic
Psychotherapy (BEP), but Eye Movement Desensitization and Reprocessing (EMDR)
will be the chosen intervention for the purpose of this paper.

Methods
of Engagement

            Due to the
masculine warrior paradigm in the military there is still such a stigma in
seeking help for mental health issues. This leads to many service members not
ever receiving the treatment they need for their PTSD. Friedman (2004), believes
that the stigma is what keeps service members from seeking treatment. Approximately
only 19% of military personnel with a psychiatric disorder ever seek treatment,
whereas in the civilian population the rate is about 28.5% (Friedman, 2004, p. 77). Even lower
than that is the rate of service members with PTSD that actually seek treatment
which is approximately only 4.1% (Friedman, 2004, p. 77). Seeking treatment for
PTSD in the military can be perceived as being weak or even failing and there
is also the fear of it ruining their career (Friedman, 2004, p. 77).

            According to Reyes (2011), military
members are more likely to be encouraged to obtain mental health services by
spouses and family members than to go on their own. Service members that are
still on active duty can receive mental health services at their duty stations
by self-referring or getting referred by their chain of command. Most duty stations
have mental health clinics or mental health clinicians that they can go to but
service members often would rather not go due to the fear of their chain of
command finding out. A service member can receive outpatient mental health
services outside of their duty station for marriage counseling since their
spouse is the primary patient. Otherwise, getting a referral for outpatient
mental health services outside of their duty station can prove to be quite
difficult. Once a service member has been honorably discharged, they can seek
mental health services at their local VA hospitals.

            It is important to keep the military
culture in mind whenever working with an active military member or veteran. This
can be crucial in order to initiate an empathic and effective therapeutic
rapport (Reyes, 2011). One might ask the service member various questions
regarding their military service and learn about what they were like before
their time in service (Reyes, 2011). Once therapeutic rapport has been
established the therapist should provide informed consent as well as education
about the therapeutic process (Reyes, 2011).  This would include providing a psycho-educational
discussion about PTSD to allow the service member to better understand what
they are dealing with (Reyes, 2011). Before the client can even approach the
trauma, it is important to establish safety and self-control (Reyes, 2011).

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