Patricia Brick is a student in the USC School of Social Work’s Global Immersion course on Military Culture, Summer 2012. Below she writes about her experience visiting the U.S. Army Garrison (USAG) Baumholder:
At USAG Baumholder, we were told that we would see things as they really are, as opposed to the textbook version we might hear elsewhere – that other bases ‘dust the rocks’ when tours come through and portray a different environment. So far, we have been processed through rarely-visited locations, from hangers to donations closets, but today we went from rare to the raw, unabashed realities of two soldiers who gave us a glimpse into their multiple deployments to combat theaters. They shared their experience in a no-holds-barred fashion, including the reason that they fight – not for family or country, but for the soldier next to them, who is depending on them – as well as their requirements for engaging with mental health practitioners.
What they require is professionalism exhibited through respect, punctuality, congruity in word and action, listening skills, and an individualized treatment plan. Most of all, they require that their provider possess the professional competency to work with a military population. They emphasized that they have similar but distinctively different experiences and therefore do not tolerate the standard reassurance of “I know how you feel” from fellow soldiers, much less from mental health providers. Both men also expressed disdain for fellow soldiers who fake post-traumatic stress symptoms in order to acquire disability status, as it cheapens and diminishes their own experience and struggle.
Today was the capstone to an amazing set of exposures to the various facets of military social work. There is a plethora of venues and arenas, from birth in a neonatal ward to serving the geriatric military population, from pre-deployment to retirement – even to simply maintaining equilibrium on the homefront. There are no small issues, be it depression in military spouses or children, substance abuse, grief, or not adjusting to military life.
I have been vastly enriched by this course and the lessons that will continue to surface as the second year of classes shed additional light and insight into the content of this immersion. My experiences today re-confirmed the area of social work I wish to pursue and reminded me of the need to treat each client as an individual.
Patricia Brick, University Park Campus
Anthony Mihalo is a student in the USC School of Social Work’s Global Immersion course on Military Culture, Summer 2012. Below he writes about how the immersion course has changed his perspective of social work in the military:
Through my immersion experience, I have acquired a new perspective of social work within the military as well as social work in general. Before coming to Europe, I imagined that the majority of issues encountered by social workers on military installations overseas dealt with severe mental illness, substance abuse, and issues with the wounded from Iraq and Afghanistan. However, after the immersion experience, I came to realize that social workers deal with many other issues on these installations. I also came to realize the tension that exists between the military mission and the ethics of the social work profession in general.
During the briefings at Ramstein Air Base and Landstuhl Regional Medical Center, I came to realize that the social workers on these installations deal with a diverse set of issues. These issues include child and adolescent behavioral health issues, domestic violence, and fatigue amongst staff. Furthermore, social workers ensure the availability of resources for military families. I came to realize that the mental health services deal with more relationship or adjustment issues than mental illnesses. Based on this, my perspective of military social work was broadened.
Overall, I came to realize that the military’s mission is often given precedence over the ethics of the social work profession. Within the civilian sector, the needs of the client are seen as the main priority of the therapeutic setting. However, within a military setting, the mission is given priority. Therefore, as a social worker within the military, a balance must be made between meeting the needs of the client and fulfilling the mission of the military. This was something that I had not contemplated before my immersion experience.
Anthony Mihalo, University Park Campus
The following day, the class traveled to the U.S. Army Garrison Baumholder, located in the hills of western Germany, not far from the borders of France and Luxembourg. There, students had the opportunity to observe Army medics from Bravo Company, 40th Engineer Battalion, as they practiced administering intravenous fluid drips (IVs) on one another, and to speak to the soldiers about their military experience and perceptions of behavioral healthcare providers.
Students then traveled to the Warrior Transition Unit (WTU) at Baumholder, a program which provides focused, continuous, and integrated care to soldiers who are injured and meet the medical criteria to be released from their unit and reassigned to a WTU. There, each soldier’s care is closely monitored and managed by behavioral healthcare and medical providers, until he/she is able to return to active duty or transitions from active duty.
Students heard from two soldiers who were transferred to the WTU for treatment of severe post-traumatic stress symptoms. Both men shared their personal experiences with combat and trauma, including the symptoms that made it difficult for them to sleep, function in daily life, perform their jobs, or interact with their families and friends. These soldiers also offered insight into what has helped them connect with certain behavioral healthcare workers or programs, and also shared behaviors and language that the students should avoid when treating a servicemember or veteran.
Due to base security regulations, no photos of the class visit to U.S. Army Garrison Baumholder are included here. However, Department of Defense photos have been included for reference. These photos include the DoD-provided caption and photographer credit information.
Michael Mann-Stock is a May 2012 graduate of the USC School of Social Work and participated in the Global Immersion course on Military Culture, Summer 2012. Below he writes about the insight he has gained regarding the experience of military families living overseas:
While in Germany, a group of fellow students and I were fortunate to be able to spend time with USC School of Social Work Virtual Academic Center (VAC) student Morgan McNabb. Morgan currently lives in Germany and is a military spouse, a program manager for the Air Force in Drug Demand Reduction Program, and a future enlisted officer and social worker in the Air Force. One insight that Morgan provided which is valuable to social workers aspiring to work with military families living overseas, is how important it is for military families moving to an overseas location like Ramstein Air Base to form a solid bond with other military families in their community. This foundation is so important because when unforeseen circumstances occur, military families often have to quickly trust one another in order to persevere. If a newly-arrived military family is isolated from neighbors or community, the transition into living overseas can result in children presenting with bad behavior in school, adolescents experimenting with drugs and/or alcohol, or spouses developing mental health symptoms such as depression.
It is therefore critical that social workers practicing with military families in overseas locations like Germany’s Ramstein AB are aware of the resources available to families living both on- and off-base, have a solid understanding of military culture, and possess a skill set which will enable them to link isolated families to either the larger local military community or to other military families in surrounding villages.
Michael Mann-Stock, Virtual Academic Center
At Spangdahlem Air Base, the class received briefings from Air Force social workers regarding the most common issues for which airmen and their family members are treated or seek out behavioral healthcare on base. Most of these issues are related to marriage or family, such as relationship counseling or adjustment to military or overseas living. However, some ‘walking wounded’ seek help regarding problems sleeping, a symptom of post-traumatic stress or depression related to past deployments.
The social workers identified the stigma regarding behavioral or mental healthcare that is prevalent in the military as a big barrier to care, especially among airmen whose work requires high-functionality, like piloting or servicing aircraft. This stigma also affects the spouses of servicemembers, who may believe that seeking help will reflect badly on their spouse’s military career. They also described the tension that exists for them – as Air Force social workers – between helping the individual airman and supporting the Air Force mission. For example, in the civilian world, a provider might advise an individual with symptoms of depression to take time away from work, whereas in the military that individual’s role in supporting the greater mission and fellow airmen must also be weighed before recommending that they be pulled out of their unit, even temporarily.
The class then toured an aircraft hanger, where students examined air munitions and military aircraft stationed on-base—an F-16 Fighting Falcon and an A-10 Thunderbolt II, known as the Warthog. Insignias from the units currently stationed at Spandahlem AB – the 81st Fighter Squadron, 606th Air Control Squadron, and the 22nd Fighter Squadron – hung on the hanger’s enormous doors.
Several pilots and members of the 52nd Aircraft Maintenance Squadron – part of the 52nd Fighter Wing which conducts operations at Spangdahlem AB – were on hand to provide information on the aircraft and munitions and answer student questions about the equipment and life in the Air Force.
A couple First Sergeants from the Maintenance Squadron told the class that when it comes to mental health, their biggest concern is safety, since the pilots and supporting airmen rely directly on the competence and focus of the maintenance crew—one tiny mistake can cause massive amounts of damage to equipment, and even death. Thus, a behavioral healthcare provider treating an active duty servicemember must be aware of the servicemember’s particular job and its significance to the safety of others, and consider the impact that any issues, diagnosis, or treatment will have on the servicemember’s ability to perform their job competently and reliably.
Following the visit to Spangdahlem AB, the class traveled to Trier, the oldest city in Germany and the site of many Roman ruins. Originally called Augusta Treverorum by its Roman founder Emperor Augustus, Trier was the Romans’ capital of the northern territories for over 400 years.
Only one of the city’s four original gates is still standing – Porta Nigra, the “black gate.” Built around 200 A.D., Porta Nigra is several stories tall and open to visitors who can climb the towers for a view of the city. It has been a UNESCO World Heritage Site since 1986.
Due to base security regulations, no photos of the class visit to Spangdahlem Air Base are included here. However, Department of Defense photos have been included for reference. These photos include the DoD-provided caption and photographer credit information.
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Sara Ajifu is a student in the USC School of Social Work’s Global Immersion course on Military Culture, Summer 2012. Below she writes about how her visit to Landstuhl Regional Medical Center has shaped her perspective of social work in regards to both the client and the caregiver:
One thing that stood out to me during our briefings at Landstuhl Regional Medical Center (LRMC) by the Army and LRMC employees was the way in which the presentations were carried out. These briefings were much more timely and strict compared to those we received at Ramstein Air Base. Also, the Army’s joking about the other branches of the military brought to my attention that although the military has its own culture, there are very distinct subcultures within it with their own rules, values, beliefs, and assumptions that, as social workers, we must always be mindful of when working with a diverse clientele. I found it very refreshing and comforting to hear experienced social workers reinforce that our work and our clients’ needs are always changing and challenging us to be innovators and to adapt, and that no one knows everything or is always prepared.
Also, I found the Combat and Operational Stress Reaction/Staff Resilience (COSR/SR) program to be such an amazing effort to combat and treat compassion fatigue among the various workers at the LRMC. Most of the time, we focus so much on the client that we forget to care for ourselves—the caregivers—as well. On a macro level, I can see the benefit to implementing similar programming within other organizations to help combat turnover and fatigue.
Overall, our briefings and time spent at the LRMC were very informative and helpful in conceptualizing service delivery for such a range of needs and highlighting how everything and everyone can come together to provide servicemembers and their families with the tools to be successful, regardless of their issues or trauma. During one briefing, Dr. Daphne Brown, the Chief of the Division of Behavioral Health at LRMC, made a very insightful and impactful statement about the need to change the way our military men and women view social workers. Creating a positive first impression and reframing the way in which social work and mental health are perceived in the military – and in general – is a huge task, as there is still much stigma attached. Though I do not anticipate this to be quick or easy transition, I plan to incorporate this goal into my own practice in the future.
Sara Ajifu, Orange County Academic Center
Cory Mazariego is a student in the USC School of Social Work’s Global Immersion course on Military Culture, Summer 2012. Below she writes about how her visit to Landstuhl Regional Medical Center has influenced her goal of serving servicemembers and their families:
My prior experience with the JROTC and ROTC has shaped my career goals. In 1916, under the National Defense Act, the United States Army Junior Reserve Officers’ Training Corps (JROTC) enacted its mission “to motivate young people to become better citizens,” and these programs have influenced me to dedicate myself to helping our armed forces. As a student concentrating in military mental health, after visiting the Landstuhl Regional Medical Center (LRMC) I am reminded of my mission to serve and my passion to one day be part of a team such as the LRMC and serve military personnel.
The behavioral health programs at the LRMC are on a mission to provide better care for wounded warriors, servicemembers, and their families. I am very glad to have visited the LRMC and am now motivated me to explore working overseas. My goal is to not only serve the 15% of military personnel who seek out behavioral healthcare, but also advocate for the 85% who fall through the cracks or do not seek help because of stigma or fear of being diagnosed with a condition that they believe would limit or end their military career.
As a future civilian social worker serving military personnel, I want to provide the kind of support that I saw at the LRMC and instill positivity where there is a lack of hope. I see myself working in the joint service environment, coordinating military and civilian staff towards a common goal in healing servicemembers and their families through trauma diagnosis, recovery, and rehabilitation. I want to make a difference in servicemembers’ lives and remind them that they are not alone – that I and other social workers are here to serve them in return for their sacrifices.
Cory Mazariego, University Park Campus
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