Trauma Counseling for Veterans

Becoming a counselor for uniformed military personnel and veterans comes with special considerations. We have covered this topic here on the W&M Blog in “Your Guide to Becoming a Military Counselor,” but today we are looking in greater depth at trauma counselors and how they can work to the benefit of veterans.

A trauma counselor works with clients who have been through a traumatic event or time period in their lives. These types of counselors have specific education and training to help these clients, who are most often dealing with a combination of negative psychological, emotional and physical effects from their trauma.

Trauma counseling, therefore, is considered a specialty within the field of counseling with a goal of helping clients address or confront the trauma, overcome the trauma and ultimately recover from the event or period of time.¹ This event can be any type of stressful experience that makes it difficult for the individual to cope afterwards.

Counselors who specialize in trauma work with patients over several months or longer, creating treatment plans tailored to the needs of each individual client via trauma-informed care, which we will discuss in greater depth in a moment. Counselors use a variety of treatment methods, including eye movement desensitization and reprocessing (EMDR), cognitive behavior therapy, exposure therapy and hypnotherapy.¹ But no matter the method of treatment trauma counselors use, the end goal is the same—to help clients find healthy ways to cope as they move past the traumatic event.

Trauma-informed care is a framework for treatment that helps health care providers shift the focus away from figuring out what is “wrong” with a patient to figuring out what happened to the patient.² Providers using this type of care aim to understand the impact of trauma and work to be able to spot signs of trauma in patients. A deeper understanding of trauma should influence policies and practices for the provider and their organization. And above all, a provider practicing trauma-informed care actively works to avoid re-traumatization.²

The U.S. Department of Veterans Affairs and the U.S. Department of Defense have put out a guide for health care providers on evidence-based practice and trauma care. In this guide, the “4 R’s of Trauma-Informed” care are highlighted. These are:³

• Realize the prevalence
• Recognize the impact
• Respond appropriately
• Resilience through skill-building

The core principles of the trauma-informed approach are outlined. These core principles exist to support the health care provider and to help the trauma survivor build coping skills. These principles are:³

• Safety—both the provider and the service member feels safe physically, psychologically and emotionally
• Collaboration and mutuality—both parties engage in shared decision-making
• Empowerment, voice and choice—trauma survivors are encouraged by providers to focus on their individual strengths to develop new skills and coping mechanisms
• Recognition of family—providers gain insights from family members who experience the service member’s stress reactions due to trauma
• Peer support and mutual self-help—providers seek out and receive support from other professionals, while the service members are connected to the appropriate support groups
• Trustworthiness and transparency—the provider and patient openly discuss treatment plans and set expectations and boundaries
• Cultural, historical and gender issues—providers understand and work to move past biases and stereotypes, but still recognize the value of traditional cultural connections

Trauma-informed care sees provider and patient working together to find solutions, thus empowering service members to build on strengths to move beyond the trauma toward wellness. This type of care will help inform the provider which trauma-focused psychotherapy will best treat the patient. Trauma-focused psychotherapy is “therapy that uses cognitive, emotional or behavioral techniques to facilitate processing a traumatic experience and in which the trauma focus is a central component of the therapeutic process.”³

There are various treatments to choose from. EMDR, as mentioned previously, is a popular treatment for PTSD symptoms. Other common treatments include cognitive processing therapy (CPT), and prolonged exposure (PE), but these are not the only options trauma counselors have at their disposal.

Of the 2.8 million U.S. service members deployed to Afghanistan and Iraq since 2001, it is estimated that up to 20 percent of them experience post-traumatic stress disorder (PTSD). Up to 15 percent experience depression. And on top of that, 44 percent have difficulty adjusting to civilian life and nearly half experience strains in family life.⁴

Beyond the numbers, different military experiences will impact veterans in unique ways. Factors that should be taken into consideration when counseling veterans include:

• Identity characteristics
• Experiences prior to military service
• Military vary by rank, grade, job role, specialized training, length and number of cumulative deployments
• Nature of deployment, relocation, exposure to high-risk or traumatic events
• Era of service

This population needs trained, culturally responsive counselors who can address the unique behavioral health needs of active-duty military personnel, veterans and military-connected families.

In addition to counseling military veterans who have been through situations most of the general population has not had to face, military families may need mental health support, as well. Life on a military base, seeing a loved one deployed to an active combat zone and the reintegration issues that can arise once the military family member returns home can all warrant the need for counseling. Counseling can benefit all members of a military family.

The esteemed faculty in the Online Master of Education (M.Ed.) in Counseling in William & Mary’s School of Education help aspiring counselors choose the counseling theories and approaches that best fit with their personal and professional strengths and preferences. Our Military and Veterans Counseling (a specialization within Clinical Mental Health Counseling) is designed for those who have a passion to give back and serve our military population. Through this specialization, you will gain foundational knowledge about all branches of the military and specific mental health needs within this population.

Explore the curriculum to see how the M.Ed. program will help prepare you to engage a diverse clientele, empowering them with the ability to manage their own well-being, ease distress and resolve crises.