Realizing that veterans and their families have sacrificed to serve others, sacrifices that often result in emotional distress and family discord, the U.S. Department of Veterans Affairs (VA) has expanded its mental health services -and its number of counselors - across the nation.
A counseling career with the VA means counseling any one of the nation's 5.5 million veterans, or providing marital therapy or family counseling. Veterans' counselors understand the unique culture of the military, are sensitive to issues of honor and sacrifice, and empathetic to disturbing accounts of intense combat experiences.
Veterans' counselors work in the VA health care system, consisting of 153 medical centers, in addition to numerous community-based outpatient clinics, and community living centers. The VA operates 232 community-based Vet Centers alone, established to provide free readjustment counseling and outreach services to all veterans and families for military related issues.
The VA's facilities and counseling services are available to all veterans, regardless of age or combat experience. That means that even veterans experiencing emotional issues related to war from 50 years ago can receive help at a VA hospital, clinic or center.
Older veterans such as those who have recently retired and now spend time reflecting on their lives and past experiences may have unsettling memories from the war. This starts a chain reaction of disturbing thoughts, and perhaps issues that he or she never fully resolved.
The VA website, which operates the National Center for PTSD, states that this "remembering" process can trigger late-onset stress symptomatology (LOSS). Symptoms of LOSS are similar to post traumatic stress disorder (PTSD), but less severe. LOSS is more closely related to aging, and counselors will work with older veterans to make sense of their war memories, preventing more severe forms of depression from developing.
When veterans seek help for more serious forms of war-related trauma, or PTSD, veterans' counselors gravitate toward one of two proven therapies for PTSD: prolonged exposure therapy; or cognitive processing therapy.
Prolonged exposure therapy helps veterans deal with troubling memories, thoughts, feelings, and situations related to the trauma - even thoughts that the veteran has avoided because they're too painful. Repeated exposure to these thoughts, feelings, and situations helps reduce the power they have to cause distress.
For example, veterans returning from Iraq and Afghanistan often have panic attacks when driving, remembering combat patrols that required heightened vigilance, searching constantly for signs of roadside bombs - now causing them panic in all driving situations.
By using prolonged exposure therapy, the counselor helps veterans confront these unpleasant thoughts, helps them put them into context, and slowly returns them to their cars, eventually getting them to handle driving again.
Cognitive processing therapy also addresses thoughts or feelings that cause panic or fear, helping the veteran discover the source of the fear, and discovering how the particular way a veteran thinks about it exacerbates the stress or panic. The counselor helps the veteran change thought processes that stop negative thoughts, turning them positive and therefore helping the vet feel better. Feeling better, the veteran then changes his or her behavior, making healthier choices and decisions.
Veterans' counselors also work with the families and couples affected by PTSD. Children and partners might not understand the anger or depression exhibited by a vet. They can become scared, feel guilty, and also act out angrily, often causing severe family disruption and discord.
A counselor works with family members on communication skills, and healthy coping behaviors. The entire family learns about PTSD and how it's handled and treated. Marital counseling works similarly, but with the couple rather than the entire family.
In total, the VA system has 200 specialized programs for treating PTSD, according to the VA website. Counselors are needed to administer these programs, to provide the appropriate interventions, and the VA especially values those who have served themselves. Veterans often make the best counselors for other veterans.
If you are interested in helping veterans and their families cope with the stresses associated with military service, sensitive to the needs of veterans and their families, contact schools offering degrees in counseling, or other psychology-related fields. A master's degree is usually required for many of the VA's counseling positions.