The keys to building successful family counseling programs for Military Service members
For two decades Louis Valente has been supervising Leidos behavioral-health counseling programs aimed at the families and especially the adolescent children of Military Service members stationed overseas. Valente, a clinical social worker by training, recently discussed the challenges of family counseling, and the keys to building successful counseling programs.
In what ways are adolescents at higher risk of behavioral-health problems?
Adolescents are the highest-risk population there is when it comes to substance abuse and suicide. It’s a critical period in a person’s development, and can easily get off track. Adolescents in military families can sometimes face special challenges, in that the family may be constantly moving, which can have a big impact on development, both positive and negative. Intervening early with counseling can make a huge difference.
Does the military see adolescent-risk issues as a special problem?
They do. Leidos has run OCONUS family counseling programs for all the military branches, as well as for other government organizations. It’s well understood now in the defense community that if a personnel member’s family is struggling, it’s going to make it harder or impossible for that person to do their job. They may have to cut a mission short, or even return to the U.S., to deal with a family problem that isn’t being effectively addressed. Imagine the disruption to the unit if key members have to leave, or can’t focus on the job. It can also disrupt the Service Member’s career.
What are some of the strategies for helping adolescents and families cope?
Our programs have taken a number of approaches that are different than standard adult counseling approaches in the military. For one thing, we deploy counselors who specialize in adolescents, because adult providers don’t necessarily have a lot of training or experience in that regard. We also realized early on that the only way to be effective with that population was to get our providers installed where the kids were--in the schools. That makes all the difference in engaging them clinically.
Another thing we did was make our counseling entirely confidential. That was unheard of at the time in the military. If a Service Member or anyone in their family engaged counseling services, that went into the Member’s file for the commander to see. We set things up so that we could do full mental-health diagnosis and counseling services to an adolescent family member without creating any clinical record that might impact a parent’s career. That was crucial, because even today some Service Members are reluctant to make use of any mental health services out of fear that it will reflect negatively on them. And they can transmit that concern to their family members. We worked hard to build trust and credibility in the community as a truly confidential service.
Another unique part of our program was our emphasis on outreach and early intervention. We didn’t wait for kids to get into real trouble before we worked with them. We were aggressively proactive, deploying trainers and educators to try to prevent problems, and outreach specialists to find people who needed help and engage with them. Early intervention makes a huge difference in outcomes.
We also worked hard to get the entire family involved in counseling when we worked with an adolescent. All the research shows that kids who are turning to substance abuse or other risky behavioral issues are a lot less likely to get better and stay better if they don't get the whole family engaged.
How did you convince local commanders to go along with these approaches?
Part of our pitch was plain dollar and cents. If a soldier’s kid has to go back to the U.S. for substance-abuse treatment, that can cost $30,000 a month, and falls directly on the local commander’s budget. Having these family problems dealt with also pays off in personnel productivity and morale. But the commanders certainly also had an interest in helping the families of their personnel because it’s the right thing to do.
And the counseling really does make a difference. During my tenure we’ve engaged with a total of more than 20,000 adolescents with all sorts of issues, many at very high risk. In all that time, we’ve never had a suicide on our watch. That’s unusual in this population.
Is finding and deploying clinical staff around the world challenging?
A lot of people are interested in the idea of being located overseas, in part because there’s a sense of romance to it. We want people with solid clinical training and experience, but we also look for people who can roll with the punches, and who have a sense of adventure. When a newly hired clinician arrives overseas, they may have to struggle to get all their credentials vetted by the local military treatment facility as well as by the local host government, and they have to find housing in the local economy. They have to quickly adjust to two new cultures, the military culture and the local host country culture.
There are always hiccups. In the hundreds of deployments we’ve overseen, not a single one went entirely according to Hoyle. When someone arrives there and finally figures out how to use a phone, the most common way they use it is to call us and tell us they want to come home. We have to talk them down and help them get past that hump. After that, things usually go a lot more smoothly, especially when they establish themselves in meaningful counseling work.