Group Therapy for Veterans Group

Group Therapy for Veterans

Group Work for Substance Dependent Veterans

Substance abuse is problematic in both combat and non-combat veterans. A number of studies confirm that the trauma does not end when the soldier comes home. The trauma associated with combat can linger for many years after the battle ends. Various veterans' mental health issues can lead to substance abuse. Combat veterans are 63% more likely to report heavy drinking than those who had not been deployed to combat zones (Gordon, 2008). Often substance abuse is a symptom, not a primary diagnosis in veterans (Gordon, 2008). Therefore, treating the underlying condition is essential in the eventual treatment of the substance abuse. Group therapy is often used part of the treatment program for combat veterans. However, there is some controversy regarding which format is most beneficial and results in the highest degree of treatment success among combat veterans. It is important for the social worker to be familiar with the success of failure of group therapy programs so that they can help their clients become involved in the most beneficial programs. It is also important to understand that veterans are unique and that they react differently than the general population to group therapy and other treatment protocols. The follow will discuss these differences and findings.

Review of Treatment Programs

One of the most important considerations in the group therapy program is to understand that for combat veterans, substance abuse is often a coping mechanism to traumatic events (Gordon, 2008). Post-traumatic stress disorder is often linked to substance abuse in veterans. Often treatment of the substance abuse means treating the underlying condition. For many veterans group therapy is the first time that they have reached out to another for kinship since their combat experiences (Tendall & Fishler, n.d.).

Many times, they have domestic or other unresolved issues that they can discuss in a trusting environment (Tendall & Fishler, n.d.). However, when the suggestion of group therapy is first discussed, many veterans are not open to the idea (Tendall & Fishler, n.d.). It may take some coaxing to get them to attend a group therapy session, but when they do, they will find the experience to be a positive place to share locked up feelings. Learning to express these locked up feelings can open the door to healing substance abuse, and other symptoms of the trauma that they experienced (Tendall & Fishler, n.d.).

Adherence to aftercare group therapy after substance abuse treatment improved the treatment outcome for Veterans enrolled in a 28-day intensive treatment program (Lash, Peterson, & O'Connor, 2001). Group therapy provides a positive environment for social reinforcement of the program interventions (Lash, Peterson, & O'Connor, 2001). Studies conclude that veterans who are involved in a vocational program, while enrolled in a substance abuse program, are more likely to return to work and become gainfully employed than those who do not participate in such a program (Kerrigan, Kaough, & Wilson, et al., 2000).

Cognitive therapy and support groups are the two most common treatment modalities (Tendall & Fishler, n.d.). Cognitive therapy plays a role in helping the veteran to learn to cope with their symptoms and to react in a less negative manner. Group therapy provides the veteran validation of their symptoms and allowed them to share their experiences in an environment where others understand their predicament, as they have similar experiences (Tendall & Fishler, n.d.). They learn that they are not alone.

In a study of Vietnam veterans with posttraumatic stress disorder, who were not receiving other treatments an intervention involving group psychotherapy was not found to significantly improve the severity of symptoms between the test and control groups (Shnurr, Friedman, & Foy, 2003). The study compared two different treatment methods. One group used present-centered therapy where the group concentrated on their present situation. The other groups used trauma-centered therapy, where they attempted to confront wartime trauma (Shnurr, Friedman, & Foy, 2003). The trauma-centered group had a higher drop out rate than the present-centered group. However, there was not significant difference in a reduction of symptoms among the two groups. Therefore, one cannot conclude whether a trauma-centered, or present-centered approach is better for the treatment of substance abuse using group therapy.

Implications for Social Work

Studies regarding group therapy in veterans with substance abuse complications, the key benefits for those who participated was a longer-term effect. Group therapy enhanced the effect of other treatment modalities. However, the type of group therapy was found to be less important than the fact that the veteran received group therapy. For the social worker who works with the veteran population, it is important to understand the benefits of group therapy for the client.

Understanding that substance abuse in the veteran population is different from substance abuse in other populations, such as teenagers, is the key to providing them with the best line of defense. Group therapy can help the veteran learn positive coping mechanisms so that they do not have to turn to negative coping mechanisms, such as substance abuse. Unless the veteran can replace negative coping mechanisms with positive ones, they will be likely to return to coping mechanisms that are destructive. This is the key important of group therapy for the veteran.

Veterans often have difficulty discussing uncomfortable subjects and may be reluctant to enter into a group therapy setting. The social worker needs to try to convince the veteran of the benefits of therapy and to provide a positive supportive environment in order to get the veteran to attend. Those veterans who attend group therapy have a greater success rate due to the positive social interaction of the group.

From a social work perspective, veterans with substance abuse problems are often different from others in the general population with substance abuse problems. With veterans, their combat experiences are likely to be linked to the substance abuse. The underlying condition must be treated before the substance abuse will go away. Knowing that they are not alone is an important part of their ability to accept and validate their own experiences.