Meeting an ongoing need: "The Veterans and Active Duty Military Psychotherapy Treatment Planner"

As part of Wiley’s Practice Planner series, Moore and Jongsma’s The Veterans and Active Duty Military Psychotherapy Treatment Planner (2009) offers mental health practitioners working with active and veteran military servicepersons a practical guide to formulating treatment plans. The authors address common problems specific to these populations and include a variety of psychotherapeutic approaches grounded in evidence based and widely used, “best practice” treatments (p. 3). Clearly written descriptions of each type of presentation enable clinicians to determine a diagnosis according to DSM-IV (APA, 2000) criteria. From this point, the readers can reference short-term objectives, therapeutic interventions, and sample treatment plans. Those seeking more in-depth information on specific topics can locate additional references toward the end of the book. 

Overall, Moore and Jongsma’s text serves as an excellent reference for both clinicians new to treating military professionals and practitioners with more experience working with these populations. This book successfully addresses an impressive number of topics covering interpersonal challenges, adjustment difficulties, and other psychological issues unique to veterans and those in active duty. Each section includes subsections on behavioral definitions, treatment goals, and interventions. For example, a chapter entitled “amputation, loss of mobility, disfigurement” begins with several concise statements describing different presentations in which clients may have suffered an injury (p. 25). These are followed by descriptions of related concerns (“verbalizes feelings of hopelessness regarding future occupational activities”). Long term goals, which pertain to acceptance and adaptation, are followed by short-term objectives and accompanying interventions for the clinician’s considerations.
         
The Treatment Planner’s accessible descriptions of various presenting problems and research-supported psychotherapy approaches speak to the growing requirements enforced by auditing and governmental agencies. These organizations, which grant accreditation to the agencies providing mental health care to active service persons and veterans, demand detailed records documenting improvement in psychotherapy. Moore and Jongsma accelerate this process, offering practitioners short and long-term goals and various assessment tools to demonstrate the effectiveness of interventions. Although there is some variability depending upon diagnosis, interventions tend to be based on cognitive and/or behavioral therapy techniques and interventions. Clinicians grounded in other theoretical orientations may find the treatment planner to be less helpful than those well-versed in cognitive and behavioral therapies.

Future editions of this text may benefit from the addition of specific topics not included in this first edition. While the book addresses PTSD, reintegration difficulties, survivor’s guilt, and other concerns particularly relevant to military personnel, this manual overlooks some important topics related to diversity issues. The authors have included a section that addresses clients’ challenges accepting individuals who differ in culture, ethnicity, religion, and racial identification. However, no mention is made of other factors such as socioeconomic status (SES), level of education, gender identity, and sexual orientation. Research suggests that there is a great deal of SES and education variability within the military (Lutz, 2008). Such variables may pose additional difficulties for military personnel unaccustomed to interacting with individuals whose experiences and stressors vary along these lines.

Gender and sexuality pose additional considerations. In all branches of the United States military, individuals who identify as transgendered are considered unfit for service and enlisted servicepersons determined to be transgendered  are discharged (McDuffie & Brown, 2010). This policy is further complicated by the fact that mental health professionals working for military agencies are expected to report transgendered behavior in active servicepersons to these individuals’ commanders. “Don’t Ask, Don’t Tell,” the military’s recently repealed and reinstated policy regarding sexual orientation, prohibits “outed” or openly gay individuals from serving (Cable News Network, 2010). Due to potential policy shifts, related controversies, and other issues affecting these populations, clinicians must take special care in treating gender and sexual minorities.
 
In addition to the aforementioned cultural considerations, Moore and Jongsma’s text may benefit from supplementary sections on addressing apprehensions about stigma related to receiving mental health services, fear of benefit loss or dismissal due to specific diagnoses, somatoform disorders, and the detection of malingering. Overall, however, the Veterans and Active Duty Military Psychotherapy Treatment Planner is a helpful resource for practitioners or case managers from a variety of mental health service backgrounds. The growing need for psychotherapeutic treatment among active servicepersons and veterans makes this text a particularly valuable resource for clinicians working with these individuals.

Author Note: Ms. Bennett is a doctoral student in the clinical psychology program at the University of Indianapolis.

References

American Psychiatric Association. (APA) (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

Chetry, K., & Roberts, J. (2010, October 21). “Don't Ask, Don't Tell"” Restored. American Morning (CNN). CNN transcripts database. Retrieved from http://search.ebscohost.com.ezproxy.uindy.edu/login.aspx?     

Lutz, A. (2008). A look at race, class, and immigration status. Journal of Political & Military Sociology, 36(2), 167-188. Retrieved from Academic Search Complete database. http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=36617466&site=ehost-live

McDuffie, E., & Brown, G. (2010). 70 U.S. Veterans with gender identity disturbances: A descriptive study. International Journal of Transgenderism, 12(1), 21-30. Retrieved from E-Journals database. http://search.ebscohost.com.ezproxy.uindy.edu/login.aspx direct=true&dbeoah&AN=21426709&site=ehost-live

Moore, B., & Jongsma, A. (2009). The veterans and active duty military psychotherapy treatment planner. Hoboken, NJ: John Wiley & Sons.