Increasing Cultural Competence with Minority Service Members and

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Lena Payne, LCSW
&
Rachel Bentley, LCSW
I. Increase knowledge of relevant military culture
and stigma that influences engagement
II. Identify barriers and benefits of the
minority/military dual cultural values in
treatment behaviors
III. Provide strategies for engaging and retaining
minority veterans
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Name, profession, population you work with
and services you provide
How many of you work with Veterans or
Active Duty Military?
This is a unique population with a myriad of
unique needs
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African Americans, Latinos and women make –
up an increasing number of the Active Duty
and Veteran Population
Active duty and Veteran populations often
seek treatment outside the military and/or VA
hospitals, which makes it imperative for mental
health professionals to strive for cultural
competence with this group
Service
Enlisted
Officers
Total
Percentage
Army
452,064
87,610
539,675
37.8%
Navy
275,296
51,388
326,684
22.9%
Marine Corps
178,213
20,202
198,415
13.9%
Air Force
258,095
64,805
322,900
22.6%
Coast Guard
33,228
8,134
41,362
2.9%
Total
1,196,897
232,139
1,429,036
100%
Demographics of active duty u.s. military. (2011, 08 02). Retrieved fromhttp://www.statisticbrain.com/demographics-of-active-duty-u-s-military/
Service
Enlisted Percent Female
Officer Percent Female
Army
13.2 %
15.5 %
Navy
15 %
15.1 %
Marine Corps
6.2 %
5.8 %
Air Force
19.9 %
18.3
Coast Guard
11.6 %
14.9 %
Total
14 %
15.3 %
Demographics of active duty u.s. military. (2011, 08 02). Retrieved fromhttp://www.statisticbrain.com/demographics-of-active-duty-u-s-military/
Service
% White
% Minorities
% Black
% Other
Army
73.9 %
26.1 %
21.5 %
4.6 %
Navy
66.2 %
33.8 %
19.3 %
14.4 %
Marine Corps
83.7 %
16.3 %
11.1 %
5.2 %
Air Force
78.1 %
21.9 %
15.6 %
6.3 %
Coast Guard
82 %
18 %
6.1 %
11.9 %
Total
74.6 %
25.4 %
17.8 %
7.6 %
Demographics of active duty u.s. military. (2011, 08 02). Retrieved fromhttp://www.statisticbrain.com/demographics-of-active-duty-u-s-military/
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“Military culture is comprised of the values,
beliefs, traditions, norms, perceptions and
behaviors that govern how members of the
armed forces think, communicate and interact
with one another as well as civilians. “
Values: Honor, courage, loyalty, integrity, and
commitment
(Exum, Coll & Weiss, 2011)

Army (Soldier)
Army Reserve
 Army National Guard

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Marine Corp (Marine)
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Navy (Sailor or Navyman)

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Navy Reserve
Air Force (Airman)

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Marine Reserve
Air Force Reserve
Coast Guard (Guardsman)

Coast Guard Reserve
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Reservist train part time near home until needed,
and members deploy alongside the Army.
Army National Guard members deploy with the
Army on a part-time basis, with a special focus on
homeland security and relief programs.
The Air National Guard trains part time to assist in
domestic disasters and international conflicts.
www.todaysmilitary.com
CULTURAL DIFFERENCES
CIVILIAN CULTURE
MILITARY CULTURE
EMPHASIS ON INDIVIDUALITY
EMPHASIS ON UNIT COHESION
INDIVIDUAL ACHIVEMENT
EMPHASIS ON THE MISSION
PERSONAL FREEDOM
DEVOTION TO DUTY
FLUID SOCIAL RELATIONSHIPS
CHAIN OF COMMAND
Exum, Coll, & Weiss (2011)
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Family Tradition
Travel and Adventure
Money for College
Money in College
Poor Economy
Career/Job
Medical Coverage
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Direction
Job Skills
Honor/Duty
Sounds Fun
Socialization/Friendship
Medical Coverage
Part-time Income

Racism in the Military
Private Danny Chen

Committed suicide last year while in Afghanistan. Prior
to his death he told a fellow soldier he was thinking of
killing himself over the harassment he was getting from
his fellow soldiers.
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Some hate groups encourage members to join
the military, especially the Army or Marines to
train to fight in the race wars (Trotta, 08).
The military has stepped up it’s efforts to
remove and prevent racists from entering
service.
Wade Page & Timothy McVeigh
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Women are the fastest growing segment
in the veteran population.
Some issues women in the military may
face are: sexism, sexual assault, disputes
in how women should serve and
requirements for serving, pressure to be
just as tough as the men
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Stress
Financial Problems
PTSD
Military Sexual Trauma
Readjustment
Marital/Family Problems
Military personnel form a distinct sub-set, or subculture of American society and as such, are governed
by a separate set of laws, norms, traditions and values
than the civilian population. Thus, individuals who
leave the military after many years of active duty
service experience the same type of culture shock as
any other newcomer to the American culture. These
individuals share the same sense of disorientation,
change of status and loss of identity as immigrants
adjusting to a host culture. In veterans, there is a search
for a new identity and an effort to recreate meaning,
and often they are met with unfavorable societal
attitudes or conditions
(Exum, Coll, & Weiss, 2011).

http://blog.whileyouwereaway.org/2010/10/21/tip-120-more-tips-for-military-families/
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A stigma exists related to Veterans and Active
Duty Military seeking mental health treatment.
Veterans and Active Duty Military may believe the
myth that seeing a “shrink” means their “crazy.”
The stigma and these myths impact their decision
to seek mental health treatment or discuss mental
health issues.
Discussion: What stigmas or myths related to
Veterans and Active Duty Military seeking mental
health treatment have you heard/experienced?
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Military culture itself can discourage seeking treatment
as a sign of “weakness”, needing “help” or being
“crazy.”
Veterans/Active Duty Military may be concerned that
seeking treatment may impact a reenlistment, service
in the reserves or benefits.
There are also concerns about “privacy” or
“confidentiality.”
Believing that irritability, isolation and somatic
complaints are just “normal” for your culture or
gender (case example).
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Family vs. Unit
Family hierarchy/family dynamics vs. military
chain of command
Traditional Gender Roles
Spirituality
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Family vs. Unit
Family hierarchy/family dynamics vs. military
chain of command
Traditional Gender Roles
Spirituality
Machismo
Language

2:02
Traditional Female Roles
vs.
Roles of Women in the
Military
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Female Service Members may avoid mental health
treatment for fear it will impact their eligibility for
service.
Female Service Members may have experienced
Military Sexual Trauma (MST) , which went
unreported and fear reprisal for reporting or seeking
treatment for MST.
Female Service Members sometimes report feeling that
they are treated as “less than” their male counterparts
when seeking help.
Just as their male counterparts, female service
members may believe seeking help makes them
“weak.”
Female Service Members sometimes feel that female
specific clinics or services are not available.
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Some Service Members do not want any
treatment from an agency connected to the
government/military.
Some Service Members have private insurance.
Africans Americans, Latinos and Women may
have experienced prejudice during military
service and want to distance themselves from
this experience or fear this may reoccur
through VA services.
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0:00 to 04:42 up to religion
04:42 to 10:11 females
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Include questions in your assessment that take
military service into account
Do not make assumptions about their service
Ask what their service experience was like
Ask how they were treated during service
Assess for Military Sexual Trauma
Incorporate Spirituality into your assessment
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1)
2)
3)
4)
During Assessment you might ask…
Describe your experience in the military?
What was your branch, rank, unit, where did
you serve and what was occupational
specialty?
How has your military experience impacted
your parenting?
What was it like being a female in the military?
Were there any challenges?
1)
2)
3)
4)
5)
Use correct terminology or ask if you do not know
Focus on the shared human experience…don’t be
afraid or nervous that you will not be able to connect,
because you are not a Veteran…building rapport and
the therapeutic relationship is significant to the
outcome of treatment.
Remember-they are the expert…let them tell their story
Even if you were in the military, your patient’s
experience could be very different from your own
Be authentic about your own experience (i.e., “You are
right, I don’t know what it’s like being in combat” etc.)
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Being aware, informed and culturally
competent
Basic cultural competence & military cultural
competence
Transculturally Competent
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Demographics of active duty u.s. military. (2011, 08 02).
Retrieved from
http://www.statisticbrain.com/demographics-ofactive-duty-u-s-military
Department of Veterans Affairs, Office of the Actuary,
Veteran Population Projections Model (VetPop)
Exum, H., Coll, J., & Weiss, E. (2011). A civilian
counselors primer for counseling veterans. (2nd ed.). Deer
Park, NY: Linus Publications.
Trotta, D. (08, 2012 21). U.S. army fights racists within its
own ranks. Retrieved from http://news.yahoo.com/uarmy-battling-racists-within-own-ranks050115179.html
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