Volume 31, Number 2, April 2009
1. Introduction: Helping Military Personnel and Recent Veterans Manage Stress Reactions (Pages 95-100)
Peter M. Gutierrez; Lisa A. Brenner
We were pleased when Dr. Rogers asked us if we would be interested in
guest-editing a special section of this journal on issues relevant to working with
Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) military
personnel and veterans. As Veterans Affairs (VA) clinician researchers we face
the timeliness of these issues on a daily basis and appreciate the many ways in
which the mental health community outside of the VA and the Department of
Defense (DoD) can play a role in working with the men and women affected
by the current conflicts.
2. A Comparative Review of U.S. Military and Civilian Suicide Behavior: Implications for OEF/OIF Suicide Prevention Efforts (Pages 101-118)
Jeffery Martin; Marjan Ghahramanlou-Holloway; Kathryn Lou; Paulette Tucciarone
Suicide is a significant public health concern within the United States military. Suicide may occur
before, during, and after military deployment or service for a multitude of reasons that may or may not
be directly related to deployment. Therefore, it is crucial that mental health counselors are trained to
identify risk at an early stage so they can offer evidence-based practices to manage and reduce it.
Enhanced understanding of the similarities and differences in suicide risk and protective factors for
civilian and military individuals is crucial for counselors who work directly with Operation Enduring
Freedom (OEF) and Operation Iraqi Freedom (OIF) active-duty personnel, veterans, and family members.
This review aims to educate counselors about the role of demographic, life event, psychopathology,
and behavioral and psychological variables in exacerbating or alleviating the desire to die. The
information presented is based on an electronic search of medical and psychological databases for terms
related to suicide by military service members. Recommendations related to identification, prevention,
and management of suicide risk in OEF/OIF service members and beneficiaries are presented.
3. Managing Posttraumatic Stress Disorder Symptoms in Active-Duty Military Personnel in Primary Care Settings*
Kent A. Corso; Craig J. Bryan; Chad E. Morrow; Kathryn Kanzler Appolonio; Diane M. Dodendorf
Monty T. Baker
*The views expressed in this article are those of the authors and do not necessarily reflect the official
policy or position of the Department of Defense, the Department of the Air Force, or the U.S.
Active-duty military personnel face deterrents to seeking outpatient mental health treatment despite the
high prevalence of posttraumatic stress disorder (PTSD) in this population. The Behavioral Health
Consultation (BHC) model may be the answer for those presenting subthreshold PTSD symptoms, at
high risk for PTSD due to their occupation, not interested in outpatient mental health treatment, or
unable to seek such treatment due to occupational limitations. Three empirically based interventions that
have been effective in managing symptoms of PTSD are summarized and then integrated into the established
BHC model as suggested treatments for managing PTSD symptoms in an integrated primary care
setting. Pilot data and recommendations for future research and practice are provided.
4. Combat Stress Reactions During Military Deployments: Evaluation of the Effectiveness of Combat Stress Control Treatment (Pages 137-148)
Aron R. Potter; Monty T. Baker; Carmen S. Sanders; Alan L. Peterson
Few studies have evaluated the effectiveness of mental health treatments for the combat stress reactions
of military service members treated in deployed locations. The present pilot investigation is the first
report on the effectiveness of a Combat Stress Control (CSC) unit treatment for deployed service members.
Thirty-eight United States military personnel (33 men and 5 women) completed a 2-day CSC unit
program at Balad Air Base, Iraq. The program included individual and group treatments to reduce the
symptoms of combat operational stress reactions and to improve coping strategies, stress management
skills, and interpersonal relationships. Measures used included the Outcome Questionnaire-45 (OQ-45)
and the Posttraumatic Stress Disorder Checklist–Military version (PCL-M). The study found significant
decreases on the OQ-45 and the PCL-M. These results provide preliminary data to support the use of
CSC units to treat combat operational stress reactions in the field.
5. Adult-Acquired Traumatic Brain Injury: Existential Implications and Clinical Considerations (Pages 149-163)
Faith L. Patterson; A. Renee Staton
Traumatic brain injury (TBI) can cause irreparable harm to individuals and have profound effects on
families and communities. In addition to the physical and neurological effects, brain injury creates an
intense boundary experience for clients that forces them to confront the existential givens of freedom,
death, isolation, and meaninglessness. This article provides an overview of TBI and its existential implications
for clients, emphasizing interventions and clinical considerations for mental health counselors
working with clients who have experienced TBI.
6. Mental Health Counseling Responses to Eating-Related Concerns in Young Adult Women: A Prevention and Treatment Continuum (Pages 164-183)
Laura Hensley Choate; Alan M. Schwitzer
Because susceptibility for eating-related concerns exists along a continuum, this manuscript first introduces
a framework for intervention that offers a continuum of responses for addressing such concerns
in young adult women. The mental health strategies needed range from early identification and interventions
for subthreshold problems to more advanced counseling approaches to address emerging and
full eating concerns. It next discusses three different types of interventions: (a) preventive approaches
for young women at risk; (b) intermediate approaches for women who demonstrate initial symptoms of
disordered eating; and (c) psychotherapeutic interventions for women whose symptoms meet diagnostic
criteria for eating disorders.