In the military society, there are numerous challenges that soldiers undergo, for instance, discrimination due to race, gender, and sexual harassment. Most of the problems remain unreported in the military, especially sexual harassment. The Department of Defence in the United State prefer reporting the incidences of sexual assault to the command to activate law enforcement actions and victim's services. The department recognizes that some of the sexual assault victims require advocacy and healthcare but not command or law enforcement involvement. Under the policy of Sexual Assault Prevention and Response (SAPR) service members and military officers have two reporting options; Restricted Reporting and Unrestricted Reporting (Mengeling et al., 2014). Restricted Reporting allows the victim to report the assault and access healthcare, advocacy services, and legal services in confidentiality without involving the command or law enforcement. Under Unrestricted Reporting, the victim can report the matter by notifying the command and law enforcement.
Desiree has two reporting options to address sexual assault in her workplace. Restricted Reported allows her to disclose sexual assault through the Sexual Assault Response Coordinator, Victim Advocate, or healthcare provider without triggering official investigative process or notification to command. Under Unrestricted Reporting, Desiree can report the assault by notifying the command and official investigation in addition to healthcare, victim advocacy, and legal services. A victim of assault can report the issue through Law Enforcement, commander, sexual Assault Response Coordinator, Victim Advocate, and healthcare personnel when using the Unrestricted Reporting option.
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The military is one of the most sensitive workplaces and, therefore, the officers need to understand the impacts of the decision they make especially when disclosing some of the information. If Desiree will decide to report Lt Col Taylor for assaulting her sexually, one needs to make several considerations. One of the important considerations is her safety and that of other women who are likely to experience the same problem in the workplace. I recommend she use the Restricted Reporting option to raise her sexual assault complaints to the authority because this method will allow her to address the issue without causing further discrimination with other members. Reporting the issue to the authority is essential towards addressing similar assaults from occurring in the future and it is also critical in saving Desiree's rights when working as a military officer.
Another important consideration that I can recommend to Desiree is to consider the impact of the matter after reporting in terms of her relationship with other military officers. Reporting the senior military officers of sexual assault can trigger hatred and discrimination by other military members towards Desiree and this can compromise her ability to work effectively. That can be the price she has to pay to save her life and those of other women who are likely to experience similar challenges in their working places. Another recommendable consideration to make if Desiree decided to report the sexual assault issue is the perception of the public on the military society. Most people believe that military officers should be providing security to the public, but when cases such as discrimination and sexual assault are perpetrated by security personnel, then the public will not trust them for providing security and safeguarding their lives because they are can become perpetrators of crime anytime.
If Desiree report Lt Col Taylor for a sexual assault she is likely to face several challenges considering that she is a woman and low ranking compared to Taylor. One of the primary challenges is discrimination from other military officers who are mainly men. Reporting the matter to the authorities could trigger a negative effect on the relationship between Desiree and other members serving in the military. By reporting the issue, Desiree can experience worse gender discrimination problems in her workplace because men who are the majority in the military can decide to retaliate. Discrimination in the workplace affects the ability of Desiree to deliver her duties effectively resulting in other punitive actions for not performing her duties well as a military service member.
Another challenge is that Desiree can receive threats against her career or denied options for help or support since Taylor is a higher ranking officer who can influence activities in the military. The event can be very frustrating because the victim of violence cannot successfully report the matter to the authorities (Holland et al., 2014). Because the perpetrator of the crime is an influential person who can suppress the issues and stop the matter from reaching relevant authorities responsible for solving the problem of assault. The victim will not be able to leave the job and will be forced to work in a hostile environment failure to which can face charges for not following the orders (Mattocks et al., 2012). Some of the victims who try to report such sexual harassment are posted to work in hardship areas by their superiors in the military as one way of silencing them or making them pay for the action of reporting their seniors for discrimination or sexual harassment.
Desiree can also experience another challenge where no action is taken against the perpetrator of sexual harassment even after reporting the matter to the relevant authorities. Because he is a male and having a high rank, Taylor can influence other members in the military not to take any action concerning sexual harassment matter between him and Desiree. When such necessary assistance and action are denied, the victim of assault is even more vulnerable to other assaults because, in the end, the perpetrators cannot face any disciplinary actions after harassing or insulting another person in the workplace.
Scenario 2
There are three primary considerations that a social worker needs to factor in to identify the health problem that Eric is facing. The first critical consideration is the inability to sleep well and experiencing nightmares, the second is the recurrent and intrusive reminders of traumatic events, and the third is negative changes in thoughts of an individual. When working as a soldier, an individual is exposed to severe trauma or life-threatening events that can cause mental health complications such as Post-Traumatic Stress Disorder (PTSD) or combat stress. Eric seems to be battling with post-traumatic stress disorder considering the symptoms he is presenting in the case scenario. One of the symptoms of PTSD that Eric is exhibiting is the lack of good sleep and screaming at night due to nightmares. The majority of the veteran experience nightmares because of the traumatic events they experience in the battlefields and when they are sleeping such memories comes into their minds giving them sleepless nights and nightmares.
Eric is also experiencing intrusive reminders of the traumatic killing of other soldiers and this is another symptom of PTSD. Eric does not contact any of his Army members and avoids talking about the activities and services while in the military. When veterans have flashbacks or think about the events they experience on the battlefield, it makes them feel that the same thing is happening again forcing them to have extreme emotions and physical reactions (Raymond, 2006). Eric is also exhibiting negative thoughts about life. Before joining the military Eric was a person full of positive ideas about life and he wanted to serve his country as a soldier and fight against terrorists that were causing havoc in the United States of America. After engaging in several battles Eric developed a negative change in thoughts and moods and he could become angry for being deployed to Iraq due to insufficient equipment and people to bring democracy and freedom. Having negative changes of thoughts, mood and feelings is another symptom for an individual experiencing PTSD.
Apart from mental issues, military veterans and their families experience other potential problems during and after deployment. One of the issues that are important to know is the challenges that the spouses experience for instance interpersonal violence and readjusting to new roles in the family. Depression and anxiety among the spouses and partners during and after deployment increase and can worsen if the spouse has physical injuries or disabilities from the combat (Presley, 2010). The rates of interpersonal violence also increase among the veterans and their spouses. After the deployment, soldiers tend to become aggressive towards their partners and can result in interpersonal violence. Some of the research studies also suggest that military members and their spouses report low marital satisfaction, especially on parenting and communication.
The impact of parental deployment on the mental health and behavior of children are some of the critical issues that an individual should know. Few studies have investigated how children respond to parental deployment and reintegration. The available research indicates when parents are deployed or reintegrated into the family, the behavioral changes among the children depend on their age. Children between the age of zero and four years exhibit attachment issues of having difficulties separating from their parents while those above 5 to 10 years will present a high level of externalizing and internalizing behaviors. The teenagers who are raised while the parent is deployed exhibit high rates of drug abuse and binge drinking compared to teenagers whose parents are not in the military (Pajak, 2016). The siblings who take part in parenting roles when their parents are in deployment can miss age-appropriate activities, for instance, spending time and playing with peers compromising their development. Ensuring effective communication in the family plays a critical role in addressing psychological and behavioral responses to parental deployment. Engaging children in school and after-school activities also help as protective factors towards psychological and behavioral changes of children whose parents are deployed.
The client's single most serious diagnosis is Post-Traumatic Stress Disorder (PTSD). The symptoms that Eric exhibits in the case scenario match most of the DSM-5 criteria for PTSD. The criterion A of stressor according to Eric's case is deadly battles and trauma sustained while in the army. Criterion B involves intrusive symptoms such as nightmares, flashbacks, and emotional distress exhibited by Eric in the case scenario. Eric did not want to think about the past, avoid meeting with his colleagues who worked together during the war, thus meeting criterion C of avoidance. Criterion D is about negative alteration in cognition and mood which is also exhibited by Eric in the case scenario. Criterion E of alterations in arousal and reactivity is another characteristic exhibited by Eric, for instance, by becoming angry, and avoiding small spaces where he feels escaping is difficult. Criterion F on the duration that the symptoms must exist for more than a month is also met by Eric's condition. Criterion G on functional significance, for instance, distress or occupational impairment is also evident in Eric's case because he stopped working as a social worker.
The most appropriate intervention to address the problem that Eric is facing is PTSD cognitive behavioral therapy that will enable the individual to improve the symptoms, teach how to handle the condition, and restore the self-esteem of the patient (Taylor, 2017). Cognitive therapy can be used to treat Eric's condition by modifying memories of trauma by interrupting and disturbing behavioral and thought patterns that the individual sustained while in the military. Prolonged exposure therapy can also be used to teach Eric to gradually approach trauma-related memories by facing what he usually fears and learn that trauma-related memories cause no harm (Riggs et al., 2006). Use of drugs such as Paroxetine (Paxil) and Sertraline (Zoloft) can also be used to help the individual to stop thinking and reacting to what happened in the past while working in the military and prevent other issues such as nightmares and flashbacks.
There are two anticipated obstacles when providing treatment in this case. One of the problems is that Eric is reluctant to seek help or medication making it difficult for healthcare providing professionals to assist him recover from the condition. The healthcare providers need to work together with the closest people to Eric, for instance, Oscar to ensure that he receives appropriate treatment. The second challenge when providing treatment to Eric is he does not want to talk about the past making it difficult to identify the primary issue disturbing him. Educating and encouraging Eric on the importance of speaking up is essential towards convincing him to open up and share problems that enable the doctors to provide appropriate treatment to his condition.
Eric has several strengths that can enhance the treatment process and his recovery. One of Eric's strengths is good physical fitness and the ability to exercise in the gym that enables him to respond to medication well. Engaging in physical exercises play a critical role in enhancing the recovery of an individual because it improves cardiovascular, and breathing system efficiently and reducing the level of stress in the body. Another strength of Eric is that he can endure tough conditions; for instance, during training other recruits were complaining about the discipline and hardship in training, but Eric was resilient. Being able to withstand hardship is critical when receiving medication especially concerning PTSD because it could be difficult and continuous demanding resilience and patience.
Diversity issues play a critical role in affecting the treatment process. When different conditions are affecting an individual there is a need to have multiple treatment approaches that will ensure that each of the conditions exhibited is correctly and sufficiently addressed. Diversity of issues will make the treatment process complicated and expensive because several methods are required to solve the problem and sometimes administering a certain combination of medication may not be practical.
When providing help to Eric, there are several ethical concerns that an individual needs to consider. One of the concerns is that involving the claims made by the clinical supervisor that Eric could be manipulating the system to get disability money. If that is the case, then Eric could not be suffering from PTSD. The clinical supervisor could be lying that Eric is attempting to get disability money, and in reality, he is sick and requires immediate attention. Conducting a diagnosis to verify Eric's mental health condition is necessary to solve the dilemma. Another ethical concern is that of providing treatment without knowing the exact health problem that Eric is suffering from. On the battlefield, Eric survived several blasts possible to cause brain damage and injuries, and diagnoses that have been conducted no results have been given to him. Once in his career, Eric was knocked unconscious and this could be the beginning of his mental illness. Providing medical assistance to Eric without knowing the exact problem raises an ethical concern because one can provide a wrong treatment for a particular health issue causing more harm to the individual.
References
Holland, K. J., Rabelo, V. C., & Cortina, L. M. (2014). Sexual assault training in the military: Evaluating efforts to end the invisible war. American Journal of Community Psychology, 54(3) , 289-303.
Mattocks, K. M., Haskell, S. G., Krebs, E. E., Justice, A. C., & Yano, E. M. (2012). Women at war: Understanding how women veterans cope with combat and military sexual trauma. Social science & medicine, 74(4) , 537-545.
Mengeling, M. A., Booth, B. M., Torner, J. C., & Sadler, A. G. (2014). Reporting sexual assault in the military: Who reports and why most servicewomen don’t. American journal of preventive medicine, 47(1) , 17-25.
Pajak, A. (2016, January 16). Psychiatric Times . Retrieved April 12, 2021, from https://www.psychiatrictimes.com/view/veterans-struggle-adjust-family-life
Presley, L. R. (2010). Interpersonal Violence and Clinical Practice. Theory & Practice in Clinical Social Work , 435.
Raymond, M. S. (2006). War Trauma: Lessons Unlearn from Vietnam to Iraq. A Vietnam Trilogy , 3.
Riggs, D. S., Cahill, S. P., Foa, E. B., & Follette, V. M. (2006). Prolonged exposure treatment of posttraumatic stress disorder. Cognitive-behavioral therapies for trauma, 2 , 65-95.
Taylor, S. (2017). Clinician's guide to PTSD: A cognitive-behavioral approach. Guilford Publications.
