Veterans Affairs Canada has recently undertaken the largest modernization of programs and services offered to veterans, members of the Canadian Forces and the Royal Canadian Mounted Police and their families since the Second World War.

The new Veterans Charter provides more extensive service programs for the rehabilitation and reintegration into civilian life of veterans and Canadian Forces members. Special emphasis is also being placed on meeting clients’ mental health needs and on significantly improving services and programs offered to the families of veterans and Canadian Forces members.

As part of the modernization, Sainte-Anne’s Hospital, the last remaining veteran’s hospital administrated by Veterans Affairs Canada, has been asked to assume a clinical leadership role in the area of operational stress injuries.

An operational stress injury (OSI) is any persistent psychological difficulty resulting from operational duties performed while serving in the Canadian military or executing duties serving as a member of the RCMP. OSIs may include a diagnosis of posttraumatic stress disorder (PTSD), major depression, social phobia, agoraphobia or generalized anxiety. OSIs can have a powerful incapacitating effect on the functioning of the client. They may subsequently also directly affect family members, potentially leading to marital distress, depression, lower self esteem, family violence, behavioural problems in children, as well as increased drug and alcohol use amongst family members. Research also indicates higher levels of caregiver burnout and compassion fatigue. Given these observed difficulties in the family system, social work constitutes an important element in the treatment of OSIs.

Operational Stress Injuries and Social Work
Social workers play a key role in the treatment of OSIs. All psychosocial based problems are referred to them for both assessment and treatment. This can mean that the social worker will intervene with an individual, couple, family or treatment group. At present, social workers at the OSI clinics across the country use a variety of theoretical approaches, including systemic, solution focussed, cognitive-behavioural, educational, and psychodynamic. They are also involved in helping families better cope with the secondary effects of OSIs by providing psychoeducational services, comprising both educational and support groups for family members.

Social workers act as consultants on psychosocial issues at all team meetings, and write psychosocial reports when necessary. They ensure that they are knowledgeable on all levels of intervention for OSIs, in order to create a harmonized treatment approach for OSI clientele. Continuing education is expected and encouraged.

Social workers involved in OSIs currently have a number of initiatives. They are attempting to measure the effectiveness of psychoeducation for families, and intend to measure whether psychoeducation effectively increases the families’ level of knowledge regarding OSIs, their awareness of resources, their ability for self-care, as well as whether psychoeducation can reduce their objective and subjective level of stress and the level of expressed emotion. Research indicates that these factors are related to healthier family functioning and greater resilience. They are also interested in discovering whether a modified cognitive-behavioural approach could be applied to couples with a partner suffering from an OSI, to determine whether this leads to improved functioning for both members. Another current research initiative is to qualitatively examine the changes in family functioning that occur when a member is impacted by an OSI.

For more information about OSIs and the role of social work in their treatment, please call Tim Marshall MSW at Ste. Anne’s Hospital National Centre for Operational Stress Injuries at 514-457-3440 ext. 3238 or write tim.marshall@vac-acc.gc.ca. You can also dial our toll free number at 1 866 750-0422.

Tailored educational training programs can also easily be made available to you as per your or your organizations’ needs.

Information on how to become a registered service provider for Veterans Affairs Canada can be found on Medavie Blue Cross Web site (www.bluecross.ca) under Federal Programs.

Prepared by: Tim Marshall