A Roadmap for Rehabilitation Counseling to Serve Military Veterans with Disabilities

Article excerpt

The need for rehabilitation services for individuals returning from military service has perhaps never been greater. Since October 2001, approximately 1.64 million U.S. military personnel have deployed as part of Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) (Tanielian & Jaycox, 2008). The current theater of military operations in Iraq and Afghanistan are resulting in a new generation of veterans with complex physical injuries and psychological and emotional trauma. Medical innovations and advanced body armor technology have enabled over 90% of military personnel injured in the OEF/OIF conflicts to survive injuries that would likely have been fatal in previous wars (Hyer, 2006; Lew et al., 2007). It is estimated that for every military personnel killed in these wars, there are at least sixteen wounded, and many will return to the United States with some type of disability. In addition to physical disabilities, the number of soldiers discharged with mental health diagnoses is estimated to be at a rate of over 20% (Hoge, Auchterlonie, & Milliken, 2006;, Seal, Bertenthal, Miner, Sen, & Manner, 2007).

The size of the number of military personnel incurring disabilities in the current military conflicts is larger than has been seen in the US in over three decades. The scope and severity of the personal, vocational, social, and economic impact of service-related disability has not yet been fully realized and the numbers will continue to escalate well past the end of military action. Certified Rehabilitation Counselors (CRCs) can and should play an important role in working with veterans with disabilities as they reintegrate into work and social roles. Specialized training and education related to vocational and psychosocial rehabilitation make CRCs uniquely qualified to address the needs of recently disabled veterans, yet that role has received surprisingly little attention in rehabilitation counseling training programs, research, and literature.

Rehabilitation counseling should take a central role in the services provided to military personnel discharged with a disability. Rehabilitation professionals are in an ideal position to provide appropriate services to disabled military veterans who wish to return to gainful employment and a rewarding quality of life. A number of important issues need to be addressed to further understand and implement the most effective rehabilitation counseling services for OEF/OIF veterans with disabilities. For example, there is not yet reliable information available about the employment status of either retired active duty personnel, or the military reservists who, as a result of disability, are not able to return to their previous employment. Nor is there information about the specific vocational rehabilitation needs of such individuals, or how effectively these needs are being addressed.

The Department of Veterans Affair's Veterans Benefits Administration's Vocational Rehabilitation and Employment (VR&E) service is vested with delivering Vocational Rehabilitation (VR) services to veterans with service-connected disabilities; in addition, for a variety of reasons, many recently disabled veterans will also be served by state VR agencies and this number will likely increase in the next few years. Because many of the veterans will no longer be able to engage in the work roles and tasks they performed prior to their military service, due to the nature of the commonly incurred disabilities and injuries (e.g., amputation, head injury, psychological disorders), effective vocational rehabilitation services will require specialized knowledge of the psychosocial, medical, and vocational aspects of this growing number of consumers.

There will be a significant impact across the U.S. occupational structure due to the numbers of veterans returning to work with a new disability. Issues including effective assessment, training and re-training, work accommodation, employment consulting, and case management are subjects that rehabilitation counselors are well-prepared to address; however, these issues have not been experienced in this context and to this extent in decades. …