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    Serving Our Veterans: Micro vs Macro (Part 3 of 4)

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    Part one of this series analyzed the impact of the Bonus Army, and part two looked at the survival of the Private vs. Public argument when providing services to those who fight our nation’s wars. In this third installment, I will be analyzing micro vs macro an even greater tension that has persisted from the Depression to present day, and it still continues to influence our effectiveness at serving our veterans.

    Bronfenbrenn-system-bigSocial work as a field is constantly living within the Micro vs. Macro tension, as were the Bonus Army veterans also known as the Bonus Expeditionary Force (B.E.F.). At the most basic micro level, social workers aim to assist individuals in need. At the macro level, social workers aim to change policy and environmental conditions that support social change and afford individuals some level of security and autonomy. All along the way, we can observe tension among individuals and agencies, who place a higher priority on one or the other.

    In the Anacostia Flats during the summer of 1932, there were certainly veterans of the B.E.F. who were there for their own personal motives, operating from a micro perspective. There were also veterans among them, who were motivated by a macro perspective, hoping to effect change for the entire veteran population. Life in Anacostia for these WWI veterans during the Bonus March had its own Micro vs. Macro tensions as a result.

    During the same time veterans of the B.E.F. were impacting macro level change; the field of social work was taking a similar approach. Throughout the 1920’s and 1930’s social workers advocated for changes at the macro level, often taking the form of community organizing. Even the field of social work itself was founded in macro level approaches. Through Jane Addams’ Hull House and the settlement house concept of the late 1800’s, social work gained its foot hold as a profession by working with groups and communities, advocating for policy change, and even Addams herself was a political leader.  After a few decades however, the field of social work began to shift more toward micro level perspectives.

    As time progressed and our society continued to challenge the status quo at the macro level, social workers by and large became distracted at the micro level. This change was largely fueled by an increase in Freudian ideology, which brought social workers out of the community and into their offices as individual counselors and case workers. With social work changing its focus to the micro level practice of diagnosing and counseling individual clients, the field had much less workers on the macro scale advocating for public services and had very little stake in the changing political climate of the 1960’s and 1970’s as a result. Only within the past decade or two has social work begun to step back into the macro level as a viable agent. So we observe this Micro vs. Macro tension shifting among social work over time.

    As Bertha Reynolds (1935) pointed out, “social case work rather finds its function in dealing with difficulties in the relationship between individuals or groups and their physical or social environment”. Her observation, which was made during the same period as the events of the Bonus Army, was true before these events and is still true to this day. The tension between Micro vs. Macro is likely to continue to persist.

    What can we learn from this? If these tensions will persist indefinitely, what’s the point? I would argue that by acknowledging the existence of these tensions, we are more apt to finding better solutions that will help us be more effective at serving our veterans for the long haul. So what are the implications of these tensions in how the U.S. government addresses it’s military veterans now? What can we do better? Stay tuned for the final segment of this series to find out.

    References:

    Addams, J. (1893). The objective value of a social settlement. Philanthropy and social progress (pp. 27-40). New York: Thomas Y. Cromwell.

    Andrews, J. & Reisch, M. (1997). Social work and anti- communism: A historical analysis of the McCarthy era. Journal of Progressive Human Services, 8, 29-49.

    Fisher, R. & Karger, H.J. (1997). Macro practice: Putting social change and public life back into social work practice. In Social work and community in a private world: Getting out in public (pp. 117-147). New York: Longman.

    Perlman, H.H.(1957). Freud’s contribution to social welfare. Social Service Review, 31, 2, 192-202

    Reynolds, B.C. (1935). Whom do social workers serve? Social Work Today, 2, 6, 5-8.

    Seigfried, C.H. (2009). The courage of one’s convictions or the convictions of one’s courage: Jane Addams’ principled compromises. In M. Fischer, D. Nackenoff, & W. Chmielewski (Eds.). Jane Addams and the practice of democracy. University of Illinois Press.

    Waters, W.W. & White, W.C. (1933). B.E.F.: the whole story of the bonus army. Mass violence in America. (1969). New York, NY: Arno Press & The New York Times.

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    Chris is pursuing a Masters in Social Work through the University of Washington's part time, extended degree program.

    Mental Health

    Strong Committed Relationships Can Buffer Military Suicides

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    Can being in a strong committed relationship reduce the risk of suicide? Researchers at Michigan State University believe so, especially among members of the National Guard.

    Suicide rates for members of the military are disproportionally higher than for civilians, and around the holidays the number of reported suicides often increases, for service members and civilians alike. What’s more alarming is the risk of suicide among National Guard and reserve members is even greater than the risk among active duty members.

    When returning from a deployment, National Guard members in particular are expected to immediately jump back into their civilian lives, which many find difficult to do, especially after combat missions. Some suffer from post-traumatic stress disorder, depression or high anxiety in the months following their return. These mental health conditions are considered at-risk symptoms for higher rates of suicide.

    The researchers wanted to know what factors can buffer suicide risk, specifically the role that a strong intimate relationship plays. They discovered that when the severity of mental health symptoms increase, better relationship satisfaction reduces the risk of suicide.

    “A strong relationship provides a critical sense of belonging and motivation for living – the stronger a relationship, the more of a buffer it affords to prevent suicides,” said Adrian Blow, family studies professor, and lead author. “If the relationship is satisfying and going well, the lower the risk. National Guard members don’t typically have the same type of support system full-time soldiers receive upon returning home, so it’s important that the family and relationships they return to are as satisfying and strong as possible.”

    The researchers surveyed 712 National Guard members who lived in Michigan, had been deployed to Iraq or Afghanistan between 2010-2013 and reported being in a committed relationship. The study measured three main variables – mental health symptoms, suicide risk and relationship satisfaction – each on a separate ranking scale. The soldiers were asked questions such as how enjoyable the relationship is, if they ever thought about or attempted suicide, how often they have been bothered by symptoms of depressive disorder, etc.

    Results showed significant associations between each of the mental health variables (PTSD, depression and anxiety) and suicide risk, indicating that higher symptoms were predictive of greater risk.

    However, once couple satisfaction and its interaction with mental health was factored in, the association between mental health symptoms and suicide risk was changed. Specifically, for those with higher couple satisfaction, the increased symptoms of PTSD, depression and anxiety were no longer a risk for suicide.

    “Our findings show that more needs to be done to enhance the quality of relationships to improve the satisfaction level and through this decrease the suicide risk,” Blow said. “Having a partner who understands your symptoms may help the service member feel understood and valued. There are family support programs available, but we need to do more to enhance relationships post deployment. Relationships do not get enough consideration in the role they play in preventing military suicides, and I would love to see more attention devoted to this issue.”

    Other co-authors included Adam Farero from MSU; Heather Walters and Marcia Valenstein from University of Michigan; and Dara Ganoczy from the Veterans Health Administration. The study was funded by the Veterans Administration. The study was published in the official journal of the American Association of Suicidology.

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    Mental Health

    Operation Surf Uses Surfing to Help Veterans

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    Photo Credit: ESPN

    Every day roughly twenty veterans commit suicide. It is estimated that 22% of all suicide deaths in the US are veterans. Former professional surfer Van Curaza wants to change that.

    Curaza originally founded the nonprofit Amazing Surf Adventures (ASA) as a way to help at-risk youth by getting them into the ocean and off the streets. He expanded ASA to help veterans overcome the challenges caused by war with surfing – a program dubbed Operation Surf.

    Operation Surf is a free program “that offers week-long adaptive surfing trips for wounded-veteran and active-duty military men and women.” They pair veterans “with their own individual surf instructor and develop a goal-based curriculum around their unique abilities. Operation Surf offers an environment of camaraderie and healing to its participants by giving them a shared experience in the water each day.”

    Curaza and Operation Surf are featured in the award-winning Netflix documentary “Resurface.” The film is about Marine Corps veteran Bobby Lane. Bobby was planning on committing suicide, but he wanted to check surfing off his bucket list first. He ended up participating in Operation Surf and it changed his life. Not only did Bobby decide he wanted to keep living, but he decided he wanted to work with Operation Surf to help other veterans.

    The first time I volunteered for Operation Surf I briefly met a young man named Tommy Counihan. He was learning how to kiteboard. With his long blonde hair and slender build, he looked more like a surf hippie than a veteran.

    In 2011, while on deployment in Afghanistan the armored vehicle Tommy was in drove over an IED. It exploded directly under Tommy’s feet. His right foot ended up needing to be amputated. But it was more than a physical injury, “I felt like when I made that decision that day to amputate my foot that I lost more than just a physical part of myself,” he said. “It plays tricks on your head. It brings you to a really dark place that’s almost impossible to get out of on your own. I remember the times when I would sit there by myself and contemplate whether or not I should commit suicide.”

    On the advice of his therapist, Tommy participated in Operation Surf. Even though Tommy had surfed when he was a teenager, he was skeptical that it would help him now. Then he caught his first wave, “I was just so ecstatic that I was able to stand up on that board because in that one instant I knew that everything that I thought I had lost was just something I was creating in my head. That I was going to be able to do it all. I just had to push myself to overcome these barriers that I placed in front of myself.” Tommy won the wounded warriors division at the Hawaii Adaptive Surfing Championship last year.

    Surfing can have a profound impact on veterans’ mental health. Dr. Russell Crawford, Air Force veteran and licensed therapist, conducted a research study on Operation Surf participants and found that surfing decreased PTSD symptoms by 36%, decreased depression by 47%, and increased self-efficacy by 68%.

    Surfing can help veterans overcome the challenges caused by war. It has given Bobby, Tommy, and hundreds of other veterans a new lease on life. You can show your support by volunteering or donating to Amazing Surf Adventures and Operation Surf by visiting their website.

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    Mental Health

    Mental Fitness: We Can Actually Train to Become Resilient Leaders!

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    What if I told you that mental fitness is something you can develop in the same way you build your physical fitness?

    We hear a lot these days about stress and when we do, the conversation often focuses on avoiding it or managing it. What if that isn’t actually useful?

    The best illustration I’ve read highlighting the direct link between mental toughness and performance comes out of a research lab. A team of researchers wanted to look at what made subjects mentally fit or resilient and took some baby chicks into the lab to study their theory. Painting the chicks and grouping them in separate pens, the first group was left alone to interact happily and normally.

    The second group was periodically picked up and stressed in a confined space. After the stress, the chick was given time back in their group pen to recuperate. The third group was continually stressed in the confined space, with no recovery time or play opportunity with other chickens. The researchers created three distinct populations with different experiences.

    After raising them for a time in this manner, all the painted chicks were placed in buckets of water, with researchers timing their struggle until drowning. I know, this sounds just awful.

    The chicks that had been continually stressed drowned almost immediately; they just had no hope in the face of hardship that they could swim. The second group to succumb was comprised of those “happy innocents” in group one who had never been confined and stressed. They didn’t know how to withstand this watery hardship and folded in the face of it. The last swimmers fighting to make it were the chicks from the stress adaptation group.

    Somehow, the confinement stressors followed by time to recover had rendered them stronger and able to swim and survive much longer than their peers. This group was resilient; they had experienced hardship before and believed they had a chance to make it and recover. They had those past mastery experiences to rely on, and they just fought to keep swimming.

    Stress has a purpose. Stress is opportunity. It’s meant to teach us to swim!

    Responding well to stress requires high functional capacity of your brain’s frontal cortex. This area of our brain houses something called our working memory capacity, which helps us with both emotional regulation (being able to think and not just react) and upper-level cognition (focus). We can improve that capacity with the use of some well-studied, relatively simple exercises.

    Think about the last time you experienced stress. I always think back to those really awkward years – for me it was 13 – and last week. Think about that age, standing in the middle of the school lunchroom with your meal tray. As you gaze over top of your sandwich, anemic vegetables, and cookie snack pack, you anxiously wonder who will make room for you at their table.

    What happened in your body at that moment? Maybe your heart sped up, you started breathing fast, your face flushed – your body fires off a full-on stress response. As the stress is registered by your brain, wherever that stress comes from – a chain reaction fires.

    Your body releases cortisol, adrenaline, and a host of other chemicals to help you cope. It also releases a hormone called DHEA into your bloodstream. DHEA’s entire role is to help your brain grow from the stressor you just survived. But there’s a catch – DHEA only does its job when you give yourself a post-stressor break.

    You need that time to de-escalate your revved up nervous system in order for DHEA to do its brain-building work for you! The hormone increases synaptic firing and neural connectivity (you’ll think faster) and increases working memory capacity (emotional regulation and focus). DHEA is what makes stressful experiences worth your time, but you have to create the space for it to do its work.

    Creating this space is the heavy lifting of mental fitness training, and it isn’t as easy as it sounds. If I say rest, self-care, nervous system regulation and you think taking a nap, you’re on the wrong track.

    When we are asleep our brain waves are long and slow. We call these delta waves, and our brain is in delta state. When you’re awake and ambulatory, walking and talking in the world you’re in Bets state. What’s interesting for a lot of us in a hyper-stimulated environment is that we find ourselves often entirely on or entirely off, and the place in the middle where DHEA does its building work is theta state.

    In this space, you’re at rest, but still aware. Also, your nervous system has space to rebuild and strengthen. So what does a drop in stress hormones and downshifting of the nervous system feel like? Think about the last time you enjoyed an activity or training – when you took a deep breath in and you just felt that “Ahhh!” feeling – even if you were working hard and running up and down trails.

    You may find it while running, skiing, doing yoga, getting a deep tissue massage, taking a bubble bath, or even lifting weights. Some people call it a “click,” or a “shift.” Here is where you have to experiment a bit. That moment will look different for everyone, but when you find it, take note.

    Do more of it – especially when you’re feeling stressed and overwhelmed. I find it often on a yoga mat. I have a friend who tells me she finds it swimming laps. Now for me, I’m trying not to drown while swimming laps, there is nothing theta state happening for me there! Dedicate the time to finding your practice. What down-shifts your nervous system? Then do it. Ritualize it. Make downshifted moments part of your training routine.

    All of us face periods of adversity, and no one is going to ask us if we can swim before the crisis. We have to train for the hard times, and we can. Make a little time for your brain and watch yourself get sharper, smarter, more focused, kinder. You’ll also be ready for the bucket of water.

    You need to know how to become mentally fit to be the best student, professional, parent, and friend that you can be. Be the chick that lived well! Train yourself to swim.

    A wrote a book on this subject that’s brand new from Praeger – check it out here.

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