Veterans Administration Readjustment Counseling Service Counselors' Training Needs: Results of a National Needs Assessment.

The Department of Veteran Affairs established Readjustment Counseling Service (RCS) to meet the mental health needs of active-duty service members, veterans, and their families. A diverse therapeutic skill set is needed to serve this complex population. To assess training needs, a national mixed-methods needs assessment consisting of a survey for RCS counselors and focus groups among counselors, RCS educational trainers, and national leadership was conducted. Survey results (n = 681) showed that RCS counselors were most interested in trainings on moral injury, acceptance and commitment therapy, and military sexual trauma (MST). Desired trainings aligned with populations served. Themes from focus groups revealed the need for foundational trainings so that all RCS counselors are adept in treating MST, moral injury, and posttraumatic disorder and proficient in caring for couples. Additionally, counselors desired advanced trainings tailored to individual counselors' needs. RCS counselors identified multiple trainings to help them treat those they serve.

Epidemiology and prevention of substance use disorders in the military.

U.S. military service members have been in active combat for more than 10 years. Research reveals that combat exposure increases the risk of substance use disorders, post-traumatic stress disorder, major depression, and tobacco use. The Services and the field of addiction medicine are working hard to find a common definition for prescription drug misuse, which is a growing concern in both the general U.S. population and the force. Meanwhile, leaders at all levels of Department of Defense are diligently working to address barriers to care, particularly stigma related to substance abuse care, by seeking a balance between improving service member privacy in order to encourage self-referral for medical care and a commander's need to know the status of the unit and its combat readiness. The treatment and management of substance abuse disorders are a complex force health issue that requires the use of evidence-based medical interventions and policies that are consistent with them.

One Shot-One Kill: a culturally sensitive program for the warrior culture.

Despite efforts to reduce the stigma of mental health services across branches of the United States military, lasting change among this warrior culture remains an uphill battle. Difficulty affecting change can be attributed in part to stigma associated with psychological services and largely, mental health providers' difficulty tailoring traditional models of treatment to military personnel. We will discuss the development of One Shot - One Kill (OSOK), a culturally sensitive mental health prevention program piloted to reduce stigma and improve help seeking behaviors among the warrior culture. Three hundred and twenty military members completed the OSOK performance enhancement and resiliency program piloted at Tallil, Iraq in 2008. Pilot data were collected to assess military members' perceptions of the training program. Results indicated positive responses demonstrating the OSOK program as a culturally sound program that could increase help seeking behaviors among military members.

Alcohol abuse prevention among high-risk youth: computer-based intervention.

SUMMARYThis study examined the feasibility of a CD-ROM intervention to prevent alcohol abuse among high-risk youths. Youths from 41 community-based agencies in greater New York City participated in a randomized trial of a skills-based interactive CD-ROM. Outcome data were collected on 489 early adolescents in these agencies before and after a randomized subset of youths interacted with a 10-session alcohol abuse prevention program on CD-ROM. Compared to control participants, youths in the intervention arm had a positive increase in perceived harm of alcohol use and increased assertiveness skills. At posttest, drinking rates for control and intervention participants were equal and unchanged from pretest. These findings suggest that CD-ROM technology offers a new and promising medium for engaging high-risk youth in an alcohol abuse prevention program. Study implications and future applications of the present approach are discussed.