Notes taken October 2017 at the NASW GA Conference during the lecture of Susanah Stone (Veterans Housing First and Harm Reduction Practice).

  1. Military/Veteran culture:
    1. Disciplined
    2. Mission Oriented
    3. Aggressive
    4. Interdependent
    5. Group
    6. Group Cohesion
    7. Group Wellbeing is first
    8. Individual is second to the unit
    9. Teamwork
    10. Comradery
    11. Courage
    12. Trust
    13. Strength
    14. Honor
    15. Self-Sacrifice
    16. Uniformity
    17. Obedience
    18. Structure
    19. Patriarchal
  2. There are habits or ways of coping that can be misunderstood or problematic in civilian life.
  3. There is a reluctance to report illness or problems out of concern there may be negative repercussions in regards to military career.
  4. They understand “team” which can be a good way to build rapport.
  5. Housing First Initiative–Housing before case management and other voluntary supportive wrap-around services.
    1. Focuses on housing retention and increased functioning.
    2. Lessens the negative consequences of addiction while also working to alleviate homelessness.
    3. It is the best harm reduction approach to reducing mortality and ending homelessness.
  6. Some Veterans went into the military at age 18 and have never “done adulthood” outside the structure of the military.
  7. Elicit from Veterans “who are your supports” which are not necessarily family.  It could be prior service members who served in the same unit (assist the Veteran in reconnecting with these individuals).
  8. Enlist the skills that the Veteran has (see number 1).
  9. Veterans “are us”.
  10. Alcohol, tobacco, and drug use (along with other unhealthy behaviors) exist on a continuum from non-problematic to life threatening).  Aim to reduce the associated harm experienced by individuals, families, and communities.
  11. Harm reduction incorporates a spectrum of strategies from safer use, to managed use, to abstinence.
  12. The individual’s decision to engage in risky behavior is accepted.
  13. The practitioner should avoid having predefined outcomes.
  14. If you drive drunk and get a D. U. I. it is not the police officer’s fault (with decisions come responsibility for consequences).
  15. Identify options while respecting self-determination
  16. Veterans often point out “no body (in the VA) asks me about my military service”.
  17. Push your assessment aside and have a conversation–a dialog.
  18. B. A. M. assessment (Brief Addiction Monitor)
  19. Treatment planning (needs, strengths, weakness)
  20. Prochaska’s States of Change (Trans-theoretical model of change)


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