Just Show Up: Building Therapeutic Relationships in Combat Zones: OEF Afghanistan 2010-2013
Keywords:
Navy medicine, operational social work, Navy mobile care team, Afghanistan, strengths perspective, Operation Enduring FreedomAbstract
Establishing, maintaining, and developing therapeutic relationships with Navy personnel in nontraditional settings during Operation Enduring Freedom (OEF), Afghanistan, required flexible professional strategies while maintaining professional boundaries and mission-oriented interventions. The Navy Mobile Care Team Five (MCT-5) consisted of five Navy personnel including two Licensed Clinical Social Workers (LCSWs), one of which additionally served as the team's Officer-in-Charge (OIC), a Navy Research Psychologist, and two Navy Hospital Corpsmen Psychiatric Technicians. MCT-5's official mission was to target all Navy Individual Augmentees (IAs) in Afghanistan from December 2011 to July 2012 (approximately 2,200 IAs) to provide preventive mental health care, surveillance, and command consultation, including care for the caregiver, at static medical commands, by engaging in routine site visits outside the traditional medical settings in an effort to reduce mental health stigma and remove barriers to care. The team motto, “Just Show Up,” reflected a strategic shift from a more traditional client/provider relationship in which traditional office structures and engagement are more carefully constructed and regimented, to a process of engaging any and all units and individuals across Afghanistan in a more collegial camaraderie in which embeddedness with each unit was central and behavioral health activities were strategically structured and conducted with full anonymity and confidentiality. This narrative addresses challenges, insights, and implications to include nebulous professional boundaries among the various disciplines, official processes and protocols for addressing clinical problems, and “care for the caregiver” strategies employed by MCT-5 to provide its own mental health hygiene and support. While the narrative is factual and accurate, no names were used and details of all situations were altered to preserve security and sensitivity for all persons and situations described.
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