For many veterans the internal struggles of adjusting to civilian life can be just as challenging as the experiences they’ve dealt with in combat. These struggles often take the form of health issues, considering 6 million veterans in 2016 used at least one healthcare service provided by the U.S. Department of Veterans Affairs, according to the organization’s most recent data.
Often these health issues affect their mental state rather than the physical, and more and more veterans are seeking treatment as the awareness around mental health and post-traumatic stress disorder is on the rise in the United States. Clinical psychologist Brittany Howell ’10 is one of many healthcare providers empowering veterans to work through and combat these issues at the James A. Haley Veterans’ Hospital in Tampa.
“It’s important to be able to have services for those who have served our country – I think it’s the least we can do.”
While studying psychology at the university, Howell developed a passion for working with veterans during her first internship experience at UCF’s Center for Drug-Free Living, where she was able to observe, participate in and lead therapy treatments for veterans.
Now her day-to-day operations include assessing difficulties in and providing evidence-based treatments to patients in both individual and group settings. Although she often has to juggle many responsibilities, she says she loves that her position keeps her on her toes and allows her give back to those who have given so much to the nation.
“It’s important to be able to have services for those who have served our country – I think it’s the least we can do,” Howell says.
Here she shares more about what it’s like to care for and treat veterans:
What’s the most challenging part of your job?
I think the most challenging part is something I also really like: It’s a fast-paced and challenging environment in general. We see a lot of patients, do a lot of outreach and are always advocating for the use of treatments that we know are effective. Maybe [the most challenging part is] shifting the culture a little bit to really focus on active, evidence-based treatments, the ones that have been scientifically studied and proven to be effective, as opposed to just supportive, talk therapy.
“I think the most challenging part is something I also really like: It’s a fast-paced and challenging environment in general.”
What are some examples of the treatments you offer at the VA?
The evidence-based treatments we offer are usually done with a certified or trained therapist weekly for about three to four months or so. However, it depends on the patient’s needs; we create a personalized plan for each veteran.
One of the evidence-based treatments we offer for PTSD is a cognitive treatment, where veterans are learning different skills to identify the way that they’re thinking, and how that’s affecting the way that they’re feeling, as well.
Then they learn skills to actually challenge the thoughts that may not be helpful to them. So we work through worksheets, concrete examples throughout the session, and they carry those skills into their daily life after treatment. Then they take over and become their own therapist at that point.
What are some of the misconceptions people have about seeking treatment for PTSD and other mental health issues?
I think a lot of times people think by engaging in a treatment that is trauma focused that their symptoms are going to get worse. For example, another evidence-based treatment is an exposure- based treatment, where you actually process and give a narrative of the trauma in session with your therapist. You also do some exercises where you’re out in the community doing things that you used to avoid or are triggering for you.
“The truth is we know that avoidance really keeps the cycle of PTSD going.”
The truth is we know that avoidance really keeps the cycle of PTSD going. So actually, approaching these things helps get us to a point where all of these symptoms and all of these triggering cues in the environment are not impacting our lives as much as they have before.
What are some issues that prevent veterans from getting help?
Many veterans live in rural communities and/or have physical limitations or transportation difficulties that may prohibit them from attending appointments regularly. The VA has put into place a complete telehealth program, where technology such as video conferencing can be used to target care and case management to improve access to care and overall health of veterans.
Currently, there are hundreds of community-based outpatient clinics, which are closer to veterans’ homes, where veterans can receive specialty services via telehealth to the main hospital or other facility. In addition, several services are being offered via provided equipment, such as webcams to veterans’ homes. This technology can be used to make diagnoses, manage care, perform checkups and actually provide certain types of treatment in various areas of health, including mental health, rehabilitation, nutrition, primary care and many more.
“If you think about the military and veterans’ culture they are often told to keep going and push through. So advocat[ing] for treatment … is very, very important.”
One of the areas you specialize in is sexual trauma. What are some of the difficulties you encounter when treating this issue?
Veterans who experienced military sexual trauma, which includes any sexual activity someone is involved in against their will while in the military, can get free treatment at the VA. The military community is a pretty tight community. A lot of times you’re working with your perpetrator, or you are told to push through and “man up,” which decreases the number of MST incidences that are reported. I think we have come a long way as far as the stigma goes in this population, but we must continue to work on this.
For a lot of people who come to the VA [with this issue,] this might be the first time that they’re talking about this. A level of comfort, understandably, might not be there in the beginning, so we have to keep working to make this a more comfortable thing to talk about and an accessible thing to get treatment for.
How do you think the stigmas around sexual trauma and mental health can be reduced?
The most important thing is education and awareness.
If you think about the military and veterans’ culture they are often told to keep going and push through. So being able to advocate for treatment if it’s needed and educate society, educate veterans, really just everybody on the effects that mental-health difficulties can have on us, the effects of a combat zone, the effects that sexual trauma can have, is very, very important.
“If a family member feels a veteran needs help, they should encourage them to seek treatment and see what services are out there for them.”
Making sure that we have professionals that are trained in these specific treatments and we have more people that are able to offer these services to veterans, I think that is very important as well.
What advice would you give to a family member of veterans who may be struggling?
We definitely encourage family involvement. If a family member wants to come and learn about what’s going on, or how PTSD or any other mental health difficulty has affected the veteran, they are more than welcome to do that.
If a family member feels a veteran needs help, they should encourage them to seek treatment and see what services are out there for them. There are different services that many people don’t know about.
We also have marriage and family services and other providers that are able to provide services as a couple or a family to the veteran. We know that PTSD along with other mental health difficulties can affect relationships, families, marriages, so being able to incorporate any family involvement is important.
“These are people who served our country so being able to work with them, our country’s brave heroes, is just amazing.”
What do you love about what you do?
I truly love just working with veterans. I developed that passion years ago at UCF with my first group treatment at the Center for Drug-Free Living. Working for the VA can be challenging, but so rewarding. When you work with such a large healthcare system, it really allows providers to do research and collaborate with so many other people, so we can provide the safest and most effective treatment for our veterans. These are people who served our country so being able to work with them, our country’s brave heroes, is just amazing.
Also, I love being able to wear so many hats. I can act as a clinician, I can educate and I can do research. I can also supervise the next generation of psychologists and mental-health providers coming up and really work together so [we] can provide the best education for our providers and the best education and services for veterans and their families.
If you’re a veteran and need help or someone to talk to, the VA’s Veterans Crisis Line is a free, confidential service that is available 24/7. You can call or text the hotline at 1-800-273-8255.
For more information about the VA and its services visit va.gov