N A T I O N A L A S S O C I A T I O N O F S O C I A L W O R K E R S

2012

ServiceMembers,

Veterans, &Their Families

N A S W S t a n d a r d s f o r

S o c i a l Wo r k P r a c t i c e w i t h

About the Association

The National Association of Social Workers (NASW) is thelargest membership organization of professional social workersin the United States. Members of NASW include over 145,000social workers from 50 states, the District of Columbia, New YorkCity, the U.S. Virgin Islands, Guam, and Puerto Rico as well as U.S.social workers practicing abroad, many of whom are uniformedsocial workers or members of their families. The mission ofNASW is to enhance the professional growth and developmentof its members, to create and maintain professional standards,and to advance sound social policies.

ServiceMembers,

Veterans, &Their Families

Adopted by the NASW Board of Directors September 2012

N A S W S t a n d a r d s f o r

S o c i a l Wo r k P r a c t i c e w i t h

National Association of Social WorkersJeane W. Anastas, PhD, LMSWPresident

Elizabeth J. Clark, PhD, ACSW, MPH, Chief Executive Officer

Service Members, Veterans, and TheirFamilies Expert Steering CommitteeDeborah Amdur, LCSW, ACSWKathryn Basham, PhD, LICSW, ACSWMichael Bermes, MSW, CAP, ICADCMAJ Michael Brand, PhDReinaldo Cardona, MSWJudith Ward Dekle, LCSW, ACSWLT Alyssa L. Gibbons, LCSW, BCDDavid A. Hammiel, Col, USAF, BSCAnthony Hassan, EdD, MSWNorma G. Jones, PhD, LCSW, BCDDavid Kennedy, MSW, CAPTJohn Kuhn, MSW, MPHCOL Ann McCullis Johnson, LCSWPatricia G. Moseley, PhD, LMSW, ACSW, DCSWSandra G. Posada, LCSW, ACSW Rafiq Raza, MSWJo Ann Regan, PhD, MSWCarol Sheets, LICSW, ACSWLTC Jeffrey Yarvis, PhD, LCSW, BCD

NASW StaffElizabeth F. Hoffler, MSW, ACSWMichael Francum, MSW, ACSW

©2012 National Association of Social Workers.All Rights Reserved.

Contents

5 Introduction

7 Definitions

11 Guiding Principles

12 Goals

13 Standards for Professional Practice

13 Standard 1. Ethics and Values

15 Standard 2. Qualifications

17 Standard 3. Knowledge

20 Standard 4. Assessment

23 Standard 5. Intervention and Treatment Planning

25 Standard 6. Practice and Program Evaluation

and Improvement

26 Standard 7. Professional Development

28 Standard 8. Supervision, Leadership, Education,

and Training

29 Standard 9. Documentation

31 Standard 10. Interdisciplinary Leadership and Collaboration

32 Standard 11. Cultural Competence

35 Standard 12. Advocacy

37 References

39 Resources

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Introduction

Many social workers, regardless of primarypractice area, will work with clients who do, or have, served in the Military and/or with theirfamily members including spouses, partners,children, and parents of the Service Member or Veteran. Using their expertise in assistingindividuals and families across the lifespan fromvarying cultures, social workers can help ServiceMembers, Veterans, and their families in avariety of ways to address challenges they may be facing.

Social workers already provide these services innumerous settings. The U.S. Department ofDefense (DoD), where military social work wasestablished over 50 years ago, includes civiliansocial workers assigned to military componentsand over 500 active military personnel who arepracticing social workers (NASW, 2011b). Inaddition, the U.S. Department of VeteransAffairs (VA) established the first social workprogram in the Veterans Bureau in 1926 and isnow the largest employer of master’s-level socialworkers in the nation. The VA is also affiliatedwith over 180 graduate schools of social workand operates the largest and mostcomprehensive clinical training program forsocial work students in the United States,training 900 students per year (VA, 2012). Social workers also work in different directpractice and advocacy organizations, whethertheir mission is to specifically assist ServiceMembers, Veterans, and their families withdirect services or to advocate with and on behalfof this population. In addition, many socialworkers are providers under TRICARE, thehealth care program for uniformed Service

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Members, their families, and survivors ofdeceased Service Members.

In addition to providing these services, socialworkers have an opportunity to influence arange of professionals, stakeholders, andlaypeople regarding the importance ofresponding to the needs of military and Veteranpopulations. The need for social workers whoare educated, trained, and skilled in workingwith this population has increased, and clientneeds are often complex, making the demandeven more critical. There are already significantshortages of social workers in several fields ofpractice, and these shortages will increase as thebaby boomers continue to age (NASW, 2011a).

Approximately 2.2 million Service Membersmake up America’s all-volunteer force in theactive, National Guard, and Reservecomponents, representing less than one percentof all Americans (White House Joining ForcesInitiative, 2011). The White House JoiningForces Initiative (2011) has noted that “the U.S.military recruits and retains the highest-calibervolunteers to contribute to the Nation’s defenseand security.” Service Members, Veterans, andtheir families sacrifice much and have earnedour respect and the resources necessary to helpthem live productive and healthy lives. Theyhave great strengths, including resilience,perseverance, courage, and criticalproblem-solving skills, yet they may also facesignificant challenges.

In past conflicts, such as World War II, troopswho experienced serious physical and mentaltrauma often did not survive long enough todeal with the repercussions of these events

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(Franklin, 2009). With advances in medicaltechnology and body armor, more servicemembers are surviving experiences that wouldhave led to death in prior wars. In addition,deployments have become longer, redeploymentto combat is common, and breaks betweendeployments are infrequent (Jaycox & Tanielian,2008). With increased exposure to combatstress, Service Members may return home with mental and behavioral health challenges.

Stressors related to military experience maychange over the lifespan as a Service Membermoves through a military career to Veteranstatus. For those Veterans who were in a warzone, biopsychosocial and spiritual needs maychange relative to life demands and exposure tocritical reminders of war experiences.

Definitions

For the purposes of these standards

Client

Client refers to the specific individual, couple, orfamily being served and includes the ServiceMember, Veteran, family member, or loved one.

DoD

DoD refers to the U.S. Department of Defense.

Family

Family refers to families of origin, extendedfamily, domestic partners, adopted and fosterfamily members, friends, and significant othersof Service Members or Veterans and survivors ofdeceased Service Members or Veterans.

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Service Member

Service Member describes any member of theU.S. Armed Forces. There are seven UniformedServices of the United States, including theArmy, the Navy, the Air Force, the MarineCorps, and the Coast Guard. The Public HealthService Commissioned Corps and the NationalOceanic and Atmospheric AdministrationCommissioned Corps are Uniformed Servicesbut not Armed Services. This term is inclusiveof those who are active duty, mobilized, onorders, or deployed.

Active-duty members of the Armed Forces arefull-time employees who are on call 24 hoursand 365 days per year and are a permanent forceof the military.

Reservists train at least one weekend per monthand two weeks per year and are subject tomobilization (called to active duty). The eightreserve components of the U.S. Military are theArmy Reserve, the Navy Reserve, the MarineCorps Reserve, the Air Force Reserve, the CoastGuard Reserve, the Army National Guard, theAir National Guard, and the U.S. Public HealthService Reserve Corps.

National Guard members serve a dual mission,providing trained and equipped units to thestates to protect life and property whileproviding to the nation units trained, equipped,and ready to defend the United States and itsinterests all over the globe. The National Guardis run by state governments except when calledinto federal service by the President. NationalGuard members can serve in the Air NationalGuard or the Army National Guard.

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Social Work Services

Social work services include but are not limited tomental and behavioral health services, healthservices, social support, case management, carecoordination, children and family services,administration, and advocacy. Services areprovided at the micro, mezzo, and macro levelsin a wide range of public and privatesettings—community-based, school,government, health, and mental healthorganizations. Services may be provided toService Members in all branches and Veteransfrom all eras and conflicts as well as to theirfamily members and loved ones.

Social Worker

A social worker has, at minimum, a bachelor’sdegree (BSW) from a Council on Social WorkEducation (CSWE)–accredited school orprogram of social work and meets staterequirements for social work practice or, injurisdictions not having such legal regulation,holds certification or credentialing from NASW.Professional social workers help individuals,groups, or communities to restore or enhancetheir capacity for psychosocial functioning whilecreating societal conditions favorable to people’sgoals. The practice of social work requiresknowledge of human development and behavior;of social, economic, and cultural institutions;and of the interaction of all these factors. Socialworkers can serve in the military as members ofthe Armed Forces or work as civilians.

Social workers holding a BSW who work withService Members, Veterans, or their familiesprovide generalist services and may providenonclinical services in a variety of differentsettings including organizations and agencies

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addressing poverty, homelessness,unemployment, child welfare, domestic violence,substance abuse, sexual trauma, and suicideprevention. They may organize communities,advocate for clients, and provide direct socialwork services, among other duties. In manystates, BSW-level social workers are licensed.

Social workers holding a master’s degree insocial work (MSW) who work with ServiceMembers, Veterans, or their families may providethe services that a BSW-level social workerprovides as well as providing advanced clinicalservices. To provide psychotherapy services toindividuals, couples, families, and groups, theymust meet state clinical licensure requirements.

Social workers holding a PhD or DSW whowork with Service Members, Veterans, or theirfamilies may provide the services that a BSW-or MSW-level social worker provides withproper licensure. They may also be more likelyto engage in research and education.

VA

VA refers to the U.S. Department of Veterans Affairs.

Veteran

Veteran describes any individual who served forany length of time in the U.S. Armed Forces.The type of discharge a Veteran receives has asignificant impact on his or her eligibility for VAbenefits and services.

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Guiding Principles

The NASW Standards for Social Work Practicewith Service Members, Veterans, and Their Familiesshould be a resource to social workers servingthis population in any way, including clinicalsocial workers providing mental and behavioralhealth services, direct practitioners in socialservice agencies addressing a wide range ofchallenges, and advocates for this population.These standards have been created to beinclusive of social work with Service Members,Veterans, and their families in all capacities.They are designed to enhance social workers’awareness of the skills, knowledge, values,methods, and sensitivities needed to workeffectively with this population. They may also be used as a resource for other constituents,stakeholders, and client populations.

In addition, these standards are meant to beinclusive of Service Members, Veterans, andtheir families from all eras. Although only about 1 percent of the country’s population iscurrently serving in the military, Veteransconstitute seven percent of the population (ABCNews, 2011). There are 22,658,000 Veterans inthe United States today, just 8 percent of whomare female (ABC News, 2011). As of September2011, there were about 1,981,000 livingVeterans of World War II, a war that more than 4 million American were deployed to fight(ABC News, 2011). The largest living cohort ofmale Veterans served during the Vietnam era(August 1964 to April 1975), whereas the largestliving cohort of female Veterans served duringpeacetime periods (VA National Center forVeterans Analysis and Statistics, 2009).

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Goals

These standards were developed to broadlydefine the scope of services that social workersserving Service Members, Veterans, and/or theirfamilies shall provide; that organizations andadministrators should support; and that ServiceMembers, Veterans, and their families shouldexpect. The goals of the standards are to

� Maintain and enhance the quality of servicesthat social workers provide to ServiceMembers, Veterans, and their familiesthrough understanding of military culture and the impact of services provided

� Maintain and enhance the quality of servicesthat social workers provide to seriouslywounded or injured and ill Service Membersand Veterans through understanding of theirunique challenges and those of primarycaregivers

� Define what is expected of professional socialworkers who work with Service Members,Veterans, and their families

� Promote the highest quality of social workservices provided to Service Members,Veterans, and their families

� Provide a basis for the ongoing developmentof continuing education materials andprograms for social work with ServiceMembers, Veterans, and their families

� Ensure that social work services provided tothis population are guided by the NASW(2008) Code of Ethics

� Encourage social workers to participate in theformulation and refinement of public policy(at the state and federal levels) relevant to theopportunities and challenges of ServiceMembers, Veterans, and their families

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� Inform and educate all social workers of theimportance of a professionwide response tothe needs of this population, regardless ofpractice area or focus

� Promote social work within our profession, aswell as to allied professionals and externalstakeholders, as a key provider of mental andbehavioral health, health, and social workservices and advocacy for Service Members,Veterans, and their families over the lifespan.

Standards for Professional Practice

Special Note: Individual social workers should decidewhich components of these Standards are applicable totheir practice on the basis of their level of education andexperience, employment setting, and services provided.

The order in which these standards appear does notreflect their order of importance.

Standard 1. Ethics and Values

When working with Service Members, Veterans,

and their families in any capacity, social workers

shall function in accordance with ethical

principles and standards of the profession as

articulated in the NASW (2008) Code of Ethics.

Interpretation

Social workers who practice with this populationmust recognize the complexity of this work andbe alert and prepared to address possible ethicaldilemmas and value conflicts as they occur.

Social workers shall demonstrate recognition ofbasic human rights, including the right ofService Members, Veterans, and their families toreceive an optimal level of social work services.

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Social workers shall demonstrate a willingness toact on professional judgment and convictions,which should be informed by the NASW (2008)Code of Ethics.

With its historic commitment to serving andempowering populations at risk and thoseconstituting a minority within the largerpopulation, and to promoting human rights andsocial justice, social work is well suited toaddress the ethical challenges that may arise.

The minimal knowledge base for work in thispractice area includes an understanding of thefollowing basic ethical principles:

� Commitment: the primary responsibility topromote the well-being of clients

� Competence: the representation of one’s selfas competent only within the boundaries ofone’s education, training, license, certification,consultation received, supervised experience,or other relevant professional experience

� Cultural Competence: the continued goal ofunderstanding the function and influence ofculture on behavior and society and meaningsascribed by clients

� Diagnosis and Reporting: the knowledge ofdilemmas that may be posed when diagnosisand reporting could have an adverse impact ona Service Member’s military career and theimplications for a military career following self-report of abuse and neglect, among other issues

� Integrity: the maintenance and promotion ofhigh standards of practice

� Privacy and Confidentiality: respect for aclient’s right to privacy and disclosure ofconfidential information only whenappropriate and with valid informed consent

from the client or a person legally authorizedto give such consent, balanced withconsiderations of national security, defense,and individual safety

� Protection of the Rights of Service Members,

Veterans, and Their Families: particularlywithin the constraints of the systems withinwhich they live and work

� Respect for the Person: the duty to honorothers, their rights, and their responsibilities

� Self-Determination: the right of clients toidentify and clarify their goals, includingallowing Service Members, Veterans, andtheir families to select or refuse services andtreatment in a noncoercive, unbiased mannerwhile understanding their uniqueresponsibilities and obligations

� Social and Political Action: the engagement inaction that seeks to ensure that all people haveequal access to resources, with understandingof the limits imposed by the client’s militarystatus or employment situation.

Standard 2. Qualifications

Social workers who work with Service Members,

Veterans, and their families shall meet the

provisions for professional practice set by

NASW and the individual social worker’s state,

jurisdiction, or institution. They shall possess

knowledge and understanding basic to the social

work profession as well as to their employer.

Interpretation

As a distinct specialty within the social workprofession, practice with this populationrequires that social workers at all levels

� Hold at least a BSW from a programaccredited by CSWE to provide generalist

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services or hold an MSW in social work froma CSWE-accredited program or a doctoraldegree in social work to provide clinicalmental and behavioral health services

� Acquire licensure by state boards of social workand certification by NASW to demonstratenecessary knowledge and experience

� Provide services in this specific practice areaonly after appropriate study, training,consultation, and supervision from peoplewho are competent in the relevantinterventions or techniques

� Acquire specialized knowledge andunderstanding of military cultures. It isrecommended that the social work studentseek this training through his or her school orprogram of social work. If that is not possible,the student or professional social worker shallactively seek continuing education, training,and practice opportunities to enhance his orher knowledge of this practice area.

� Develop an understanding of their ownpersonal and cultural values and beliefs inregard to Service Members, Veterans, andtheir families

� Obtain ongoing supervision to maintainaccountability, increase job performance, andenhance specific services to Service Members,Veterans, and their families

� Strive to increase professional knowledge and skills and apply them in practice to bestserve clients

� Contribute to the knowledge base of theprofession and promote the unique skill setand services provided by social workers

� Practice self-awareness as a basis forprofessional development and/or to increaseawareness of personal assumptions, values,and biases

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� Refrain from boundary conflicts and dual ormultiple relationships with clients.

Standard 3. Knowledge

Social workers who work with Service Members,

Veterans, and their families shall demonstrate

a working knowledge of relevant theories and

essential practice behaviors. All professional

social workers, regardless of practice focus or

level, should have a basic understanding of the

opportunities and challenges facing this

population and how, as a profession, we can

support and respond to the population in an

effective and meaningful way.

Interpretation

The social worker working with Service Members,Veterans, and their families shall possess theknowledge necessary to achieve optimaloutcomes for the client. The social worker shalldemonstrate the following knowledge:

� Benefits, Services, and Resources: Tocontinually understand benefits and servicesavailable to Service Members, Veterans, andtheir families and/or caregivers from the VA and/or DoD and how to access them; to recognize the availability of communityresources and how to gain access to them on behalf of clients

� Biopsychosocial Issues: To acquire knowledgeabout and understand the context of thephysical, mental health, and psychosocialissues facing Service Members and Veterans,and their families and facilitate well-beingand—for clinical social workers—to providecounseling in the areas of mental andbehavioral health, particularly separation, loss,grief, substance use disorders, posttraumatic

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stress, other anxiety disorders, depression,suicidal or homicidal ideation, anger,aggressive behavior, domestic violence orintimate partner violence, and incarceration;clinical social workers shall also understandthe range of psychosocial interventions toaddress these areas and should be able torecognize and respond to health-related issuessuch as traumatic brain injury (TBI), militarysexual trauma, acute stress reaction, andchronic posttraumatic stress disorder (PTSD);and all social workers should understand thepossible stigma related to seeking mental andbehavioral health treatment

� Communication: To successfully work withthe Service Member, Veteran, or familymember and relevant agencies andorganizations, such as DoD or the VA, aworking knowledge of the complex flow ofcommunication and common militaryterminology is a requirement

� Culture: To understand the elements andcomplexity of military culture as a part of U.S.culture, along with subcultures of the Servicesand Components as well as ethnic, religious,and other cultural differences of clients; tounderstand and be prepared to adequatelydiscuss and respond to the environment,concerns, and challenges of the client

� Discrimination: To recognize the possibilityfor discrimination or prejudice toward clientson the basis of their military service

� Discharge: To understand the militarydischarge system, including the different typesof discharge, military discharge documents,and the impact that discharge will have onservices and resources available to the Veteran

� Disparities: To recognize the possibledisparities of Service Members, Veterans, and

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their families as these relate to theopportunities and services afforded to themduring and after service

� Evidence Base: To learn about and understandevidence-based and research-informedpractice models in this social context

� Family Systems and Interpersonal Dynamics:

To conduct a comprehensive assessment andto assist the client and family in the best waypossible; to recognize how to apply astrengths-based approach while alsorecognizing vulnerabilities and the impact ofrecurring deployments on family functioningand the military family life cycle, includingbut not limited to transfers, relocations,deployments, adjustment, and separation

� Financial Resources: To understand financialresources and challenges—including but notlimited to financial health, employability,debt, financial planning, and solvency—andtheir impact on the Service Member, Veteran,or their families’ decision making; torecognize that other challenges may gounaddressed until financial issues are resolved

� Legal and Regulatory Issues: To understandand, if necessary for uniformed socialworkers, adhere to applicable laws andregulations regarding Service Members,Veterans, and their families, such as theUniform Code of Military Justice (UCMJ)

� Roles and Functions: To express themultifaceted roles and responsibilities of, andopportunities for, professional social workerswho practice with Service Members, Veterans,and their families

� Settings: To understand and work within therange of settings that provide services for thispopulation, including the DoD; the VA;Military and Veteran service organizations;

and related nonprofit organizations, agencies,and foundations.

Standard 4. Assessment

Social workers who work with Service Members,

Veterans, and their families shall use appropriate

theoretically and evidence-based practice

models, skills, and interventions that reflect

their understanding of the opportunities and

challenges facing this population. The depth

and breadth of the assessment shall depend on

the qualifications of the social work provider.

Interpretation

Basic and specialized social work skills can beused to provide services to Service Members,Veterans, and their families. Social workers’biopsychosocial–spiritual perspective is ideal fortheir roles as liaison between the client and largesystems, client advocate, and provider ofpsychosocial support services and therapy.Assessment is a fundamental process of socialwork practice. Treatment and interventionstrategies (for clinical social workers) and plansrequire that social workers both assess andreassess client needs and modify plans accordingly.Social work assessments can facilitate theidentification of individuals in need of specificsocial, health, mental health, and/or behavioralhealth services. The social worker should serveas an advocate for these clients, helping them tofind the services and resources that they need.

Social workers who work with ServiceMembers, Veterans, and their families shoulddevelop the skills to

� Engage in a process of assessment thatmutually engages the social worker, client,and client systems

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� Understand the history and development ofsocial work with Service Members, Veterans,and their families

� Identify the theory, principles, and methodsof social work—including casework, groupwork, community organization,administration, supervision, planning, andresearch—that support Service Members,Veterans, and their families

� Recognize the environmental factors thatcreate and contribute to challenges, includingbut not limited to deployment, relocation,combat exposure, reintegration into the homecommunity, and significant life events (such asmarriage, birth of a child, divorce, and death)

� Identify both strengths and vulnerabilities insociocultural and institutional, interpersonaland family, and individual contexts

� Assess clients in the context of militaryexperience and understand the impact ofmilitary experience on all aspects of theService Member or Veteran’s life throughtheir lifespan

� Recognize and promote resiliency using astrengths-based approach when working withService Members, Veterans, and their families

� Recognize the parameters of confidentialityrequirements and obligations concerning datagathered for such assessment.

Areas for assessment:

� Military history, including if clients have ever served, if their family member(s) haveserved, where and when (what era) theyserved, locations where they were stationed,number of deployments and reintegrationhistory, whether they were drafted or whythey chose to join, whether they are enlisted

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or commissioned, if they are currentlydeployed, their reintegration progress,exposure to trauma both in combat andnoncombat settings, wounds and injuries orservice-connected illnesses, type of discharge,and whether they are a former prisoner of war

� Relevant past and current health, mentalhealth, and behavioral health situation (forclinical social workers), including the impactof challenges such as frequently occurringmental and behavioral health concerns (PTSD,other anxiety disorders, substance abuse,suicidal or homicidal ideation, depression),physical injuries (TBI, burns, exposure totoxic chemicals, amputations), and psychosocialissues (intimate partner and domesticviolence, military sexual trauma, education,unemployment, incarceration, homelessness)

� Mental health functioning, including history,coping style, crisis management skills, andrisk of suicide (for clinical social workers)

� Previous treatment for physical, mental, andbehavioral health and psychosocial issues

� Family structure and roles and the impact ofdeployment or reintegration on familialrelationships, child development, and parenting

� Patterns and styles of communication anddecision making in the family

� Spirituality, religion, and/or faith� Client’s and/or family’s goals � Social supports, including support systems,

resources available, and barriers to access� Client’s perception of social work services and

mental and behavioral health treatment,including past experiences

� Client’s experience with benefits and servicesthrough the DoD and the VA

� Unique needs and issues relevant to specialpopulations, such as Service Members and

Veterans who are female, lesbian, gay,bisexual, transgender, or have disabilities

� Perceived relationship between the client andmilitary or Veteran system within which theycurrently function.

Standard 5. Intervention and Treatment Planning

Social workers shall incorporate assessments

in developing and implementing intervention

and treatment plans that best serve the

client’s and/or family’s needs on both an

individual and an organizational basis.

Interpretation

Intervention and treatment plans define ordescribe steps identified by the social worker—in collaboration with the client and/or familyand with other members of the interdisciplinary,collaborative team—to achieve objectivesidentified during assessment. Social workersshall be able to engage the Service Member,Veteran, and/or family member in a client-centered model of care with shared decisionmaking and adapt practice techniques to bestmeet client needs. Social workers shall apply amultisystem approach in developing interventions(individual, family, group, and so on) that makeoptimal use of resources available to the client aswell as those that reside within the client. Socialworkers shall recognize strengths andvulnerabilities where they exist and work withthe client to develop and maintain autonomyand self-determination.

In intervention and treatment plans, socialworkers should strive to

� Use a thorough biopsychosocial–spiritualassessment to craft a service (or treatment)

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plan with the Service Member or Veteran thatdefines measurable goals and hoped-foroutcomes (for clinical social workers)

� Engage clients in a culturally responsivemanner to facilitate attention to goals andprovide culturally sensitive services to ServiceMembers, Veterans, and their family members

� Draw from evidence-based and research-informed practice models when possible tofacilitate the accomplishment of goals

� Select the appropriate practice model for each client

� Prevent further client stressors when possiblethrough a strengths-based approach,recognition of resilient behaviors, andappropriate interventions

� Provide a collaborative, phase-oriented,multimodal approach that addresses the issuesfacing the Service Member, Veteran, andmilitary family members

� Communicate (in clear written and oralstatements) to clients the purpose andavailability of community resources

� Seek consultation on cases, techniques,assessments, or knowledge as deemed relevantby the social worker while maintainingconfidentiality and anonymity, as permitted inthe case

� Safeguard the privacy and confidentiality ofclient information to the extent possible

� Exercise careful, informed judgment and takeresponsible steps to protect clients

� Work in a multidisciplinary team approach toachieve maximum client benefit

� Provide effective clinical case managementservices that facilitate access to a range offinancial, housing, health, mental health,education, and community resources

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� Engage in advocacy with clients when possibleto accomplish the stated treatment goals

� Evaluate the ongoing processes and outcomesof interventions (for clinical social workers).

Standard 6. Practice and Program Evaluation

and Improvement

Social workers working with Service Members,

Veterans, and their families shall be a part of an

ongoing, formal evaluation of their practice to

assess quality and appropriateness of services,

to improve practice, and to ensure competence.

Interpretation

The evaluation of social work practice is a vitalpart of social work service delivery. Themethods used to evaluate such practice includepeer review, self-evaluation, supervision, andother research methods. Increasingly, socialwork outcomes from evaluations are used forposition justification; performance review; andsocial work standards for practice, goal setting,and research efforts. Evaluation practices mayinclude the following:

� Protecting the privacy of the client and theclient system and ensuring consistency withall federal, state, and local legal and statutory,regulatory, and policy requirements and withthe organization’s or facility’s policies onreporting, maintenance of and access torecords, and confidentiality

� Disseminating evaluative data to clients andother professionals when possible andadhering to privacy rights

� Using appropriate tools, such as clinicalindicators, practice guidelines, andstandardized performance assessments (for clinical social workers)

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� Assessing both outcome and process objectives� Involving the Service Member or Veteran,

their family, and colleagues in the evaluation process

� Using external practice evaluators asappropriate

� Participating in social work research specificto practice with Service Members, Veterans,and their families.

Standard 7. Professional Development

Social workers who work with Service Members,

Veterans, and their families shall assume

personal responsibility for their continued

professional development in accordance with

the NASW Standards for Continuing

Professional Education (NASW, 2002) and state

requirements. The systems in which social

workers work with this population are complex

and subject to change, and therefore it is

crucial that social workers remain current in

both theoretical, research, and practical

knowledge of the populations and systems in

which they work and the general network of

psychosocial, health, and mental and

behavioral health services.

Interpretation

To practice effectively, social workers workingwith Service Members, Veterans, and theirfamilies must remain knowledgeable about bestpractice models, emerging innovative models,and changes to the systems in which they work.It is essential for social workers to understandthat health and behavioral health issues relatedto military service evolve over time in waysspecific to a Service Member or Veteran’scombat experience or exposure. Social workersmust remain informed about research and

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evidence-based practice specific to a ServiceMember or Veteran’s health issues. Toaccomplish this goal, social workers shallcontinually seek to improve their practicethrough education and training and to promotethis knowledge with colleagues. Opportunitiesfor enhancing professional identity anddevelopment include the following:

� Actively seeking continuing education,training, and practice opportunities tocontinually enhance knowledge of social workwith Service Members, Veterans, and theirfamilies in areas such as military culture,evolving physical and mental health needs ofclients, and the impact of services provided

� Participating and leading in NASW and otherprofessional organizations and coalitions atlocal, state, and national levels

� Participating in and contributing practiceknowledge regarding social work with ServiceMembers, Veterans, and their families toprofessional conferences, training events, andother activities

� Assisting in the ongoing development of theknowledge base on social work with ServiceMembers, Veterans, and their families bycontributing to professional publications

� Identifying emerging issues and topics relatedto social work with Service Members,Veterans, and their families for professionaldevelopment in research

� Encouraging organizations and institutions tocollaborate, advocate, and provide appropriateeducation on social work with ServiceMembers, Veterans, and their familiesgrounded in practice and implemented insocial work field settings.

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Standard 8. Supervision, Leadership, Education,

and Training

Social workers with expertise in working with

Service Members, Veterans, and their families

have a responsibility to provide leadership for

educational, supervisory, administrative, and

research efforts with individuals, groups, and

organizations that both directly and indirectly

influence this population.

Interpretation

Social workers shall offer their expertise andconsultation to individuals, groups, andorganizations as well as offer education, training,and mentoring opportunities to beginning socialworkers or those transitioning into work withService Members, Veterans, and their familiesand to those who are developing theircapabilities. When able, skilled social workersshall work in conjunction with schools of socialwork and the continuing education communityto advocate for programs in military andVeteran social work and to enhance andencourage interest in this specialization.

Social workers shall offer supervision to practicingsocial workers, interns, and students to provide aguiding expertise to clinicians in this area. Socialworkers shall contribute to research initiatives,not only to demonstrate the efficacy of thesocial work profession and social workinterventions, but also to advance recognitionamong colleagues in other professions of theneed to address the psychosocial needs ofService Members, Veterans, and their families.

Social work leaders typically demonstrateknowledge, skills, and abilities in the following areas:

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� Access to Services and Care: includesinformation for underserved and marginalizedmilitary and Veteran populations

� Consultation: on current best practices inaddressing clinical and related social workpractice approaches to issues facing ServiceMembers, Veterans, and their families.

� Legal, Ethical, and Professional Standards:

including certain aspects of the UCMJ andstandards of documentation and qualityimprovement activities

� Management/Administration: includessupervision, consultation, negotiation, and monitoring

� Policies and Regulations: understanding howthese can affect social work practice and care toService Members, Veterans, and their families;development of and adherence to organizationalpolicies, procedures, and regulations

� Research and Education: within the DoD orthe VA and academic and research institutions

� System Navigation: includes specializedknowledge of how to function within systems,such as the DoD or the VA and relatedagencies and organizations

Standard 9. Documentation

Social workers shall maintain records or

documentation of social work services with

Service Members, Veterans, and their families

that reflect pertinent information for assessment

and treatment of clients and client systems,

social work involvement and outcomes with and

for clients, and legislative and administrative

regulations and policies in accordance with

care goals.

Interpretation

Clear, concise, and organized documentation isthe hallmark of quality social work services andoften serves as the mode of communicationbetween a social worker and other professionalsand clients. There are core elements that needto be included and responsibilities to follow inrecord keeping. Progress notes, reports, andsummaries of services shall be regularlyrecorded and be consistent with all federal, state,and local legal and statutory, regulatory, andpolicy requirements and with the organization’sor facility’s policies on reporting, maintenance ofand access to records, and confidentiality.Policies and procedures shall be developed andimplemented to protect the client’s rights toprivacy, including confidentiality of records andprocedures for release of information.

The elements and responsibilities of thoroughand comprehensive documentation include thefollowing:

� Comprehensive assessment and accounting ofservices delivered to the client and client systems

� Ongoing assessments, interventions, andpractice planning

� Goals and planning that reflect an explicitstatement of agreement with the client, clientsystems, and the treatment team

� Relevant historical information� Referral sources and collaboration� Dates, times, and descriptions of client and

client system contacts� Documentation of outcomes� Reason for case closure or transfer� Awareness of and sensitivity to the impact of

release of records and reporting on militaryservice and careers

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� Mandated reporting requirements (such aschild abuse), duty to warn, and duty to protect

� Written permission to release and obtaininformation, where appropriate

� Documentation of compliance withconfidentiality rights and responsibilities.

Standard 10. Interdisciplinary Leadership and

Collaboration

Social workers should be part of an

interdisciplinary effort for the comprehensive

delivery of services to Service Members,

Veterans, and their families and should strive to

enhance interdisciplinary and interorganizational

cooperation. Social workers shall work in

partnerships with local, state, and federal

organizations relevant to thier clients that

feature mutual respect, shared information,

and effective communication where

appropriate and possible.

Interpretation

As leaders and members of interdisciplinary teams,social workers must be aware of the overallgoals, objectives, and tasks of their practice areaand interpret them to clients, families, and otherrelevant professionals and organizations.

As part of such teams and collaborations, socialworkers shall demonstrate the ability to

� Understand the mission and functions of theinstitution, organization, or group by whichthey are employed

� Understand the role of other relevantprofessions and organizations

� Communicate, cooperate, and collaborateappropriately with other disciplines andagencies

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� Encourage and assist clients in communicatingwith individuals and organizations that couldcontribute to their well-being.

� Ensure that the social work role andresponsibilities are clearly delineated andcommunicated to other members of the team

� Ensure that the roles and responsibilities ofeach collaborating organization are clearlydelineated and communicated

� Communicate the client’s information in arespectful and objective manner and protectthe client’s confidentiality and privacy

� Work together on leadership anddecision-making functions

� Articulate areas of expertise in content areasrelevant to the needs of Service Members,Veterans, and their families.

Standard 11. Cultural Competence

Social workers shall have and shall continue

to develop specialized knowledge and

understanding about history, traditions, values,

and systems as they relate to Service Members,

Veterans, and their families. Social workers

shall be knowledgeable about and act in

accordance with the NASW Standards for

Cultural Competence in Social Work Practice

(NASW, 2001).

Interpretation

Service Members, Veterans, and their families areincreasingly diverse. Social workers shall respectand continually obtain and integrate knowledgeabout how Service Members, Veterans, and theirfamilies are influenced by their professionalcultures, such as characteristics of the branch ofthe uniformed services in which they serve.Social workers recognize that culturalcompetence is never fully realized, achieved, or

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completed but, rather, is a lifelong process forsocial workers, who will always encounterdiverse clients and new situations in theirpractice (NASW, 2001). Social workersapproach their work with a relationally based,culturally responsive, and theoretically informedperspective (CSWE, 2010). They explore,identify, and resolve biases, myths, andstereotypes about military and Veteran culturesand how these cultures interface with thecivilian communities (CSWE, 2010).

In addition, social workers shall recognize thepossibility for discrimination or prejudicetoward clients on the basis of their militaryservice, which can have the same impact andramifications as others forms of discriminationand prejudice, such as those based on race,ethnicity, national origin, geographical location,immigration status, age, religious or spiritualaffiliation, sexual orientation, gender identity,political beliefs, marital status, or mental orphysical disability. Social workers recognize thecomplex confluence of possible discriminationor prejudice based on combinations of the abovepersonal identifiers. Social workers shouldunderstand systems of oppression and how thesesystems might affect client decision making.

Social workers must consider both personal andprofessional cultures, as they both may influencehow a client perceives and accesses social workservices. Social workers who understand howculture affects these decisions and experienceswill be better able to individualize care.Therefore, social workers should be familiarwith the practices and beliefs of the culturalgroups with whom they practice so that they candeliver culturally appropriate services.

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As adapted from the NASW Standards forCultural Competency in Social Work Practice(NASW, 2001), cultural competence andcultural responsiveness involves then following:

� Ethics and Values: to function in accordancewith the values, ethics, and standards for theprofession, recognizing how personal andprofessional values may conflict with oraccommodate the needs of diverse clients

� Self-Awareness: to develop an understandingof one’s own personal and cultural values andbeliefs in regard to Service Members,Veterans, and their families

� Cross-Cultural Knowledge: to have andcontinue to develop specialized knowledgeand understanding about military culture andthe history, traditions, values, and familysystems of Service Members, Veterans, andtheir families

� Cross-Cultural Skills: to use appropriatemethodological approaches, skills, andtechniques that reflect the social worker’sunderstanding of the role of military culturein the helping process and its intersectionwith other diversity factors

� Service Delivery: to be knowledgeable aboutand skillful in the use of services available inthe community and broader society and ableto make appropriate referrals; to understandthe lack of needed resources, particularly inunderserved and/or rural communities

� Empowerment and Advocacy: to be aware ofthe effect of social policies and programs onService Members, Veterans, and theirfamilies; advocating for and with clientswhenever appropriate

� Diverse Workforce: to support and advocatefor cultural diversity in recruitment,

admissions and hiring, and retention efforts insocial work programs and agencies that serveService Members, Veterans, and their families

� Professional Education: to advocate for andparticipate in educational and trainingprograms that help to advance militarycultural competence

� Language Diversity: to seek to provide andadvocate for the provision of information,referrals, and services in the languageappropriate to the client

� Cross-cultural Leadership: to be able tocommunicate information about diverse clientgroups to other professionals.

Standard 12. Advocacy

Social workers have a responsibility to

advocate for the needs and interests of Service

Members, Veterans, and military family clients.

Interpretation

Social workers should advocate to ensure that all people have equal access to the resources,employment, services, and opportunities theyrequire to meet their basic human needs and todevelop fully (NASW, 2008). Social workershave a special responsibility to advocate for theneeds of all clients, particularly those who aredisenfranchised or most vulnerable, at both themicro and macro levels. Social workers willidentify barriers to services and actively seek toresolve them. The responsibility to advocate forquality improvement also implies a responsibilityfor social workers to act as advocates to expandthe role of the profession, develop leadershipprograms, and mentor new professionals. Social workers who work with ServiceMembers, Veterans, and their families shall use their best professional judgment whenchoosing advocacy activities.

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Social workers working with Service Members,Veterans, and their families shall

� Help clients and their families to negotiatetheir goals of care and navigate throughsystems of care

� Help clients to gain access to and effectivelyuse formal and informal community resourcesthat enable Service Members, Veterans, andtheir families to self-advocate

� Identify barriers to care and needs from theclient’s perspective and define resources andservices that are not readily available

� Work with clients so that they can becometheir own best advocates and advocate ontheir behalf when appropriate

� Engage and build collaborations with externalorganizations and agencies to create the bestpossible service delivery and advocacy systems for clients

� Be aware of court decisions, budget decisions,legislation, rules and regulations, and policiesand procedures that affect social work withService Members, Veterans, and their familiesand provide feedback when possible

� Identify allies at local, state, and federalgovernment levels to support causes,initiatives, legislation, and policies that are key to this population

� Follow and understand the policy agendasand positions of elected officials

� Participate in or be aware of governmentalhearings and briefings and provide testimonyand commentary when possible

� Understand advocacy from the micro andmacro level, or from “case to cause”

� Advocate to expand the role of the profession,develop leadership programs, and mentornew professionals

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� Serve as public spokespeople helping toeducate colleagues, the media, alliedprofessionals, decision and policymakers, andother stakeholders on the unique needs of thispopulation and the important role ofprofessional social work

� Understand how budget considerations affectthe profession and this population andadvocate for enhanced funding for social workservices when necessary

� Remain up to date on relevant news anddevelopments affecting this population andthe profession

� Understand the limits of advocacy foractive-duty Service Members or others on thebasis of their professional roles.

References

ABC News. (2011). U.S. Veterans: By thenumbers. Retrieved from http://abcnews.go.com/Politics/us-veterans-numbers/story?id=14928136

Council on Social Work Education. (2010).Advanced social work practice in military social work.Alexandria, VA: Author.

Franklin, E. (2009). The emerging needs ofVeterans: A call to action for the social workprofession [Guest Editorial]. Health & SocialWork, 34, 163–167.

Jaycox, L.H., & Tanielian, T. (2008). Invisiblewounds of war: Psychological and cognitive injuries,their consequences, and services to assist recovery.Santa Monica, CA: RAND Corporation.

National Association of Social Workers. (2001).NASW standards for cultural competence in socialwork practice. Washington, DC: NASW Press.

National Association of Social Workers. (2002).NASW standards for continuing professionaleducation. Washington, DC: NASW Press.

National Association of Social Workers. (2008).Code of ethics of the National Association of SocialWorkers. Washington, DC: NASW Press.

National Association of Social Workers. (2011a).Dorothy I. Height and Whitney M. Young, Jr.Social Work Reinvestment Act (H.R. 1106 & S.584—112th Congress) important points. Retrievedfrom www.socialworkreinvestment.org/2011/documents/SWRA%20Important%20Points%20112th%20Congress.pdf

National Association of Social Workers.(2011b). Social workers in government agencies:Occupational profile. Washington, DC: NASWCenter for Workforce Studies.

U.S. Department of Veterans Affairs. (2012).History VA social work: Social work in theDepartment of Veterans Affairs. Retrievedwww.socialwork.va.gov/about.asp

U.S. Department of Veterans Affairs, NationalCenter for Veterans Analysis and Statistics.(2009). Profile of Veterans: 2009: Data from theAmerican Community Survey. Retrievedwww.va.gov/vetdata/docs/SpecialReports/Profile_of_Veterans_2009_FINAL.pdf

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White House Joining Forces Initiative. (2011,January). Strengthening our military families:Meeting America’s commitment. Retrieved fromwww.whitehouse.gov/sites/default/files/rss_viewer/strengthening_our_military_families_meeting_americas_commitment_january_2011.pdf

Resources

National Association of Social Workers:

socialworkers.org/military.asp 202.408.8600

NASW’s military Web page offers additionalresources and information for social workerswho work with, or would like to work with,Service Members, Veterans, and their loved ones.

Council on Social Work Education: cswe.org

The Council on Social Work Education(CSWE) is the accrediting agency for socialwork education in the United States. CSWEoffers competencies in advanced social workpractice in military social work.

Defense Centers of Excellence: dcoe.health.mil/

Center for Deployment Psychology:

deploymentpsych.org

The Center for Deployment Psychologytrains military and civilian behavioral healthprofessionals to provide high-qualitybehavioral health services to ServiceMembers, Veterans, and their families tobetter address the unmet need fordeployment-related behavioral health services.

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Center for the Study of Traumatic Stress:

centerforthestudyoftraumaticstress.org

The Center for the Study of Traumatic Stressworks to advance psychological health byproviding research, education, andconsultation on trauma exposure.

Defense and Veterans Brain Injury Center:

dvbic.org

The Defense and Veterans Brain InjuryCenter works to treat, support, train, andmonitor service members, veterans, theirfamilies, and medical providers who have been affected by, work with, or care formilitary personnel diagnosed with traumaticbrain injuries.

Deployment Health Clinical Center:

pdhealth.mil

The Deployment Health Clinical Centerprovides information for health careproviders, Service Members, Veterans, andtheir families about deployment health andhealth care and assists clinicians with thedelivery of postdeployment health care.

National Center for Telehealth and

Technology: t2health.org

The National Center for Telehealth andTechnology is a leader in the development oftelehealth and technology for psychologicalhealth and traumatic brain injuries.

National Intrepid Center of Excellence:

nicoe.capmed.mil/SitePages/Home.aspx

The National Intrepid Center of Excellencesupports the families of military personnelwho were lost in service or were severelywounded while serving their nation.

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Department of Defense Social Work Careers:

Air Force: airforce.com/careers/detail/

clinical-social-worker

Army: amedd.army.mil/r2d/social_work.html

Navy: navy.com/careers/healthcare/

clinical-care/social-work.html

Give an Hour: giveanhour.org

Give an Hour is a nonprofit organization whosemission is to develop national networks ofvolunteers capable of responding to the mentalhealth needs of Veterans and their loved ones.Clinical social workers may volunteer to providefree mental health services to U.S. militarypersonnel and families affected by the conflictsin Iraq and Afghanistan.

Joining Forces: joiningforces.gov

Joining Forces is a national initiative, created byFirst Lady Michelle Obama and Second LadyDr. Jill Biden, to mobilize all sectors of societyto give our Service Members and their familiesthe opportunities and support they have earned.

TRICARE: tricare.mil

Substance Abuse and Mental Health Services

Administration (SAMHSA) Technical Assistance

Packet on becoming a TRICARE provider:

thenationalcouncil.org/cs/resources_services/

becoming_a_tricare_provider#ta_packet

TRICARE is the military health benefit for over9.6 million beneficiaries comprising active-dutyService Members, retirees, and their familymembers. This health benefit for private sectorcare includes mental health and substance abusecare. Services are provided by authorizedTRICARE providers outside of militarytreatment facilities throughout the United Statesand overseas.

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Under TRICARE, clinical social workers can beauthorized to serve this beneficiary populationand receive reimbursement when certain criteriaare met. Certified clinical social workers areauthorized to assess or diagnose illness and toestablish, manage, and efficiently implement aplan-of-care and render allowable services.(Patients’ organic medical problems mustreceive appropriate concurrent management by a physician.)

United States Department of Veterans Affairs:

va.gov

VA Social Work: socialwork.va.gov

Social workers work in every VA MedicalCenter, Vet Center, and in manycommunity-based clinics.

VA Mental Health: mentalhealth.va.gov

The Office of Mental Health Services’mission is to maintain and improve the health and well-being of Veterans throughexcellence in health care, social services,education, and research.

VA Caregiver Support: caregiver.va.gov

855.260.3274

Support and services for family caregivers are offered by the VA.

VA National Center on Homelessness

Among Veterans:

va.gov/homeless/nationalcenter.asp

The National Center on HomelessnessAmong Veterans is working to meet theDepartment of Veterans Affairs’ Five YearPlan to End Homelessness by providingrecovery-oriented care for homeless or at-risk Veterans.

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Veterans Crisis Line: veteranscrisisline.net;

800-273-8255; text:VETALK (838255)

The Veterans Crisis Line/Chat/Text isavailable for Veterans, families, and caregiversin crisis. Trained, caring VA professionals areavailable 24 hours a day, 7 days a week, and365 days a year.

Vet Centers: 877-WAR-VETS

For Veterans who have served in any combatzone, Vet Centers are in communities to helpthem and their families with readjustmentcounseling and outreach services.

VA Clinical Practice Guidelines:

healthquality.va.gov

Evidence-based interventions and skill sets thatare aligned with the VA/DoD Clinical PracticeGuidelines can address signature injuries and themore commonly experienced illnesses,depression, anxiety, and substance abuse disorders.

Iraq War Clinician Guide:

ptsd.va.gov/professional/manuals/iraq-war-

clinician-guide.asp

This manual, developed with the Departmentof Defense, addresses the unique needs ofVeterans of the Iraq and Afghanistan wars.

National Center for PTSD: ptsd.va.gov

The National Center for PTSD is the center ofexcellence for research and education on theprevention, understanding, and treatment ofPTSD.

Returning Service Members (OEF/OIF):

oefoif.va.gov/index.asp

Returning Service Members provides servicesand resources for Service Members returningfrom Iraq and Afghanistan.

NATIONAL ASSOCIATION

OF SOCIAL WORKERS

750 First Street, NE

Suite 700

Washington, DC 20002-4241

202.408.8600

SocialWorkers.org