Joy McCrady, Jill L. Snodgrass, Ph.D.
Pastoral Counselors As Veteran Advocates: PTSD, DSM-5, and the Ecological Model
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Poster objectives include the following:
• Identify potential impacts to the U.S. military and veteran population for assessment
and diagnosis for Posttraumatic Stress Disorder (PTSD) as redefined in the DSM-5
• Name various ways pastoral counselors can become equipped and advocate for this
population
• Gain an understanding of key ways to advocate for this population using Bronfenbrenner’s
ecological systems theory (Santrock, 2011)
Background
A new chapter on Trauma- and Stressor-Related Disorders has been established in the
DSM-5 to differentiate that an adverse, traumatic event is the reason for the onset
of symptoms of Posttraumatic Stress Disorder (PTSD). In the last decade, the United
States government has deployed hundreds of thousands of military personnel and civilians
to Iraq and Afghanistan, many of whom have experienced traumatic events in combat.
While PTSD has not been a new diagnosis for combat veterans who have served in previous
wars, attention has been brought to this new cohort due to the length of the conflicts,
the number of deployments, and the deterioration of traditional combat zones and rules
of engagement. The changes to PTSD in the DSM-5 could have positive and adverse effects
regarding research methods, access to care, and appropriate treatment methods for
this population. Pastoral counselors and other mental health professionals can work
to advocate for this population regarding reducing the stigma of PTSD diagnosis, improving
access to care, and contributing to research to improve treatment methods.
Research and Advocacy Summary
A compilation of secondary research was analyzed regarding the changes to PTSD for
the DSM-5, PTSD diagnosis and treatment methods for military returnees from Afghanistan
and Iraq, and various barriers to care for this population including stigma, proximity
to care, and gender and ethnicity. A summary of ways in which counselors can advocate
for this population were distilled from a synthesis of these data and methods. Since
trauma not only impacts the individual, but every system, Bronfenbrenner’s ecological
theory of development model (Santrock, 2011) was applied to illustrate counselors’
opportunities to treat and advocate for this cohort from the microsystem through the
chronosystem.