The Veteran Supported Education Service Treatment Manual: VetSEd

As you are likely to have Veterans on your VetSEd caseloads who are also receiving VA
Substance Abuse and Mental Health Treatment Services, you should be aware of the
philosophies and approaches used to treat co-occurring disorders. This is particularly
important when working with Veterans who have serious mental illnesses (SMI), as
substance abuse is the most common co-occurring disorder among individuals with SMI
(Brunette, Mueser & Drake, 2004; Adams et al, 2007).
Treatment Philosophy and Approaches
For the past 30 years, addictions researchers and mental health treatment providers have
been developing and testing various therapeutic approaches and clinical interventions to
better assist individuals with mental illness, substance abuse, and COD (Smelson et al.,
2011). As a peer VetSEd provider, it is very likely that you will interact with Veterans
who have a mental illness, struggle with substance abuse, or both. Therefore, in the
remainder of this section, we will place a great deal of focus on addressing COD among
Veterans participating in SEd programs. Moreover, you may find some of the
motivational approaches included here to be useful in your work linking Veterans to
educational programs.
When working with Veterans with a substance abuse history or current problem, you are
strongly encouraged to embrace a harm reduction approach in addressing substance
abuse. A harm reduction approach is one that is based on the recovery principles, most
notably the principles of self-direction and individualized care. While it may be tempting
as a peer VetSEd provider to tell Veterans who are engaging in illicit substance use that
they simply need to quit or get help if they want to do well in school, such a statement
from you would likely be perceived as judgmentmetal by the Veteran. However, using a
harm reduction philosophy, you might use Motivational Interviewing (MI) strategies to
engage Veterans in conversations about ways they might be able to reduce the impact of
their substance use on their educational goals. The strategies listed below can help you
minimize judgment and maximize the Veteran‘s engagement with VetSEd:
Try to understand where the Veteran is coming from and their own experience of
substance use. You can do this by asking open-ended questions and asking the
Veteran if they believe their substance use is affecting any important areas of their
lives.
Use Motivational Interviewing techniques to determine how important it is for a
Veteran to decrease or get a better handle on their substance use. If a Veteran
states mid- to-high importance, it is good to follow-up with a question about their
confidence with meeting their short-term substance use reduction goal.
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