The Veteran Supported Education Service Treatment Manual: VetSEd

Evidence-Based Practices for Treating Mental Illness, Substance Abuse and Co-
Occurring Disorders
As you work with Veterans enrolled in a SEd program who have mental illness,
substance abuse, or COD, it will be helpful for you to have a general understanding of
some of the evidence-based practices used to treat substance abuse and mental illness. In
this section, we will briefly discuss some these approaches. Because an exhaustive
description of all evidence-based practices used to treat mental illness and substance
abuse is beyond the intent of this section, we strongly encourage you to visit the
Substance Abuse and Mental Health Services Administration (SAMHSA) Web site
www.samhsa.gov for further information.
iv.
Approaches to Mentoring Veterans with Co-Occurring Disorders
Current approaches to treating Veterans with co-occurring disorders are described below.
Motivational Enhancement
Motivational Enhancement is designed to enhance motivation by helping Veterans
resolve ambivalence about addressing and ultimately changing their problem behaviors
(e.g. substance abuse; or perhaps more commonly found in your work, completing
assignments throughout the semester rather than going out for drinks with buddies).
Motivational Enhancement techniques are also designed to enhance rapport between
Veterans and helpers, such as VetSEd providers, and are particularly useful during initial
sessions. The acronym ―OARS‖ is used to identify the fundamental skills of
Motivational Enhancement: Open-ended questions, Affirming, Reflective listening, and
Summarizing.
Open-ended questions
Open-ended questions are questions that are designed to encourage Veterans to elaborate
about their thoughts and feelings and provide details about their situations. In other
words, open-ended questions stand in opposition to questions that ask for a simple "yes"
or "no" response from the client. Additionally, open-ended questions should not sound
judgmental. For example, unless the Veteran has expressed concern about his/her
drinking, the question ―What do you intend to do about your use of alcohol?‖ will only
elicit client resistance. Open-ended questions are designed to help create internal
motivation for change. Questions that sound judgmental will only cause clients to resist
their treatment provider‘s influence. More is said about how to deal with such resistance
below.
Affirming
Affirmations are a way of validating a Veteran‘s experiences and/or feelings, and to also
indicate that you are present and focused. However, it is important to note that this does
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