Mark DeKraai

Chaplaincy and Mental Health in the Department of Veterans Affairs and Department of Defense

Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: 1) input from key subject matter experts; 2) quantitative data from the VA / DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and 3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

Liability in Child Therapy and Research

Three areas with special relevance to liability and child therapy are considered: informed consent, confidentiality, and child-abuse reporting laws. In each area, issues that may be confronted in therapy or in research on therapy are discussed, and a sampling of relevant laws is explored. Suggestions for avoiding potential liability and protecting the interests of minor clients are considered.

Confidentiality and Mental Health/Chaplaincy Collaboration

Confidentiality can both facilitate and inhibit working relationships of chaplains and mental health professionals addressing the needs of service members and veterans in the United States. Researchers conducted this study to examine opportunities for improving integration of care within the Department of Defense (DoD) and Department of Veterans Affairs (VA). Interviews were conducted with 198 chaplains and 201 mental health professionals in 33 DoD and VA facilities. Using a blended qualitative research approach, researchers identified several themes from the interviews, including recognition that integration can improve services; chaplaincy confidentiality can facilitate help seeking behavior; and mental health and chaplain confidentiality can inhibit information sharing and active participation on interdisciplinary teams. Cross-disciplinary training on confidentiality requirements and developing policies for sharing information across disciplines is recommended to address barriers to integrated service delivery.

Faith-based organizations in a system of behavioral health care

Through community service activities, and ministries to members within their congregations, faith communities will encounter individuals with behavioral health needs. This article suggests that faith communities have inherent resources that can enhance the reach and effectiveness of behavioral health systems. A framework is presented that will create a bridge of understanding about how behavioral health can leverage faith organization assets and how faith organizations can actively assist adults, children and families with behavioral health needs within the context of their faith and their community.

Perceived Impacts of a Public Health Training Center Field Placement Program among Trainees: Findings from a Small Group Externship Experience.

There is heightened interest in identifying the impact of the federally funded Public Health Training Center (PHTC) program. Although evaluation studies have been conducted of public health training in general, evaluations of PHTC programs are rare. Field placement components are congressionally mandated requirements of PHTCs. Field placements are typically intensive, supervised externships for students to gain public health experience with local health departments or non-profit organizations. We have found no published evaluations of PHTC field placement components. This may be because of their small size and unique nature. We designed and evaluated a 200-h field placement program at an established PHTC. The evaluation included pre/post surveys measuring public health core competencies, and post-experience interviews. We found significant increases in three competency domains among trainees: policy development and program planning, communication skills, and community dimensions of practice. These outcomes contribute to evidence based on the efficacy of PHTC field placement programs, and underscore their role in public health training.