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MRE Practice Guidelines: The Military Intake Interview

MRE Practice Guidelines: The Military Intake Interview

Mark A. Stebnicki, Ph.D., LPC, DCMHS, CRC, CMCC

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Introduction to the Military Intake Interview

            The intake interview is critical in understanding your service member or veterans’ current medical, physical, psychosocial, vocational, family, and socio-cultural status as it relates to their military service. Military-specific intake interview questions are one of the most effective means to assess a range of critical life-events as it relates to your clients’ military life. Most standardized diagnostic tools do not address military mental health, career development as the service member transitions to civilian life, family dynamics within the deployment cycle, and other critical elements in military life. Thus, competent CMCC’s use person-centered skills facilitating attending, listening, and empathic responding to build rapport and gain the circle of trust with their military clients.

The content revealed within each of the questions listed below should yield many relevant details about the individual service member or veteran’s background. This should ultimately assist in developing the client’s treatment plan and help identify resources, coping and resiliency skills, as well as other unused opportunities. A word of caution should be noted during the intake interview. Military counselors should not expect or anticipate full disclosure of information during the intake interview (i.e., where are you being deployed? What is your specific mission?). This is because service members cannot disclose many categories of information as it relates to military confidentiality, security clearances, and any matters relating to national security interests. Some of these categories include, but are not limited to, geographic location of their mobilization, deployment, or mission, the nature and extent of their work and what they did on their mission, the types of tools, knowledge, machinery, weaponry, computer programs, or other materials they dealt with while in garrison or in combat theater of operations. Accordingly, the lack of disclosure should not be viewed as client reluctance, resistance, or defensiveness.

Military Sexual Trauma in the Intake Interview

It is of paramount importance to understand that women in the military, as well as members of various minority groups (i.e., African-Americans, Latinos/as, LGBT), may have experienced military-life much differently. Particularly, female service members are four times more likely than males to experience military sexual trauma (MST) and intimate partner violence (IPV) (Iverson, Mercado, Carpenter, & Street, 2013). Accordingly, intake interview questions for female service members and veteran clients should integrate questions related to the exposure of any interpersonal violence and/or sexual trauma. It is also important to ask questions related to any history of childhood or adult sexual abuse, sexual harassment, or assault by males during training or while deployed.  MST questionnaires often times include specific questions such as:

  • While in the military have you/did you receive uninvited and unwanted sexual attention such as touching or cornering pressure for sexual favors, or verbal remarks?
  • Did someone ever use force or the threat of force to have sexual contact with you?
  • How did you respond to these critical incidents?
  • Did you report any of these incidents? What was the response to your reporting?

If the person responds in the affirmative to any of these questions, then the military counselor must also consider these extraordinary stressful or traumatic life-events in planning for treatment. The exposure, experience, and response to incidents of military sexual trauma, assault, or harassment vary individually. Overall military counselors must consider the unique experience of the individual before suggesting or inferring any conclusions, attribution of feelings/emotions, and the person’s overall experience of their life in the military.

Intake Questions for Military Clients

The following sample intake questions assume that you have already completed the traditional intake demographic questions with your military clients (i.e., age, education, marital status, medical/physical/mental health conditions, previous treatment, current medications). It is also anticipated that the sample military intake interview questions may require follow-up information for clarification; some of which can be used in treatment planning. It is critical to re-emphasize that earning the circle of trust is foundational in establishing rapport and achieving an optimal working alliance with your military client. For many therapists, the art of listening is the toughest skill of all to facilitate. Many of the sample questions will be answered by your client if you use the optimal skills of attending, listening, and empathy. The use of open-ended questions yield the best results. This is because close-ended questions many times can be experienced by clients as too directive, intrusive, and at times feels like they are being “examined” or “analyzed”. So approach your military client with a person-centered focus and listen objectively and unconditionally. It is essential to listen for your military client’s unstated responses, what they may be stating indirectly, and any coping or resiliency skills they may have overlooked.

General Intake Qs:

  • What is/was your MOS (Military Occupational Service- Army and Marines)?
  • What is/was your RATE (Navy pay grade) or Rating (Navy occupational service)?
  • What is/was your AFSC? (Air Force Specialty Code)?
  • What is/was your rank at the time of separation from service?
  • Where did you do your basic training?
  • What advanced training schools have you completed?
  • Do you have any academic work towards college credit, degrees, and/or certifications?
  • Where did you earn these degrees? Take classes while deployed?
  • Do you (have you ever) used the VA for services?
  • Have you ever received mental health services before? Where (Base Chaplain, MFLC)?

Family-relational Qs:

  • Are you (were you) married or dating during your time in the service (or during your deployment)?
  • How did you communicate with family and friends (text, Cell/Sat phone, Skype, Fb)?
  • How frequently did you communicate?
  • How would you describe the quality of these interactions and communications?
  • Where there any critical or stressful life-events that happened while you were deployed?

Deployment-related Qs:

  • Where have you been deployed? [Combat, Non-combat vs Humanitarian]
  • Any experiences that you remember that caused negative or disturbing memories?
  • Where you deployed OCONUS in a combat zone (ground troops infantry primarily) combat space (Navy Air Force)? F.O.B. (Forward Operating Base) Rear Base?
  • Did you go on combat missions, patrols, stand guard, Your job?
  • Have you ever been surrounded by the enemy? Blown up? Under fire?
  • Have you witnessed the death or serious injury of anyone in your unit?
  • Have you talked to anyone about these experiences?
  • Any unwanted sexual advances, intimidation, harassment, assault?

References

Iverson, K.M., Mercado, R., Carpenter, S.L., & Street, A.E. (2013). Intimate partner violence among women veterans: Previous interpersonal violence as a risk factor. Journal of Traumatic Stress, 25, 767-771.

Stebnicki, M.A. (2016). Military counseling. In I. Marini & M.A. Stebnicki The professional counselors desk reference (pp. 499- 506). New York: Springer Publishing.

Veterans Administration Community Provider Toolkit (2019): https://www.mentalhealth.va.gov/communityproviders/

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