Many online resources that promote mental health recovery for veterans and their families reflect the influence of WRAP and the ethics and values it embraces. U.S. Department of Veterans Affairs (VA) centers in Florida, California, Washington, D.C., Vermont, Ohio, Massachusetts, Idaho, and other states offer peer support services, including regularly facilitated WRAP groups. Veterans Health Administration (VHA) clinical guidelines for major depression, posttraumatic stress disorder (PTSD), bipolar disorder, and substance use disorders all recommend “patient self-management support that helps people identify early warning signs and intervention strategies.” The VHA online library offers an overview of peer support programs and services:
VA has hired Veterans who are in recovery. These Veterans have a lived mental health experience. Veteran staff in recovery help you with your recovery. You may choose to involve Peer Support in your Individual Recovery Plan.
After Deployment, the U.S. Department of Defense (DOD) website for self-care solutions to mental health problems that follow deployment, features a peer-to-peer forum that includes the anonymous post below.
Developing a recovery lifestyle using WRAP and other mental health tools has proven to be effective when it comes to dealing with the traumas of combat…. The VA and community mental health service providers are now utilizing the value of Veterans helping Veterans by hiring Veteran Peer Specialists. I encourage more Veterans to become Peer Specialists and I encourage our OEF/OIF Veterans and their families to get the support that will help you to have wellness in your lives.
I wanted to understand more about the reasons for this strong affinity and learn about how WRAP is being implemented in the VA system, so I contacted Larry Buttel, an advanced WRAP facilitator and peer support specialist at the VA Medical Center in Boise, Idaho.
Larry was incredibly generous with his time, despite the demanding WRAP facilitation schedule he and the two other members of his team maintain. WRAP is offered quarterly to veterans with general mental health issues, monthly to vets in the residential substance use disorder treatment program, and every 60 days to the residential PTSD treatment program. These individuals consistently ask Larry two questions after they complete WRAP:
1) Why didn’t I get this 20 years ago?
2) When can I take this again?
Larry spoke about his work at VA with a contagious enthusiasm I recognized immediately. It comes from the unique experience of sharing a simple set of strategies that have been effective in your life with those who face similar challenges and experiencing the satisfaction of seeing it work for them. “I am so passionate about this, I have a tendency to take off like a roman candle,” he said. “I have learned to yield the floor and to become a better listener.”
Larry’s participation in the Copeland Center for Wellness and Recovery trainings on storytelling and leadership helped him fulfill one of the mandates of his position at VA—“to model recovery shoulder to shoulder.” When I asked him about the reasons WRAP works so well with veterans, he responded by paraphrasing Gina Calhoun, National Director for Wellness and Recovery Education at the Copeland Center—because the focus is on what’s strong instead of what’s wrong. Veterans are responsive to the idea of regaining a measure of control by applying skills they already possess. WRAP is simple and flexible, and its application is highly individualized.
I asked Larry if they have adapted or tailored the training to their audience. He indicated that when it’s delivered to cohorts that are already in a 30- to 60-day residential treatment program, they can skip many of the ice-breakers and games and streamline some of the activities. However, they maintain a high degree of fidelity and have resisted pressure to scale down the 16 hours required.
The elements that challenge veterans are generally related to building and using a support system. Larry points out that military culture is predicated on looking out for others: concern for the soldier on your right and the soldier on your left is paramount. He likes to help participants see that other people also want the opportunity to support them. Sometimes it’s difficult for people who have faced mental health challenges to recall what they’re like when they’re well, but an abundance of hope and humor helps the group address these issues. In addition, WRAP and Recovery Books offers many materials to support veterans and people in the military in applying WRAP to their lives.
Larry and his team work with the Veterans Justice Outreach Program to include justice-involved veterans in community-based WRAP trainings that are offered twice a year. In 2017, the team is coordinating a WRAP facilitator training for other VA peer support programs in states within their region. They are working with Alaska, Oregon, and Washington via monthly planning calls. Larry believes that, although resources are limited, WRAP’s potential to benefit the veteran population is unlimited.