LOOKING FOR A WAY TO GET BACK HOME VIGNETTE LEARNING POINTS

Issues Raised in Vignette Robert Holiday was raised in 18 different foster homes, where he was physically, sexually and emotionally abused by foster parents and street gang members. Living a precarious life on the streets, he survives by becoming streetwise, also he was proficient in basketball and wrestling, and by maintained a strong faith in God. With dreams of a career in professional basketball put on hold, he desperately searches for meaning in life and wants to prove that he can succeed. Robert is recruited into the Army Special Forces by a savvy recruiter who appeals to his athleticism and street smarts.

Robert is assigned dangerous missions in Iraq. Robert has found a surrogate family in the Army, and his loyalty and bravado does not waiver when ordered to take on the enemy. While serving as a sniper during one mission, he is ordered but refuses to withdraw from his position. In the ensuing air strike, he is pummeled by falling concrete when the attack aircraft destroys a building next to his position. Robert is struck on the head by concrete chunks from the air strike, and suffers a Traumatic Brain Injury resulting in temporary loss of consciousness, disorientation, impaired judgment, confusion and visual impairment.

While recovering suffers from confusion. When another soldier offers his medications to Robert, he calmly and without question takes them. Despite his cloudy sensorium, Robert supports Chaplain Kelly’s decision to refuse to bear arms during a surprise attack on the hospital compound. Robert stays by the chaplain’s side after the angry Sergeant Major leaves in disgust, having been refused by the Chaplain. Still suffering from confusion due to the head injury, Robert is discharged from the Army, and becomes a homeless alcoholic on the streets of Skid Row. He is frustrated, angry, and discouraged.

He talks to a helpful Veteran Benefits Counselor who assists him in applying for the disability evaluation process, and refers Robert to a therapist. Robert seeks counseling with an empathic psychologist who helps him discover the ability to trust in himself. The therapist also helps him connect his early history of abuse and lack of support with his current stressors. He is hired as a Vet-to-Vet Counselor, maintains his sobriety, regains hope and develops self-worth by reaching out to other veterans who are struggling on the streets.

Issues Addressed in Therapy Robert suffers from an early traumatic history of deprivation and abuse. The effects of abusive foster parents, beatings from gang members, the premature loss of his mother and grandmother, as well as the trauma of surviving 18 foster placements. He has trust issues. Robert has poor impulse control, resulting in constant combat. His assets are his street smarts and his relationship with God.

Robert receives emergency assistance from an empathic Veterans Outreach Counselor. The importance of benefits counseling and application for homeless Veterans resources become evident to Robert at the hands of a good counselor. An astute psychologist helps Robert to deal with issues of trust, goal setting and self-management. Robert reveals his awareness of his combat related experiences of trauma and loss.

He discovers self-worth and competency during the readjustment process by reaching out and helping others. With Traumatic Brain Injury, Robert could have benefited from a referral to a VA Medical Center for assessment and follow-up appointments. An alcohol and drug abuse counselor, AA or NA Meetings could have helped him also.

Questions What engagement skills worked? What could have been done better? What’s your hypothesis for his future?