How to Access Family Counseling for Vets

by

The transition from military to civilian life can present unique and significant challenges for veterans and their families. While veterans often carry the visible and invisible wounds of service, their family members frequently experience their own set of struggles, from navigating new family dynamics to coping with the ripple effects of trauma, stress, and reintegration difficulties. Family counseling plays a crucial role in bridging these gaps, fostering understanding, and building resilience within the family unit. This guide provides a comprehensive roadmap for veterans and their loved ones to access the vital support they need.

Understanding the Need for Family Counseling

Military service profoundly impacts not just the individual but also their entire family. Deployments, combat exposure, military sexual trauma (MST), and the constant demands of military life can lead to a range of issues that manifest long after a service member returns home. These can include:

  • Post-Traumatic Stress Disorder (PTSD): A common challenge, PTSD can lead to symptoms like flashbacks, nightmares, hypervigilance, irritability, and emotional numbness, which can strain relationships and create a sense of distance within the family.

  • Traumatic Brain Injury (TBI): TBI can result in cognitive, emotional, and behavioral changes, affecting communication, memory, and personality, often requiring significant adjustments from family members.

  • Depression and Anxiety: The stresses of service and reintegration can trigger or exacerbate depression and anxiety, leading to withdrawal, mood swings, and difficulty engaging in family life.

  • Substance Use Disorders: Some veterans turn to alcohol or drugs to cope with trauma or stress, creating further instability and challenges for their families.

  • Communication Breakdown: Service members often develop a different communication style in the military, which can clash with civilian family dynamics, leading to misunderstandings and unresolved conflicts.

  • Role Changes and Readjustment: The return of a service member can disrupt established family roles and routines, requiring a period of readjustment that can be stressful for everyone involved.

  • Secondary Trauma: Family members, particularly spouses and children, can experience vicarious or “secondary” trauma from living with a veteran who is struggling with mental health issues.

  • Grief and Loss: Families may grieve the loss of the person their loved one was before service, or the loss of a “normal” family life due to the ongoing challenges.

Family counseling offers a safe and structured environment for families to address these complex issues together. It’s not about assigning blame but about fostering empathy, improving communication, developing coping strategies, and rebuilding a stronger, more cohesive family unit.

Avenues for Accessing Family Counseling

Accessing family counseling for veterans involves navigating a landscape of options, primarily through the Department of Veterans Affairs (VA) and various non-VA organizations. Understanding the pathways and eligibility criteria is the first step toward finding the right support.

1. Department of Veterans Affairs (VA) Services

The VA is the primary provider of healthcare for veterans, and its mental health services extend to family members in various capacities.

Vet Centers

Vet Centers are community-based counseling centers offering a wide range of social and psychological services, often located closer to where veterans and their families live than larger VA medical centers. They are a particularly accessible option for family counseling.

  • Eligibility: Vet Centers provide confidential counseling, community engagement, and referral services to eligible individuals and their families. You do not need to be enrolled in VA healthcare or have a service-connected disability to receive services at a Vet Center. Eligibility for veterans typically includes having served in a combat theater or area of hostility, experienced military sexual trauma (MST), provided mortuary services or treated war casualties, or performed on an unmanned aerial vehicle crew providing operations support in a combat theater. Family members are generally eligible if their counseling supports the growth and goals of the veteran or service member.

  • Services Offered: Vet Centers offer a relaxed, confidential setting for:

    • Individual Counseling: For veterans or family members.

    • Group Counseling: Often theme-based (e.g., PTSD, grief, military sexual trauma).

    • Marriage and Family Counseling: Focused on improving communication, resolving conflicts, and navigating the impact of military service on family dynamics.

    • Bereavement (Grief) Counseling: For families coping with loss.

    • Referral Services: Connecting families to other VA or community benefits and services, including medical and benefits referrals, and employment assessment and referral.

  • Cost: Services at Vet Centers are free of charge to eligible individuals and their families.

  • How to Access:

    1. Find a Vet Center: Visit the VA’s Vet Center website or call their 24/7 Vet Center Call Center at 1-877-927-8387. This call center is staffed by veterans and family members of veterans who can discuss your military experience or other concerns during your transition.

    2. Contact the Center: Once you locate a Vet Center, you can call or visit in person to schedule an initial consultation. They will guide you through the eligibility verification and intake process.

    3. Initial Assessment: A counselor will conduct an initial assessment to understand your family’s needs and recommend appropriate services.

VA Medical Centers (VAMCs)

VA Medical Centers offer a broader range of mental health services, including family therapy, as part of their comprehensive healthcare system.

  • Eligibility: Access to family counseling through VAMCs typically requires the veteran to be enrolled in VA healthcare. Eligibility for VA healthcare is based on several factors, including service history, discharge status, income, and the presence of a service-connected disability. While family members can participate in therapy that supports the veteran’s treatment plan, their direct eligibility for individual services may vary.

  • Services Offered: VAMCs provide:

    • Family Therapy: Sessions focused on improving communication, resolving conflicts, and helping family members understand the unique challenges veterans face, such as PTSD, TBI, or other mental health conditions.

    • Couples Counseling: Specifically for the veteran and their spouse or partner.

    • Caregiver Support Programs: The VA Caregiver Support Program offers training, educational resources, and mental health counseling for eligible family caregivers. This program can also provide a monthly stipend and access to healthcare benefits (CHAMPVA) for primary caregivers.

  • Cost: For service-connected conditions, healthcare, including mental health services, is generally free. For non-service-connected conditions, copays may apply depending on the veteran’s priority group and income level. Family counseling provided as part of a veteran’s treatment plan is typically covered.

  • How to Access:

    1. Enroll in VA Healthcare: If the veteran is not already enrolled, they must apply for VA healthcare. This can be done online, by mail, or in person at a VA medical facility.

    2. Consult with a VA Primary Care Provider or Mental Health Clinician: Once enrolled, the veteran should discuss their family’s needs with their VA primary care provider or a mental health clinician. They can provide a referral for family counseling.

    3. Apply for Caregiver Support (if applicable): If a family member is a primary caregiver for a veteran with significant care needs, they and the veteran can apply together for the Program of Comprehensive Assistance for Family Caregivers (VA Form 10-10CG). This program explicitly includes mental health counseling for eligible caregivers.

2. Non-VA Organizations and Programs

Beyond the VA, numerous non-profit organizations, community mental health centers, and private practitioners specialize in supporting military families. These options can be particularly valuable for families who may not be eligible for VA services, prefer a non-VA setting, or are seeking additional resources.

Military OneSource

Military OneSource is a free service provided by the Department of Defense (DoD) for active-duty service members, National Guard, Reserve members, and their families. While primarily for active-duty, they also offer extensive resources for veterans and their families during the transition period.

  • Eligibility: Available to active-duty, National Guard, and Reserve service members and their families, and often extends support to veterans within a certain timeframe after their separation from service (e.g., 365 days).

  • Services Offered: Military OneSource provides free, short-term, solution-focused, confidential counseling services for a wide range of issues, including:

    • Relationship conflicts

    • Stress management

    • Parenting issues

    • Coping with grief and loss

    • Managing deployments and reintegration

    • Non-medical counseling (e.g., financial, educational). Counselors are licensed professionals with master’s or doctoral degrees.

  • Delivery Methods: Counseling can be accessed in person (with a counselor in the local community), over the phone, via secure online chat, or through secure video sessions. This flexibility makes it accessible globally.

  • Cost: All Military OneSource counseling services are free and confidential, meaning they are not reported to the chain of command or other agencies.

  • How to Access:

    1. Contact Military OneSource: Call 1-800-342-9647 24/7 or visit their website to initiate a request for counseling.

    2. Consultation: A Military OneSource consultant will help you determine your needs and connect you with a suitable counselor.

    3. Scheduling: You typically have 30 days after authorization to schedule your first session.

Wounded Warrior Project (WWP)

The Wounded Warrior Project is a prominent non-profit organization dedicated to honoring and empowering wounded warriors. They offer comprehensive mental health and wellness programs that often include support for family members.

  • Eligibility: Primarily serves post-9/11 veterans and service members who incurred a physical or mental injury, illness, or wound, co-incident to their military service. Many of their programs extend to family members and caregivers.

  • Services Offered:

    • Warrior Care Network: A partnership with top academic medical centers, offering intensive outpatient programs for PTSD and TBI that often include family components. These are highly structured, evidence-based treatment programs.

    • Project Odyssey: Adventure-based mental health workshops that bring veterans together, and often include family members, to build resilience and expand support structures.

    • WWP Talk: Weekly calls with WWP staff members who provide a supportive ear and encouragement to warriors, family members, and caregivers. This can be a valuable resource for ongoing support and goal setting.

    • Referrals: WWP can also help connect veterans and families to other relevant resources and services.

  • Cost: Services provided directly by WWP are generally free of charge to eligible participants.

  • How to Access:

    1. Contact the WWP Resource Center: Call 1-888-997-2586 or email resourcecenter@woundedwarriorproject.org.

    2. Eligibility and Needs Assessment: The resource center will help determine eligibility for programs and connect you with appropriate services.

Cohen Veterans Network (CVN)

The Cohen Veterans Network is a national network of mental health clinics that provides high-quality, accessible mental health care to post-9/11 veterans and their families.

  • Eligibility: Services are focused on post-9/11 veterans, active duty service members, and their families, regardless of combat experience or discharge status.

  • Services Offered: CVN clinics offer evidence-based therapy and counseling with a strong focus on issues like PTSD, anxiety, depression, and family relationship challenges. They provide individual, couples, and family therapy.

  • Delivery Methods: Services are available in person at their clinics across the country, and many offer telehealth services, making care accessible to those in rural areas or with mobility challenges.

  • Cost: CVN strives to be low-cost or no-cost for eligible individuals. They work with insurance providers and offer financial assistance based on need.

  • How to Access:

    1. Find a Clinic: Visit the Cohen Veterans Network website to find a clinic near you.

    2. Contact the Clinic: Call the chosen clinic directly to inquire about services, eligibility, and scheduling.

Give an Hour

Give an Hour is a non-profit organization that provides free mental health services to U.S. military personnel, veterans, and their families through a network of volunteer mental health professionals.

  • Eligibility: Open to military personnel, veterans, and their families.

  • Services Offered: Free, confidential counseling for a range of mental health concerns, including PTSD, anxiety, depression, and family-related issues. Services are provided by licensed mental health professionals who volunteer their time.

  • Cost: Free for eligible individuals.

  • How to Access:

    1. Apply Online: Visit the Give an Hour website and complete their online application to request services.

    2. Matching: They will match you with a volunteer mental health professional in your area.

Other Veteran Support Organizations

Many other non-profit organizations offer specialized support for veterans and their families, often including or referring to family counseling. Examples include:

  • National Military Family Association (NMFA): Educates military families about their rights, benefits, and available services. While not direct providers of counseling, they are a valuable resource for finding support.

  • VFW Auxiliary: Provides financial and moral support, including a resource card listing organizations and agencies that offer support to veterans, service members, and their families. They also promote suicide awareness and prevention, and help veterans access earned benefits.

  • Tragedy Assistance Program for Survivors (TAPS): Offers grief counseling and support for families who have lost a service member.

  • National Alliance on Mental Illness (NAMI): Offers a free, eight-session educational program called “Family-to-Family” for family members, partners, and friends of people experiencing mental health conditions. While not direct counseling, it provides crucial education and support.

  • How to Access: Research these organizations online, as most have dedicated websites with information on their programs, eligibility, and contact details. Many also have local chapters or networks that can provide more localized support.

The Counseling Process: What to Expect

Once you’ve identified a potential resource, understanding the typical counseling process can help ease any anxieties and prepare your family for the journey ahead.

Initial Consultation and Intake

The first step usually involves an initial consultation, either over the phone or in person. During this session:

  • Assessment of Needs: The counselor or intake specialist will ask about your family’s concerns, history, and what you hope to achieve through counseling. This helps them understand the dynamics and specific challenges.

  • Eligibility Verification: For VA services, they’ll verify the veteran’s enrollment and service history. For non-VA organizations, they’ll confirm eligibility for their specific programs.

  • Program Explanation: They’ll explain the types of counseling available, the therapeutic approach, session frequency, and any associated costs or coverage.

  • Goal Setting: While initial, you might discuss broad goals for therapy, such as “improving communication” or “coping with PTSD symptoms.”

Therapeutic Approaches

Family counseling for veterans often draws on several therapeutic models tailored to address the unique experiences of military families.

  • Family Systems Therapy: This approach views the family as an interconnected system, where each member’s actions influence the others. The therapist helps identify unhealthy patterns of interaction and facilitates healthier ways of relating. For example, if a veteran’s hypervigilance from PTSD creates tension, the therapist might help the family understand this behavior as a symptom and develop strategies to respond with empathy rather than frustration.

  • Cognitive Behavioral Therapy (CBT): While often used individually, CBT principles can be applied in family therapy to help family members identify and change negative thought patterns and behaviors that contribute to conflict or distress. For instance, a family member might learn to challenge catastrophic thoughts about the veteran’s future.

  • Trauma-Informed Therapy: Given the prevalence of trauma in military populations, this approach emphasizes understanding the impact of trauma on behavior and relationships. The therapist creates a safe environment, avoids re-traumatization, and helps the family process the effects of traumatic experiences.

  • Emotionally Focused Therapy (EFT): EFT focuses on understanding and transforming emotional bonds within the family. It helps family members identify underlying emotional needs and express them in ways that foster connection rather than conflict. This can be particularly helpful for couples struggling to reconnect after deployments.

  • Psychoeducation: A crucial component, psychoeducation involves teaching families about mental health conditions (like PTSD or TBI), their symptoms, and effective coping strategies. Understanding what a veteran is going through can significantly reduce frustration and foster empathy among family members. For example, learning that a veteran’s anger outbursts might be a symptom of PTSD, rather than a personal attack, can change a family’s response.

Confidentiality and Privacy

Confidentiality is a cornerstone of counseling. Mental health professionals are bound by ethical codes and legal requirements to protect client information.

  • Limits to Confidentiality: While highly confidential, there are legal and ethical limits, such as:
    • Imminent Harm: If there is a risk of immediate harm to oneself or others.

    • Child or Elder Abuse: Suspected abuse or neglect.

    • Court Order: In rare cases, a court may subpoena records.

  • Military OneSource and Vet Centers: These services often emphasize strict confidentiality, ensuring that seeking help will not negatively impact a service member’s career or security clearance. This reassurance is vital for many military families.

  • Shared Information: In family counseling, information shared within the session is typically considered part of the family’s joint therapeutic process. However, individual sessions with family members may be held, and the therapist will discuss the limits of confidentiality in those contexts.

The Role of the Therapist

The family therapist acts as a neutral facilitator, guiding discussions, identifying patterns, and teaching new skills. Their role includes:

  • Creating a Safe Space: Ensuring all family members feel heard, respected, and safe to express their feelings without judgment.

  • Improving Communication: Teaching active listening, “I” statements, and constructive conflict resolution skills. For example, instead of “You always ignore me,” a therapist might guide a family member to say, “I feel unheard when you don’t respond to my questions.”

  • Identifying and Addressing Dysfunctional Patterns: Helping the family recognize unhelpful cycles of interaction and develop healthier alternatives.

  • Educating the Family: Providing information about mental health conditions and their impact.

  • Developing Coping Strategies: Equipping the family with tools to manage stress, trauma symptoms, and daily challenges.

  • Advocacy and Referrals: Connecting families to additional resources and support systems when needed.

Overcoming Barriers to Access

Despite the clear benefits, military families often face unique barriers when trying to access mental healthcare. Addressing these challenges proactively can improve the likelihood of successful engagement.

Stigma

The stigma associated with mental health issues can be a significant barrier. Service members and their families may worry that seeking help will be seen as a sign of weakness, negatively impact a career, or lead to social judgment.

  • Countering Stigma:
    • Education: Understanding that mental health challenges are a natural response to extraordinary circumstances, not a character flaw.

    • Confidentiality: Emphasizing the strict confidentiality of services, particularly with Vet Centers and Military OneSource, can alleviate fears about career repercussions.

    • Peer Support: Connecting with other military families who have sought counseling can normalize the experience and provide encouragement. Organizations like the Wounded Warrior Project often facilitate peer connections.

    • Leadership Support: When military leaders openly support mental health initiatives, it can reduce perceived stigma within the military community.

Navigational Challenges

The VA system, while comprehensive, can be complex to navigate, with various eligibility criteria, programs, and referral processes.

  • Simplifying Navigation:
    • Utilize VA Resources: The VA’s “Make the Connection” website offers a resource finder to help locate VA programs and resources. The Vet Center Call Center and VA patient advocates can also provide guidance.

    • Veteran Service Organizations (VSOs): Organizations like the VFW (Veterans of Foreign Wars) and American Legion often have accredited service officers who can assist veterans and their families in understanding and applying for VA benefits and services, including mental health care.

    • Caregiver Support Coordinators: VA medical centers have Caregiver Support Coordinators who can help navigate the system specifically for caregivers and families.

    • Military OneSource: For active-duty and recently separated families, Military OneSource consultants are experts in navigating military benefits and can provide personalized assistance.

Geographic Limitations and Accessibility

For families in rural areas, accessing in-person counseling can be challenging due to distance and limited providers.

  • Leveraging Telehealth:
    • VA Telehealth Services: The VA has significantly expanded its telehealth capabilities, offering mental health appointments via video conferencing or phone. This allows families to receive care from the comfort of their homes.

    • Military OneSource: Offers telephonic and secure video sessions, making it highly accessible regardless of location.

    • Cohen Veterans Network: Many of their clinics offer robust telehealth services.

    • Private Providers: Many private therapists now offer online therapy, which can be covered by TRICARE or other insurance plans. Ensure the provider is licensed in your state.

Financial Concerns

While many services are free or low-cost, some families may worry about the financial burden of ongoing therapy.

  • Understanding Coverage:
    • VA and Vet Centers: Generally free for eligible individuals.

    • TRICARE: The healthcare program for uniformed service members and their families covers mental health services, including family therapy, when provided by TRICARE-authorized providers.

    • Non-Profits: Many non-profit organizations, like Give an Hour and Cohen Veterans Network, offer free or significantly reduced-cost services.

    • Community Mental Health Centers: These centers often operate on a sliding scale fee based on income, making therapy more affordable.

    • Health Insurance: For those with private health insurance, check your policy’s mental health coverage for family therapy.

Finding a Culturally Competent Provider

Finding a therapist who understands military culture and the unique challenges faced by veterans and their families can significantly impact the effectiveness of therapy.

  • Seeking Specialized Expertise:
    • VA and Vet Centers: Clinicians at these facilities are typically well-versed in military culture and trauma.

    • Organizations Specializing in Military Families: Groups like Wounded Warrior Project, Cohen Veterans Network, and Military OneSource specifically train their providers in military-specific issues.

    • Professional Associations: Organizations like the American Association for Marriage and Family Therapy (AAMFT) may have directories of therapists who specialize in military family issues.

    • Ask Direct Questions: When interviewing potential therapists, ask about their experience working with military families, their understanding of military culture, and their approach to trauma-informed care.

Benefits of Family Counseling for Veterans and Their Loved Ones

Engaging in family counseling can yield profound and lasting positive impacts for military families.

  • Improved Communication: Learning to express feelings constructively, actively listen, and understand different perspectives. This helps bridge communication gaps that often arise from military experiences. For example, a veteran might learn to articulate feelings of hypervigilance rather than just reacting with anger, and family members learn to respond with empathy.

  • Enhanced Emotional Support: Creating a safe space where family members can openly share their emotions, validating each other’s experiences, and building a stronger network of support. This can be especially important for spouses and children who often feel isolated in their struggles.

  • Stronger Family Bonds: By working through challenges together, families can rebuild trust, deepen understanding, and strengthen their emotional connections, leading to a more cohesive and resilient unit.

  • Coping Mechanism Development: Acquiring healthy coping strategies for stress, anxiety, PTSD symptoms, and other challenges. This includes techniques for managing triggers, practicing mindfulness, and developing relaxation exercises. Families learn to cope with difficult situations as a team.

  • Increased Understanding and Empathy: Family members gain insight into the veteran’s experiences and struggles, while veterans develop a deeper appreciation for the emotional toll their military service has taken on their loved ones. This mutual understanding reduces resentment and fosters compassion.

  • Conflict Resolution Skills: Developing effective strategies for addressing disagreements and conflicts in a respectful and productive manner, preventing issues from escalating. Instead of arguments, families learn to engage in discussions aimed at solutions.

  • Successful Reintegration: Facilitating a smoother transition from military to civilian life by addressing the unique challenges of readjustment, such as role changes, social reintegration, and establishing new routines.

  • Reduced Secondary Trauma: Providing family members with tools and support to process their own experiences and prevent or mitigate the effects of secondary trauma, burnout, or compassion fatigue.

  • Empowerment: Empowering families to navigate future challenges with greater confidence and resilience, knowing they have the tools and support system to face adversity together.

Family counseling is an investment in the health and future of the entire family. It acknowledges that military service is a family affair, and healing is a collective journey.

Conclusion

Accessing family counseling is a proactive step toward healing and strengthening the family unit after military service. While challenges like stigma, navigation complexities, and accessibility may arise, a wealth of resources exists through the VA, Military OneSource, Wounded Warrior Project, Cohen Veterans Network, and numerous other dedicated organizations. By understanding the available options, overcoming potential barriers, and embracing the therapeutic process, veterans and their families can build stronger communication, deepen empathy, and forge a more resilient future together. The journey of military service is shared, and so too can be the path to profound healing and renewed connection.