Counseling Today, Online Exclusives

From Combat to Counseling: Service members, veterans and military family mental health

By Duane France July 14, 2019


This is the debut article of what is intended to be a monthly online column about counseling military-affiliated clients.


Service members, veterans and their families face some unique challenges both during and after military service. There’s the stuff that is widely known — deployments, constant moving, a regimented lifestyle — and then there’s the stuff that isn’t so well-known. This includes the experience of living in a mutually supportive community; a lack of individualism and getting used to relying on others while others rely on you; for veterans, a lack of purpose and meaning in post-military life; for family members, experiencing the aftermath of the military, because it’s a stressful job. No one is getting out of the military without a couple of dents in the fender.

Sometimes, the challenges faced by the military population turn into crisis. The high rate of suicide in the service members, veterans and their families (SMVF) community is well-known. Given a higher level of exposure to trauma, service members and veterans may be more likely to develop posttraumatic stress disorder and other psychological conditions. And with greater physical danger comes a higher risk of catastrophic injury, which comes with its own problems, including the need to adjust to a new reality.

This is where the counseling profession comes in. As clinical mental health professionals, we are uniquely qualified to help the SMVF population live the life that they desire and deserve. We look at mental health from a wellness perspective, not an illness perspective. People with a military background will reject the concept of “sickness” and “brokenness” because, to them, that’s equal to weakness. If someone approaches a service member, veteran or military family member with pity, as if they’re a broken-winged bird, there will probably be a bit of a confrontation.

I know, because I’m a member of this community.

Who am I?

I retired from the U.S. Army in 2014 after a 22-year career. After retiring, I took on a new mission to help my brothers and sisters in arms, and their families, adjust to the circumstances that put some of those dents in their fenders. After several years of clinical work, I realized that my lived experience combined with my clinical background could help others. Which is where this column comes in.

Over the coming months, I’ll be sharing some of my insights about the culture and character of the military. Even though the need is great, the counseling profession doesn’t include a lot of people like me — former service members who have become professional counselors. As a matter of fact, that is what brought me to the profession — a chance encounter at just the right time and someone saying exactly the right thing to someone who was open to hearing it.

I was not a mental health professional when I was in the Army. I was in logistics, which is the Army’s euphemistic way of describing supply and transportation. In 2007, knowing that I would eventually have to leave the military, I started going back to school while I was deployed to Iraq. I was looking for a degree with the least amount of math possible and came across an associate degree in counseling and applied psychology. I thought that might make me a better leader, and I was interested in psychology, so I figured why not?

Fast-forward nearly a year. My unit was redeploying from Iraq after 15 months, and we were participating in post-deployment reintegration sessions. We all went to a conference center at a local hotel, where we were presented with breakout sessions on not going too wild with our drinking, not being mean to the neighbors … that kind of thing.

One of the breakout sessions was led by a counselor from the local Vet Center. For those of you not familiar with Vet Centers, they are outpatient mental health clinics that are part of the Department of Veterans Affairs (VA) but separate from the main VA health care system. The counselors at the Vet Centers are typically veterans themselves, as was the case with this clinician. She introduced herself and said that she was a retired Air Force officer. I don’t remember much of what she talked about that day, but something she said struck me then and stays with me now: “By the way, if any of you are interested in psychology, consider a career in the mental health industry. There are not enough combat veterans in our field.”

That’s all it took. Up until that point, I had not considered becoming a mental health counselor. After that, I started on the path that I’m on now and, with the help of many mentors along the way, currently work as a counselor at a private outpatient clinic in Colorado Springs, Colorado, that primarily serves the military population.

What the counselor said that day was correct then, and it still holds true now: There are not enough veterans in the counseling career field serving others in the military population. At the same time, that truth does not minimize the need for mental health counseling for the military population. There are two solutions to this: Bring more veterans into the counseling profession, and help those clinicians in the counseling profession who are not veterans to understand more about the unique needs of the military population.

As professional counselors, we recognize the need to be culturally competent with whatever client populations we work. We can’t work with someone from another culture without knowing about that culture; the ACA Code of Ethics clearly identifies this.

In that sense, the military population is an entirely different culture. Anything that defines the characteristics of a culture — ways of dressing, language, conceptualization of the world — applies to the military. I often describe it this way: It’s as if I went to England to live for 22 years and then moved back to the United States. Sure we spoke the same general language in those two countries, but there were also significant cultural differences between them and, therefore, adjustments that I needed to make. That’s how service members and their families feel after military service.

So, the goals of this column will be:

  • To provide insights into the culture of military-affiliated clients
  • To support counselors who find themselves working with service members, veterans and their families
  • To answer questions (if you have any, feel free to drop me a line at

Thank you for your willingness to serve the military-affiliated population and for your willingness to learn more. Your efforts are greatly appreciated




Duane France, LPC

Duane France is a retired U.S. Army noncommissioned officer and combat veteran who practices as a licensed professional counselor in Colorado Springs, Colorado. He is the director of veteran service for the Family Care Center, a private outpatient mental health clinic specializing in service members, veterans and their families. He is also the executive director of the Colorado Veterans Health and Wellness Agency, a 501(c)3 nonprofit that is professionally affiliated with the Family Care Center. In addition to his clinical work, he writes and speaks about veteran mental health on his blog and podcast at Contact him at




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.


  1. Sarah A.

    As an Army wife and Counseling Grad student, this sounds wonderful! Thank you for taking the time to devote to this population!!

    1. Duane France

      Sarah, thank YOU for choosing the counseling profession! Just as there are not enough service members to meet the need, there are not enough military spouses to meet the needs either. Hopefully you can find something beneficial to the clients you’ll be serving.

  2. Derek Silski

    As a veteran turn counselor myself, I can’t wait to read more into this series. I have followed your work and I can say you always have a good voice and message.

    1. Duane France

      Derek, great to hear it! I believe that if we, as veterans, have the ability to help our colleagues understand this unique population, then we have a responsibility to do it. I appreciate the feedback and support!

  3. Kaitlyn Myers-Brooks

    Looking forward to reading more! Thank you for providing these important insights into working with active duty and veteran clients.

    1. Duane

      Kaitlyn, I appreciate your interest. There are so many counselors who have a heart to serve the military affiliated population, we owe it to them and their clients to provide the most support possible. Thanks!

  4. John Grady, LPC, LCADC, ACS, CCS, NCC

    Thank you for your service, sir.

    I applaud your holistic approach to helping our country’s veterans – a family systems perspective can truly help create the conditions for sustained change, persistent healing, and advanced wellness.

    Very best and thank you, I am looking forward to reading your work each month.


    1. Duane

      John, I appreciate your appreciation. And working with the military population is not a one-size-fits-all, as it’s a significantly diverse population (as we’ll talk about in the next article). Like any other client, we have to determine what the primary concern is, and address that using our skills or refer the client to someone who has the skills that the veteran needs.

      There are a number of times where a veteran I’m working with is not dealing with PTSD or depression, but the primary concern is addiction or family issues. Thankfully, I work with an organization that has a wide range of clinicians who specialize in each of those, so the counselor-client fit is made.

      Thanks for your support!

  5. Nelson Ormsby, Callsign CavDad

    When do you have time to breathe? From serving our veterans and families, to sensitizing your mental health colleagues to the realities of how veteran mental health issues may superficially present akin to those of tree-hugging civilians like me, yet have dimensions all their own. And then the “mission difficult”: helping those like me, who never raised the right hand, to better understand just how wide the gap is between the 7% of the US population who wore the uniform and those of us who never served, and how we can close that gap to our collective benefit. Thank you for helping to bridge better understanding of the experiences of your brothers and sisters in arms, allowing those like me to better facilitate the transition, in all its many facets and dimensions. Carry on, Brother!

  6. Ashley Donovan

    Very excited to read more! Is there a way to subscribe to updates? I would really like to stay up on this!

    1. Counseling Today

      Hi Ashley, Enter your email address in the “subscribe” box at the upper right of our homepage to receive a notification each time a new article is posted at CT Online.
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