Rolling into SUDCC (Substances Use Disorder Clinical Care) presented a myriad of challenges. From a clinical standpoint, I felt familiar with SUDCC care as I spent the bulk of my social work career in addictions treatment. However, the SUDCC clinic I was assigned to was embedded into the BDE (brigade), which was an introduction to my role as a future BHO. In this role, I became familiar with BDE leadership and systematic issues.
I entered into the SUDCC rotation in October of 2019 at the tail end of holiday block leave. Two months later, the world shut down to (you guessed it) the COVID-19 pandemic. Providing clinical care given the obvious barriers of COVID-19 created a challenging scenario. However, social workers are adept at navigating complicated barriers. Prior to the shut down, I was trained in EMDR and was eager to practice it in the SUDCC realm, but tele-therapy proved to be too challenging for that ambition, rendering me unable to engage in it until I began my BH rotation in May.
SUDCC, previously knowns as Army Substance Abuse Program (ASAP) is broken up into two separate missions. SUDCC is focused on clinical treatment, where ASAP is focused on prevention and education.
The goal of the intern is to understand the ins and outs of SUDCC and ASAP, in order to provide accurate information to leaders. I normally had daily correspondence with leadership, with questions about referrals, chapter 9s’ (rehabilitation failure), and soldier updates). These correspondences presented a host of ethical dilemmas as you balance the Soldiers care and confidentiality, along with the Army’s overall deployment mission.
Interns should familiarize themselves with the ASAM guide to determining the prevalence of substances use, as it’s a tool to decide the appropriate course of treatment for the presenting service member. Soldiers would voluntarily enter SUDCC, or be command-referred following a substance use incident, to be evaluated by a provider. The provider then determines the most appropriate course of action:
- Two-day psychoeducation course on substance use
- Enrollment in outpatient SUDCC
- Enrollment in Intensive Outpatient
- Enrollment in Residential Treatment
- Referral to hospital for detoxication service.
Interns will provide clinical services during these phases (depending on where their stationed). I operated within the outpatient clinic, as it presented the best opportunity to work within the brigade. Interns that evaluate and refer Soldiers become case managers, tracking the progress of these Soldiers. I would refer Soldiers to various levels of care depending on their needs. Should Soldiers be referred to a higher level of care (IOP or Residential), they would be dropped down to outpatient for follow up care.
I had the unique opportunity to be supervised by a provider who carries the CSAC identifier, which gave me the opportunity to achieve the CSAC title as well.
I engaged in SUDCC care until May of 2020, where I then engaged in my final rotation of SWIP for the next 12 months.