Linda Blank, MSW, New Jersey Coordinator for Social Work p.r.n., sat down and spoke with Doris Ruiz, LCSW, who served a 12-month tour of duty in Kandahar, Afghanistan.

Ruiz was responsible for running one of the largest military mental health clinics in Afghanistan. During her service in the Army, she was the recipient of several prestigious awards, including the Afghanistan Campaign Medal, the National Defense Service Medal, and the Global War on Terrorism Service Medal.

Since the interview, Ruiz was placed in a permanent full-time position at Community Hope where she counsels veterans at the U.S. Department of Veterans Affairs.  

 

WHEN DID YOU DECIDE TO JOIN THE MILITARY?

My father was in the Army and I was always interested in enlisting; however, my father persuaded me to go to college instead.  While attending college, I made the decision to join the ROTC.

After graduating from NYU in 2001, my family visited New York City and we celebrated at “Windows of the World” Restaurant atop the World Trade Center.  I still have fond memories when I look at photographs of my family posing in front of the Twin Towers.  In 2001, when the towers fell, I felt compelled to join the Army Reserves as a social worker. I eventually volunteered for deployment to Afghanistan as a clinical social worker.  

WHAT KIND OF TRAINING WAS INVOLVED?

In December 2011, I began three- month training as part of the 1972D Combat Stress Control Unit.  We received instruction on shooting, driving Humvees, clearing buildings, and checking for IEDs (improvised explosive devices). In addition to military training, I was also trained in providing clinical social work services to the service men and women.   

TELL ME ABOUT YOUR ADJUSTMENT UPON ARRIVAL?

We arrived in May. It was very hot in Afghanistan, but fortunately, we had air conditioning in our living areas. In the beginning, we slept in tents. Later, we stayed in barracks with four people to a room. It was frightening in the beginning. There were mortar attacks and bombings nearby, we had to remain on high alert every night. Frequently, we would run out in our pajamas seeking protection in a cement bunker.  We especially needed to be careful of IED explosives.  At one point, our clinic was hit by enemy fire and the Taliban made their way into our base. Because of the constant threats, I always slept with my M-16 by my side.    

TELL ME ABOUT YOUR JOB DUTIES & THE MENTAL HEALTH SERVICES.

There are pockets of mini-clinics throughout Afghanistan where the Restoration Prevention Center Program is offered to soldiers. I began as a clinician, but was promoted and placed in charge of one of the large clinics in the area.  This particular clinic also had a special program for brain injury.  In addition to overseeing staff, including psychiatrists and social workers, I would see clients, back-to-back, from Monday to Sunday, beginning as early as 7:00 am until sometimes as late as 11:00 pm.  The majority of soldiers would remain in the program for 7-10 days and approximately 95% of the clients we saw would return to the battlefield after treatment.

WHAT WERE SOME OF THE PREVALENT ISSUES?

We were primarily working with soldiers in their mid-20s. Many had witnessed their fellow soldiers being blown up or badly injured. There was one young man who witnessed his First Sergeant blown to pieces. During his counseling session, he only wanted to return to his men and insisted that he was fine.  Shortly thereafter, it was determined that he was mentally unfit to return to combat and was sent back home.       

Other prevalent issues included stress from multiple deployments and family issues; including communication challenges with wives and children or dealing with infidelity.  Many of the female clients we spoke with were dealing with sexual abuse among their fellow soldiers.   

WHAT CHALLENGES DID YOU FACE AS A SOCIAL WORKER?

At times, there was a lack of support. For example, some commanders insisted their soldiers were “playing the mental health card” simply to avoid being in combat. Fortunately, other commanders were more supportive.

Another challenge faced was maintaining balance between gaining a client’s trust, while also having the obligation to report certain behaviors that could potentially be harmful. 

In addition to face-to-face counseling, we also utilized a Tele-Behavioral Health Program (similar to Skype) for clients to receive remote counseling, as a trip to our clinic could be dangerous because of the IEDs.

CAN YOU DESCRIBE WHAT IT WAS LIKE TO RETURN HOME AFTER 12 MONTHS?

It was both happy and sad.  Returning home was wonderful, but leaving fellow comrades behind was difficult. We were like family and learned to take care of our own.

Transitioning to civilian life can be difficult. You have left Afghanistan, but in some ways the experience remains with you.  While vacationing at the Jersey Shore, I heard a horn and my immediate impulse was to hit the ground, as I had been trained to do in Afghanistan.

WHAT LESSONS HAVE YOU LEARNED FROM THIS EXPERIENCE?

One lesson is that of human resiliency and the ability to adjust to situations that we never dreamed of. With connections and a support system, it is possible to live with essentially nothing.   

WHAT’S NEXT FOR YOU?  

I returned from Afghanistan in March of 2013 and I have been taking a much needed break for the past few months. Last night, I went to a Bon Jovi concert! I still continue to do some part-time follow-up work with soldiers and have begun to send out my resume.  I hope to continue working with soldiers through running support groups, working for the VA, etc.  If I were asked to return to Afghanistan, I would pack my bags immediately. [Since the interview, Social Work p.r.n. has placed Ruiz in a permanent full-time position at Community Hope where she counsels veterans at the U.S. Department of Veterans Affairs.]

ANY ADVICE TO SOCIAL WORKERS CONSIDERING THIS LINE OF WORK?

There is still a need for additional mental health specialists in the military. It is essential to be a team player and to be emotionally prepared for the devastation of war.