Vol.:(0123456789) 1 3
Clin Soc Work J
DOI 10.1007/s10615-017-0616-7
ORIGINAL PAPER
Developing a Problem-Solving Treatment for Gulf War Illness:
Cognitive Rehabilitation of Veterans with Complex Post-
Deployment Health Concerns
Lauren M. Greenberg
1
· David R. Litke
1,2
· Kathleen Ray
1,8
· Joseph F. Rath
3
·
Wilfred R. Pigeon
4,5
· Drew A. Helmer
1,6
· Nicole Anastasides
1
· Lisa M. McAndrew
1,7
© Springer Science+Business Media New York (Outside the USA) 2017
improve the health function for those with GWI. The goals
of this article are to provide social workers with informa-
tion about GWI, and describe how we modiied an evi-
dence-based treatment, problem-solving therapy, for veter-
ans with GWI. This tailoring of an existing treatment may
serve as a model for adapting evidence-based treatments for
veterans and civilians with multiple chronic symptoms and
other complex health concerns. Furthermore, the detailed
description provided may facilitate dissemination of prob-
lem-solving therapy among social workers and trainees.
Keywords Gulf War Illness · Veterans · Problem-
solving therapy · Post-deployment health · Cognitive
rehabilitation · Problem solving
Social Workers and Post-Deployment Health
Social workers serve an important role in the rehabili-
tation and reintegration of veterans post-deployment.
There are currently 12,000 social workers within Veterans
Afairs (U.S. Department of Veterans Afairs 2016) and an
unknown number of social workers who care for veterans
in non-Veterans Afairs settings. With increased empha-
sis on access to care (e.g., Veterans Access, Choice, and
Accountability Act of 2014), veterans are seeking social
work services within the community. In Veterans Afairs
and community settings, social workers connect veterans
to services and facilitate veterans’ reintegration into their
communities and daily lives. To best serve our veterans, it
is essential for social workers to understand the context of
veterans’ presenting problems, particularly regarding post-
deployment health. A tailored approach to the delivery
of evidence-based treatments, such as the one illustrated
Abstract Social workers play an essential role in facilitat-
ing veterans’ reintegration into their communities and daily
lives. Many veterans, particularly those who have been
deployed, experience comorbid physical, psychological,
and neurocognitive problems that signiicantly impact their
health function in multiple domains. Veterans deployed
to Operation Desert Shield/Operation Desert Storm have
reported a wide range of persistent, diverse, medically
unexplained symptoms that have come to be known as Gulf
War Illness (GWI). These symptoms make it diicult for
veterans to participate in daily activities, thereby impact-
ing health function. There are few efective treatments to
The contents of this publication do not represent the views of
the U.S. Department of Veterans Afairs or the United States
Government.
* Lauren M. Greenberg
Lauren.Greenberg@va.gov
1
War Related Illness and Injury Study Center, Veterans Afairs
New Jersey Health Care System, East Orange, NJ, USA
2
Department of Rehabilitation Medicine, New York
University School of Medicine, New York, NY, USA
3
Rusk Institute of Rehabilitation Medicine, New York
University Langone Medical Center, New York, NY, USA
4
Department of Psychiatry, University of Rochester Medical
Center, Rochester, NY, USA
5
Center of Excellence for Suicide Prevention, Canandaigua
VA Medical Center, Canandaigua, NY, USA
6
Department of Medicine, New Jersey Medical School,
Rutgers University, Newark, NJ, USA
7
Department of Educational and Counseling Psychology,
University at Albany, Albany, NY, USA
8
School of Social Science and Human Services, Ramapo
College, Mahwah, NJ, USA