Clinical Associate Professor Kim Finney addresses the benefits and challenges of leveraging psychopharmacology to treat military service members who struggle with PTSD and other mental health issues.

The lasting effects of combat trauma on veterans have been well-documented: research indicates that one in four active duty military service members exhibits signs of a mental health condition, and 20 percent of veterans who served in Iraq or Afghanistan suffer from either major depression or post-traumatic stress disorder (PTSD).

Kim Finney is a clinical associate professor of social work, veteran and recipient of the 2014 Sylvia Blanton Award for her continued work toward ensuring the well-being of veterans. Finney employs traditional psychotherapy practices within a framework of psychopharmacology—the branch of psychology exploring the effects of pharmaceutical drugs on behavior, mood and cognition. Finney spoke with us about how psychopharmacology factors into the treatment of mental conditions including depression, anxiety and PTSD within the military population.

USC Suzanne Dworak-Peck School of Social Work: How did you become interested in the intersection of social work and psychopharmacology, and how these fields can be applied to improve the lives of military service members and veterans?

Kim Finney: My passion for working with service members and veterans stems from my career in the military. I joined the Air Force in 1989 as a laboratory officer and served for 24 years. I had several assignments but spent the majority of my service as a military psychologist. I had five different assignments as clinical director, the last of which was at the Air Force mental health clinic on the El Segundo military base in Los Angeles.

After completing my doctorate in clinical psychology, I completed a post-doctoral master’s degree in psychopharmacology so that I would be authorized to prescribe medication. When I was transitioning out of the military, I came across a pamphlet about the USC Center for Innovation and Research on Veterans & Military Families (CIR). I decided I wanted to become a member of their team of educators, who were training future clinicians who had a desire to work specifically with military service members and their families. It is now my hope to educate younger generations about how psychopharmacology can be effectively leveraged in the treatment of mental illness for military service members and veterans.

USC: How has your training in psychology and psychopharmacology helped you to provide more comprehensive care to service members and veterans struggling with mental health issues?

KF: Understanding how different medications can mitigate symptoms, work over time, cause side effects or produce adverse effects has provided me with a more complete picture of my patients’ needs and how to effectively address them. In turn, this has allowed me to become a more informed practitioner and a better advocate for my clients.

My practice has always focused on the whole person—analyzing a patient’s symptoms, their contextual environment, where they come from and the experiences they have had. For example, when evaluating possible prescriptions for an active duty service member, I must consider the demands of their job. As such, it’s unlikely that I’d recommend a medication that is likely to cause weight gain, as I know he or she must pass a periodic fitness test and this could inhibit their performance.

In essence, diagnosing and offering appropriate treatment for mental health issues is a complex endeavor that may involve consideration of biological, psychological, social and even spiritual factors. Race and gender also play a significant role in my approach to treatment. An appropriate intervention should address all of these components thoroughly, which may require psychotherapy, medication, as well as the support of friends and family.

USC: What does a typical treatment plan look like for a service member or veteran struggling with mental health issues?

KF: Every patient’s journey is different. Veterans come from a breadth of diverse backgrounds, and they struggle with the same variety of mental health issues as the civilian population.

The first step is simply establishing a clinician-patient relationship based on mutual trust and respect. It may take anywhere from a few weeks to six months of meeting with a patient before I can gain a full diagnostic picture. For example, symptoms of anxiety or depression may emerge early — but you can’t jump the gun with a diagnosis, because those symptoms may be indicative of a more complex issue, such as obsessive-compulsive disorder (OCD) or PTSD.

When I feel comfortable diagnosing a condition, we will work together to build an effective treatment plan. I often invite family members of the patient to join in on the process. These are the people who know the service member or veteran best — so their presence can promote transparency and help us work together to figure out the best solution.

USC: What challenges have you encountered in the treatment of mental health issues among service members and veterans?

KF: Aside from learning to use your judgment appropriately to diagnose and treat clients in a way that best meets their individual needs, a major challenge is confronting the pervasive stigma surrounding mental health care among military service members.

Military culture is centered upon notions of strength and self-sufficiency. As such, a lot of stigma remains around asking for help. Military service members are warriors—and in their minds, warriors should never need help.

Overcoming this stigma requires a paradigm shift. As it stands, I think word-of-mouth testimonies are helping to move the needle. A service member who has a positive experience receiving mental health care is likely to share the story with friends, who may share it with others and thereby create broader awareness of the benefits of seeking professional care. That’s the ultimate goal: to create a military culture that not only accepts, but empowers and supports, service members and veterans in pursuing treatment for their mental health needs.