This study examined the relationship between the percentage of time social workers spend working with OIF/OEF/OND veterans and their perceptions of interdisciplinary collaboration at a VA medical center. A mixed methods approach was used, collecting survey and interview data from social workers. The results showed a positive association between time spent with veterans and reflection on the interdisciplinary process. Qualitative interviews suggested that frequent high acuity cases push teams to streamline their collaboration to better manage overwhelmed veterans. The implications are that education should teach skills in giving feedback to other professions, assessing and treating complex behavioral health conditions, and managing overwhelmed clients.

1. Serving OIF/OEF/OND Veterans through
Collaborative Practice: Implications for Education
MICHAEL CLARKSON-HENDRIX, PHD
JOHN CARROLL-BARBUTO, PHD

2. Background
The skills necessary for proficient social work practice in the Veteran health care
sector (VHCS) are in the midst of change (ACA/PACTs)
Interdisciplinary collaboration – A multidimensional construct – is the new norm
The needs of OIF/OEF/OND Veterans as a war cohort
What, if any, connection is there between the amount of time serving this war
cohort and various features of interdisciplinary collaboration?

3. Purpose
1. Look for potential associations between the percentage of time
social workers spend working with Veterans and their perceptions
of interdisciplinary collaboration
2. Explore VHCS social worker perceptions of practice with this
population
3. Explain significant associations using social worker perceptions of
practice with this population

4. Methods
Mixed methods design (Survey and Interviews)
Survey sample (N = 21; 31% completed survey)
◦ Voluntary and snowball sampling
◦ 81% Female, 95% White, 86% Direct practitioners
Interview sample (N = 13)
◦ Voluntary and snowball sampling
◦ 10 Female, White, most direct practitioners with a couple of supervisors
Qualitative data collection
◦ Interview guide with specific probes as needed
◦ Tape recorded and transcribed

5. Measures
Interdisciplinary collaboration - Index of Interdisciplinary Collaboration
(Bronstein, 2002)
◦ Five subscales representing components of interdisciplinary collaboration
◦ Responses: 1 = strongly disagree to 5 = strongly agree
Percentage of time working with OIF/OEF/OND Veterans and/or returning
service members
◦ “Which of the following choices best represents the percentage of time you work with
Operation Iraqi Freedom (OIF) Veterans and/or returning service members?” (Adapted from
Beder, Postiglione, and Strolin-Goltzman, 2012)
◦ Responses: 0% to 100% in increments of 10%

6. Data analysis
Quantitative analysis
◦ Univariate analyses to assess normality and scale reliability
◦ Bivariate analyses to test significance of associations between percentage of time
working with OIF/OEF/OND Veterans and Index of Interdisciplinary Collaboration
subscales
Qualitative analysis
◦ Thematic analysis
Mixed methods analysis
◦ Explain associations using themes

7. Quantitative results – Descriptive statistics (N = 21)
Variables Mean (SD) Range
Interdisciplinary Collaboration (IIC)
Interdependence (thirteen items; α = 0.81) 4.08 (0.50) 2.54-4.62
Newly created professional activities (two items; α = 0.71) 3.88 (0.69) 2.50-5.00
Flexibility (two items; α = 0.71) 4.13 (0.86) 1.50-5.00
Collective ownership of goals (eight items; α = 0.74) 3.71 (0.49) 2.38-4.50
Reflection on process (ten items; α = 0.79) 3.65 (0.49) 2.60-4.40
Percentage of time working with OIF Veterans 27.14 (17.92) 0-70

8. Quantitative results- Bivariate
associations
Interdisciplinary collaboration
Interdependence
Newly created
professional
activities
Flexibility
Collective
ownership of
goals
Reflection on
process
Variable r r r r r
% OIF
Veterans
0.14 0.05 -0.06 0.41 0.46*
*p < .05

9. Qualitative results – Characteristics of work with
OIF/OEF/OND Veterans and/or returning service
members
Addressing frequent high acuity in behavioral health
conditions
“Every time I’ve worked with a younger veteran it is
much more intense; it’s more traumatic. I think it’s a
couple things, so one thing I think it is based upon is
the fact that they are fresh out of war.”

10. Qualitative results – Characteristics of work with
OIF/OEF/OND Veterans and/or returning service
members
Containing and managing overwhelmed patients by
targeting services based on Veteran need
“They are just overwhelmed. They're getting back.
They think like in their head they have a plan maybe
set up in their minds so they often brush off some of
the (transitional) services.”

11. Mixed methods results
Frequent high acuity pushes attention to the process
of working together in interprofessional health care
teams
Containing and managing overwhelmed
OIF/OEF/OND Veterans and/or returning service
members inclines members of interprofessional
health care teams to streamline their work together

12. Limitations
Small non-stratified sample
Non-specific effects (PACTs)
Single coder for qualitative interviews

13. Conclusions
Percentage of time working with OIF/OEF/OND Veterans
and/or returning service members was positively associated
with the reflection on process subscale.
Frequent treatment of high acuity with overwhelmed
Veterans and/or returning service members push
interprofessional health care team members to discuss
strategies to make more efficient their process of working
together.

14. Implications for education
Teach skills in talking successfully with colleagues about interprofessional working
relationships
◦ How to give and receive feedback to other professions to improve interprofessional efficiency and
effectiveness
Teach skills in assessing and treating chronic high acuity in behavioral health conditions
Teach skills in managing overwhelmed clients
◦ Social worker as broker in a complex service system
*This research was conducted at Stratton VA Medical Center, in Albany, NY. The opinions and findings expressed here are not those of SVAMC or the VHA.
Michael Clarkson-Hendrix had a VA appointment at SVAMC at the time of this study. John Carroll-Barbuto is an employee of SVAMC at the time of this study.
The study was approved by the SVAMC IRB.