Practical for Your Practice Podcast

Practical for Your Practice, Season 5

Listen to Episode 12, Season 5:  Practically YOU! How It Took 5 Seasons to Have a Call-in Show
Tap, tap, tap. Is this thing on? Hello? Anyone out there? Turns out, YES! Podcasts are funny things where it sometimes feels like we might just be talking into the void. And what we REALLY want is to have collegial interactions with you, the listeners. So for our 60th episode, we asked for your questions, comments, and “What is your why?” stories, and you delivered! Thank you to all who contributed to this episode. Join us as we respond to listeners' questions and hear about LPCs in clinical practice, clients that aren’t a “perfect” fit with EBP protocols, not mixing EBP “cocktails”, lots of “woohoo!”s, and Jenna being voted “Most Likely to be Ariel in Little Mermaid 2” in high school. What a great community of practice!

Listen to Episode 11, Season 5: A Visit to Dr. Ruzek's PTSD Group Laboratory
Guest: Dr. Josef Ruzek
Today we are joined by Dr. Joe Ruzek, a clinical psychologist and former Director of the National Center for PTSD Dissemination and Training Division. Dr. Ruzek recently published a book on group therapies for PTSD and shares his findings and innovations with Jenna and Carin. We discussed the unique benefits of group therapies, more flexible ways of measuring progress, and future directions. As always, we wrap up with Actionable Intel; Dr. Ruzek provides listeners with numerous tips and resources to hone skills in group therapy.

Listen to Episode 10, Season 5: When the Going Gets Tough, the Tough Get Stress First Aid (SFA)
Guest: Dr. Patricia Watson
As behavioral health providers, many of us receive training, and are well positioned to help people after a disaster or traumatic event. But what do you do in situations of ongoing threat, ongoing stress and adversity perhaps lasting months or years? In this episode, we are joined by the amazing Dr. Patricia Watson, a psychologist at the National Center for PTSD, who walks us through the incredibly versatile Stress First Aid (SFA) model to include its essential elements, relationship to the stress continuum model.

Listen to Episode 9, Season 5: Shut Your Mouth and Open Your Ears: The Real Deal With the Righting Reflex
Guest: MAJ Abby Diehl
In this episode of Practical for your Practice, we are joined by motivational interviewing maven and one of our USU colleague besties, Dr. Abby Diehl, who challenges us to become more aware of our righting reflex - or our tendency, as behavioral health providers, to become problem detectors who offer immediate solutions to eradicate said problem(s). This is easier said than done when one tries to operate in the larger (quick) “fix it” culture many of us find ourselves in. Her advice? Shut your mouth and open your ears and listen to understand. You might be surprised how just being with people and deeply listening can lead to deeper connection and ultimately profound change. 

Listen to Episode 8, Season 5: Meeting Clients Where They Are: EBPs in Dual Diagnosis Cases
Guest: Dr. Mark Campanile
One of the most common co-morbid conditions with many of the disorders treated by mental health providers is substance-use disorder (SUD). And while many of us as providers are trained in evidence-based psychotherapies for disorders such as PTSD, MDD, GAD, Primary Insomnia, etc, many of us are not as well trained regarding how to manage or treat co-morbid SUD. Research demonstrates that concurrent treatment of the primary condition and co-morbid SUD has the highest likelihood of positive treatment outcomes.

Listen to Episode 7, Season 5: Reclaiming Power with Scooby Snacks - Nightmare Rescripting Therapy for Youth
Guest: Dr. Shantel Fernandez-Lopez
Treatment of nightmares is an evolving field. Today we’re joined by Dr. Shantel Fernandez Lopez, who introduces us to a treatment option for youth. Exposure, Relaxation, and Rescripting Therapy (ERRT) is one of the evidence-based treatments for nightmares. Though it was originally developed for adults, modifications have been made for use with children and adolescents. As one of the treatment developers, Dr. Fernandez Lopez walks us through those evolutions and shares examples of ERRT in practice….including how to use Scooby Snacks to reclaim good sleep!

Listen to Episode 6, Season 5: The Big Bears: Medication-Assisted Treatment of Substance Use Disorders with Comorbidities
Guest: Catherine Perri, LCSW, LCDC
Medication-Assisted Treatment may be intimidating, but it can also be life-saving for clients who are facing withdrawal from opioid or alcohol dependency. Today we’re joined by Catherine Perri, Clinical Director of the Ripple Ranch. Catherine provides us with a crash course in understanding what MAT is, addressing the stigma associated with dual diagnoses, and the goal of utilizing MAT in conjunction with evidence-based psychotherapies to treat “the whole person.”

Listen to Episode 5, Season 5: E is for "Enhanced": CBT-E for Eating Disorders
Guest: Suzanne Straebler, Ph.D., PMH-BC
Eating disorders often have a “bad rap” as being intractable, difficult to treat, and dangerous. There is a wide range of eating disorders, each with their own unique features and challenges. And to make matters more complicated, many mental health providers do not receive focused training on how to treat these disorders, oftentimes leading to reticence to engage, worried that we’ll say or do the wrong thing. Fortunately there is an effective evidence-based psychotherapy for eating disorders–CBT-E (The E is for “Enhanced”).

Listen to Episode 4, Season 5: Special Considerations for Working With Guard/Reserve Service Members
Guest: Jennifer Nevers, MSW, LCSW
Always been curious about working with the National Guard or Reserves? In this not-to-miss episode we sit down with CDP’s own Jennifer Nevers, who not only serves as an integral team member of the Star Behavioral Health Providers Program (SBHP) that aims to expand the availability of high-quality behavioral health services, especially for those in the reserve components, BUT Jennifer is also a Major in the Indiana Army National Guard serving as a Behavioral Health Officer (BHO).

Listen to Episode 3, Season 5: Don't Forget the Caregivers - Support for Caregivers of Children and Teens After Self-Directed Violence
Guest: Dr. Alejandra Arango
Working with clients with suicidal thoughts and behaviors is one of the more challenging aspects of being a behavioral health provider. This is perhaps even more so when the client is a child or adolescent. An important, and sometimes overlooked, aspect of working with suicidal youth is working with and supporting their caregivers–moms, dads, grandparents, whoever may be primarily responsible for their care. How can we best support them while they are dealing with the scary unknown territory of suicide risk management for their child? At at time when almost 20% of high school students report suicidal ideation in the past year, and 10% report a suicide attempt in the same time period, join us for this vital discussion about caregiver care after youth self-directed violence.

Listen to Episode 2, Season 5: What is Your Why? How Did We Get Here, and Why Do You Care?
Guests: Dr. Andy Santanello
On this episode, Carin and Kevin are joined by long-time host and Friend of CDP, Dr. Andy Santanelllo. Andy has been focused on dissemination and implementation science through The ACT Academy, and returns to the P4P Podcast to share ideas about how we can deliver EBPs more consistently and competently.
His suggestions are not just aspirational or “fanciful,” but rather small tweaks that we can make to existing training, supervision, and consultation efforts. Join us as we catch up with Andy and discuss ways to merge cutting-edge science with practical applications for learners, instructors, supervisors, consultants, and everyone in between.

Listen to Episode 1, Season 5: What is Your Why? How Did We Get Here, and Why Do You Care?
Guests: Drs. Ermold, Holloway & Lefkowitz
Guess who's back? Back again… Welcome to Practical for your Practice (P4P) Season 5! Your hosts are excited to kick things off with a reveal of this season’s theme. On P4P, we believe in the importance of relating to each as a behavioral health podcast community. So in that vein, for Season 5 we will be asking our guests “What is their why?”
What drew them into the field of behavioral health and the specific slice of the field that they're in? Behavioral health provider origin stories, if you will. What better way to kick things off than to have your hosts disclose theirs. You might even hear about their superpowers. So tune in for some actionable intel about career paths and get excited for a great season!

This podcast is produced by the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences. The views expressed are those of the speakers and do not necessarily reflect the opinions of the Uniformed Services University, the Department of Defense, or the US Government. In addition, reference to any specific company, products, processes, or services does not necessarily constitute or imply endorsement by the Uniformed Services University, the Department of Defense, or the US Government.

Practical for Your Practice, Season 3

Listen to Episode 12, Season 3: Evolving Our Thinking about Thinking in Psychotherapy
Guest: Dr. Jeff Mann
From the time Aaron Beck and Albert Ellis recognized the importance of addressing unhelpful cognitions and cognitive processes in the treatment of depression in the 1960’s, cognitive behavioral therapy has become a driving force in the world of evidence-based practice. Initially, Drs. Beck and Ellis focused on the content of thoughts as the primary target for psychological interventions. Similarly, modern behavioral psychology has emphasized the importance of addressing cognition as a key aspect of successful psychotherapy. However, B.F. Skinner’s focus on verbal behavior as a generalized operant and modern contextual behavioral scientists’ work on Relational Frame Theory tend to emphasize the importance of addressing contextual factors that influence the function or impact of language over the content of thoughts. In this wide ranging episode, Drs. Jeff Mann, Andy Santanello, and Kevin Holloway discuss places of convergence between these two great traditions and look toward the future of process-based approaches to cognition. Make sure you grab some coffee and a snack: this is a LONG one!

Listen to Episode 11, Season 3: Sharpening our EBP Focus Through the Lens of Military Culture
Guest: Dr. Shannon McCaslin
Cultural competency training is an essential component of all behavioral health training curriculums and often a requirement for continuing education for licensed providers. But how often do those training opportunities include “military service” in the mix of cultural dimensions of identity that influence or shape an individual’s experience? Not often enough. In this episode we are joined by Dr. Shannon McCaslin as we explore the importance of keeping “eyes on” military culture to better understand how it can and should inform our EBP work. Come hear how military culture can influence your patients’ perspectives of their symptoms and treatment options level of, engagement, adherence, and treatment outcomes.

Listen to Episode 10, Season 3: Shifting Perspectives Through Moral Injury to Posttraumatic Growth
Guest: David Dahl
Reactions to trauma vary from person to person. Although Post-traumatic Stress Disorder (PTSD) is often a main topic of conversation regarding trauma, two other important post-traumatic trajectories, Moral Injury and Post-traumatic Growth, are gaining recognition. In this episode, Marine Corps Veteran, Social Worker, and Zen priest David Dahl share his unique perspective on trauma recovery, modeling the importance of shared perspective-taking in helping service members in their journey to recovery.

Listen to Episode 9, Season 3: Diamonds in the Rough: Finding and Integrating Evidence-based Apps Into Evidence-based Psychotherapies
Guest: Dr. Greg Reger
Like we’ve heard hundreds of times, “there’s an app for that!” Mobile apps are ubiquitous in modern life. With the proliferation of mental health apps available, it can be difficult to determine which apps have been rigorously tested and validated. Additionally, the mental health app market is largely unregulated, meaning that many apps may make claims about their effectiveness without sufficient evidence to support them. This can be problematic, as using an app without evidence-based support may not only be a waste of time and money but also potentially harmful if it leads to delayed treatment or incorrect self-diagnosis. How is a mental health practitioner to find evidence-based apps to use in therapy? And what are the challenges to NOT considering utilizing mobile apps in clinical work? Join us in a fascinating discussion with Dr. Greg Reger about the current mental health mobile app landscape and you can integrate mobile app use in your clinical practice.

Listen to Episode 8, Season 3: Is There an Elephant in Your Room? What to do When Sociocultural and Political Issues Stomp Into Your EBP
Guest: Dr. Abigail Angkaw
You can sense it coming, feel it before you see it and hear it. The small tremors in conversation that warn you the elephant is incoming. You brace, trying to keep the focus on your agenda, perhaps cling to the familiar safety of your EBP protocol. But the elephant is coming into your clinical space and now you have to decide what to do. In this episode of Practical for your Practice, we roll up our sleeves with Dr. Abigail Angkaw to address the topic of what clinicians can do when sociocultural and political issues stomp into their EBP. More specifically, what to do when we clinicians, as humans, have a strong reaction to those issues. THAT, is the elephant in the room. Tune in for some tips to tune up on areas like disclosure, self-reflection, microaggressions, finding empathy, context and case conceptualization, and what is best for your client and YOU when those elephants won’t leave your room.

Listen to Episode 7, Season 3: The Beginning of the Beginning: What Might be Promising about Psychedelic Assisted Therapy
Guest: Dr. Brian Pilecki
Psychedelic Assisted Therapy. Perhaps reading that phrase brings about word associations like “mushrooms” “LSD” “Molly” “Mescaline” “altered state”, “euphoria” and even “the 60’s”. Or perhaps just seeing those words makes you curious enough to take a listen to this awesome podcast with Dr. Brian Pilecki, a clinician and researcher in the emerging field of integrating psychedelics into the treatment of behavioral health disorders. Listen in and learn as Dr. Pilecki explains some of the ins and outs of psychedelic assisted therapy to include what it is, who might benefit, types of psychedelics that have been most studied, where the research stands, as well as how to get more information.

Listen to Episode 6, Season 3: Is it Really Taboo? Inviting Spirituality into Evidence-Based Practices
Guest: Dr. Andy Santanello
Any guide to “small talk” will tell you that there are just some topics that you shouldn’t broach in most social situations. One of those topics is spirituality. But should spirituality be taboo in psychotherapy? Does the direct discussion of spirituality have a place inside evidence-based practice? In this episode, Andy, Kevin, and Jenna chat about some practical ways to answer these questions and offer ideas for “going there” when spirituality might be a useful domain to explore with your clients.

Listen to Episode 5, Season 3: ACTing on Anger, but in a Good Way
Guest: Dr. John Donahue
Anger is something all humans experience. It can be uncomfortable for us as therapists when it shows up in therapy, whether it is the focus of intervention, or when expressed in session. Indeed, traditional clinical approaches have often focused on managing, preventing, or suppressing anger. But perhaps anger itself isn’t always the problem, but rather aggression or other values-inconsistent behavioral choices. Join us as we discuss being curious about anger and its function from an ACT-informed perspective with our guest, John Donahue, Psy.D.

Listen to Episode 4, Season 3: Practicing Being with Scary Things: Helping Clients Get Better at Being With Their Difficult Stuff
Guest: Mike Twohig
Exposure-based interventions are some of the most powerful tools that therapists can offer to their clients, especially those who struggle with anxiety. However, there are different models of exposure with different proposed mechanisms and different desired outcomes. In this episode, anxiety disorders and Acceptance and Commitment Therapy expert Mike Twohig exposes us to some useful ways to help clients get better at being with their difficult stuff.

Listen to Episode 3, Season 3: If We Just Say All the Right Things, Everyone Will Love This Episode - Talking About the "Just World Belief"
Guest: Dr. Carin Lefkowitz
The Just World Belief (JWB), or the notion that good things happen to good people and bad things happen to bad people, is a fundamental and often problematic assumption for both clients and therapists. Believing that doing all the “right things” will lead to the outcome we want doesn’t match up to the realities of life in many cases and can lead to stress and perfectionism. In this episode, Kevin and Andy chat with Senior Military Behavioral Health Psychologist Carin Lefkowitz about the impact of the JWB on clients and therapists and some practical ways to make all the right moves to address it.

Listen to Episode 2, Season 3: Take That Nap! Strategies and Tips for Working with the Sleep Deprived
Guest: Dr. Diana Dolan
When we think of “sleep problems,” most of the time, our brains go to insomnia – that group of people we work with who have difficulty falling asleep or staying asleep despite adequate opportunity to sleep. But what about the opposite side of the sleep coin… or pillow, if you will? What about the group of folks who desperately want sleep, need sleep, crave sleep, AND could sleep if only given adequate opportunity to do so? In this episode, we sit down once again with one of CDP’s sleep experts, Dr. Diana Dolan, to talk about sleep deprivation and the associated functional impairments.

Listen to Episode 1, Season 3: Making Room for Emotions: Emotionally Focused Therapy for Military Couples
Guest: Ms. Liz Polinksy
Emotionally-Focused Couples Therapy (EFT) is an evidence-based psychotherapy for couples that helps couples get better understanding and accepting their emotions, to be vulnerable in communicating those emotions to each other, and to get better at validating and supporting their partners. A challenge that therapists often face when working with military clients who are in committed relationships is deciding when to address relationship issues in individual therapy and when to refer your client to couples therapy. In this episode, certified EFT therapist Liz Polinksy share some actionable intel related to her work with military couples.

This podcast is produced by the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences. The views expressed are those of the speakers and do not necessarily reflect the opinions of the Uniformed Services University, the Department of Defense, or the US Government. In addition, reference to any specific company, products, processes, or services does not necessarily constitute or imply endorsement by the Uniformed Services University, the Department of Defense, or the US Government.

Practical for Your Practice, Season 1

Listen to Episode 13: "Wide Awake to Talk About Sleep - Common Pitfalls in the Assessment and Treatment of Sleep Disorders"
Guest: Dr. Diana Dolan
While disrupted sleep is one of the number one presenting concerns for military-connected clients, it remains under assessed and mis- or undertreated. In this episode, we pull the covers back to reveal the most common pitfalls for providers when it comes to addressing sleep disorders with CDP’s own sleep guru, Dr. Diana Dolan. There are a lot of ways sleep can go wrong and often sleep problems take on a life of their own and become a primary diagnosis. Come join us for a discussion on how to improve your assessment of sleep problems and hear actionable intel to strengthen your treatment approaches.

Listen to Episode 12: "There’s (already!) an app for that! Utilizing lighter, targeted, ecologically valid tech in EBPs"
Guest: Dr. Peter Tuerk
The future is now. Technology augmentation of the dissemination and implementation of EBPs has never been more widely accepted, from mobile apps to synchronous telehealth to asynchronous post-workshop support. Join us as we geek out with Dr. Peter Tuerk about the merits of technology adoption in EBPs, thinking creatively about using familiar technologies in new ways, provider-crowd-sourcing, and avoiding the trap of insisting that technology solutions must be replications of the old ways of doing things. Come for the tech talk, stay for the “skewmorphs.”

Listen to Episode 11: "Commiting to Consultation: Five Barriers and Tips for Facing Them"
Guest: Dr. Andrew Sherrill
Almost all of us clinicians agree that consultation helps us to be better at our jobs. Committing to the consultation can be another story. In this episode, Dr. Andrew Sherril of the Emory University Prolonged Exposure Consultant Training Program shares some actionable intel on facing, and overcoming, five common barriers to committing to consultation.

Listen to Episode 10: "Manifesting the Spirit of Motivational Interviewing in the Context of EBP"
Guest: Dr. Onna Brewer
Motivational Interviewing (MI) is a style of communication that can be useful in many different clinical situations. Maintaining the spirit of MI while practicing EBP presents a challenge. In this episode, Dr. Onna Brewer shares some actionable intel that will help you to listen with an ear for connection and change talk and to do what comes naturally (or maybe NOT so naturally) in practicing EBPs.

Listen to Episode 09: "Making Common Factors Common in EBP Practice"
Guest: Dr. Michael Jones
When learning a protocol for evidence-based psychotherapy, the question commonly arises about common factors: “Why do I need to learn this protocol if most of the change in psychotherapy can be traced back to common factors?” or conversely “If I follow the steps on this protocol checklist, I don’t have to worry about common factors at all like therapeutic alliance, right?” Join us as we discuss the interplay of common factors and EBP protocols, how they are not mutually exclusive, and how to make sure you are attending most to the real person and the real relationship with you in the room while applying EBP techniques.

Listen to Episode 08: "Angry Again: Tips on Managing Emotions to Reduce Aggression"
Guest: Dr. Shannon Miles
Anger is the most highly reported challenge, across disorders, for Service members and Veterans, especially postdeployment. In this episode we get fired up talking about anger, aggression and the role of other secondary emotions such as guilt, shame and fear. Our guest, Dr. Shannon Miles, helps us distinguish between impulsive and premeditated aggression and walks us through the main components of her protocol Managing Emotions to Reduce Aggression.

Listen to Episode 07: "Recognizing and Responding to Microaggressions in Clinical Practice"
Guest: Dr. Ryan C. Warner
Microaggressions are subtle, covert forms of discrimination that impact marginalized populations. In this episode, Dr. Ryan Warner shares his insights on the importance of recognizing and responding genuinely to microaggressions in a clinical context as well as some of his own experiences of microaggressions.

Listen to Episode 06: "Practicing What We Preach - Applying Best Clinical Practices to Caring for Ourselves"
Guest: Dr. Carin Lefkowitz
Provider self-care is an important and ethical responsibility for all providers. Our training as behavioral health providers does not render us immune from stress and even symptoms of mood or anxiety difficulties. Many of us found that some of the self-care behaviors we relied on prior to the COVID-19 pandemic were suddenly unavailable. What can be done? Consider creatively applying the advice we give to our clients to ourselves. Listen as Andy discusses with Dr. Carin Lefkowitz practical adjustments we can make to our self-care routines in the current environment.

Listen to Episode 05: "Functionally Speaking: Conceptualization with the Head and the Heart"
Guest: Dr. Robyn Walser
In this episode we sit down with Dr. Robyn Walser for a rich discussion on how clinicians can get better at conceptualizing cases on the fly. We talk about moving from technical to functional, from fidelity to competence, the importance of contextual factors, and most importantly, balancing the need to be present with our clients with our hearts as well as our heads. Come hear Dr. Walser’s actionable intel about improving case conceptualization through understanding the purpose of behavior (the clients and ours), the client’s desired trajectory and the importance of understanding the psychological inflexibility processes that keep clients stuck.

Listen to Episode 04: "When Chronic Pain Enters the Room: Responding Effectively when Physical Pain is Reported by Your Clients"
Guest: Dr. Sharon Birman
Physical pain can be tough to address when it is a focus of psychotherapy, and it can be even tougher when it “shows up” unexpectedly like an unwanted guest. In this podcast, our colleague Dr. Sharon Birman shares some practical, evidence-based tips for responding to comorbid physical pain during the course of therapy for other presenting issues. Dr. Birman’s take-home message… don’t be afraid to engage with chronic pain!

Listen to Episode 03: "This IS the Track - How Talking About Afghanistan Doesn't Have to Derail an EBP"
Guests: Drs. Kelly Chrestman and Sonya Norman
The recent events in Afghanistan have left many military-connected clients (and providers!) reeling, creating a sense of anxiety in clinics about how to best provide support. In this episode, we bring lead EBP consultants from VA and DoD together to talk about the importance of examining our own reactions, making room for our client’s grief, anger and other emotions and how to be fully present in the room as our clients struggle to (re)create balance and meaning. We explore how validation serves as the essential substrate across EBP’s, as well as ways providers can support clients to examine values and move with intention through these historical events. Don’t miss this special episode as your colleagues discuss “doom scrolling,” the “EBP police” and much more!

Listen to Episode 02: "Flexing New Muscles When Doing Prolonged Exposure Therapy (and Assigning in vivo Exercises) Amidst a Pandemic"
Guest: Dr. Kelly Chrestman
Masks, social distancing and hand sanitizer, oh my! This week we are joined by Dr. Kelly Chrestman, one of CDP’s Prolonged Exposure mavens, to talk about practical tips for doing in vivo work during the pandemic. We dig into how assigning in vivo items may or may not have changed in the midst of the pandemic and creative ways to maintain momentum. Not doing PE? There is still actionable intel for you on how to collaborate with clients to get them engaged in meaningful activities despite all the barriers of COVID. This is the time to flex new muscles and think outside the box with us as we talk about doing PE (via telehealth) during the pandemic.

Listen to Episode 01: "I Went to the Workshop. Now What? Tips for Improving EBP Skills"
Guests: Drs. Kevin Holloway and Andy Santanello
All of us have been to multiple day workshops to learn new clinical skills. Although we might leave with some enthusiasm, new skills, and new information, that doesn’t always mean that we are proficient in applying new learning. In this podcast, Drs. Holloway and Santanello chat about some of the strategies that they have used as EBP practitioners to improve their skills.

Listen to Episode 00: "The Most Impractical Episode - The Why Behind Practical for Your Practice"
Guests: Drs. Andy Santanello, Jenna Ermold and Kevin Holloway
Three clinical psychologists and trainers from the Center for Deployment Psychology (CDP) at the Uniformed Services University (USU) come together to talk about the good, the bad, and the ugly of actually implementing Evidence-Based Psychotherapies (EBPs). Practical for your Practice is a bi-weekly podcast featuring stories, ideas, support, and actionable intel to empower providers to keep working toward implementing EBPs with fidelity and effectiveness. In this first episode your hosts Drs. Jenna Ermold, Kevin Holloway, and Andy Santenello share the who, what, where, and why behind this podcast and more importantly how these conversations between colleagues can enhance the work you do.

This podcast is produced by the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences. The views expressed are those of the speakers and do not necessarily reflect the opinions of the Uniformed Services University, the Department of Defense, or the US Government. In addition, reference to any specific company, products, processes, or services does not necessarily constitute or imply endorsement by the Uniformed Services University, the Department of Defense, or the US Government.