There are tens of millions of children (youth and adult) of parents who are veterans. These individuals can experience traumatic injury alongside the parent who is a combat veteran. It is a parallel process called “veterans-by-proxy.” A proxy is an individual that acts on behalf of another individual. The proxy witnesses how combat traumatizes their parent and vicariously experience the trauma themselves. When a proxy suffers secondary trauma, ambiguous loss, and insecure attachment, one or more ego functions fail to adequately develop. This article proposes a conceptual framework of the proxy’s loss as it relates to the parent’s trauma and discusses research-based resiliency-focused interventions critical to healing the relationship between the proxy and the parent who is a combat veteran.
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1 - 12 of 121 Veterans-by-proxy: A conceptual framework of ambiguous loss among children of combat veterans
Veterans-by-proxy: A conceptual framework of ambiguous loss among children of combat veterans
APA Citation:
Kelly, D., & Paul, M. (2018). Veterans-by-proxy: A conceptual framework of ambiguous loss among children of combat veterans. Journal of Family Social Work, 21 (4/5), 255-270. https://doi.org/10.1080/10522158.2017.1321605
Focus:
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Adulthood (18 yrs & older)
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Research & Summary
Kelly, Diann; Paul, Marilyn
2018
Professionals' perspectives on relevant approaches to psychological care in moral injury: A qualitative study
APA Citation:
Serfioti, D., Murphy, D., Greenberg, N., & Williamson, V. (2023). Professionals’ perspectives on relevant approaches to psychological care in moral injury: A qualitative study. Journal of Clinical Psychology, 79(10), 2404-2421. https://doi.org/10.1002/jclp.23556
Focus:
Programming
Mental health
Trauma
Veterans
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Serfioti, Danai; Murphy, Dominic; Greenberg, Neil; Williamson, Victoria
2023
Objectives: Despite the increasing consensus that moral injury (MI) is a unique type of psychological stressor, there is an ongoing debate about best practices for psychological care. This qualitative study explored the perceptions of UK and US professionals in the field of MI investigating advances and challenges in treatment or support delivery and issues relating to treatment/support feasibility and acceptability. Methods: 15 professionals were recruited. Semi-structured, telephone/online interviews were carried out, and transcripts were analyzed using thematic analysis. Results: Two interconnected themes emerged: perceived barriers to appropriate care for MI cases and recommendations for providing effective care to MI patients. Professionals highlighted the challenges that occur due to the lack of empirical experience with MI, the negligence of patients' unique individual needs and the inflexibility in existing manualised treatments. Conclusions: These findings illustrate the need to evaluate the effectiveness of current approaches and explore alternative pathways, which will effectively support MI patients in the long-term. Key recommendations include the use of therapeutic techniques which lead to a personalised and flexible support plan to meet patients' needs, increase self-compassion and encourage patients to reconnect with their social networks. Interdisciplinary collaborations (e.g., religious/spiritual figures), could be a valuable addition following patients' agreement.
Marriage and family therapists’ exposure to trauma, access to support, and intention to leave: It takes a village
APA Citation:
Armes, S. E., Seponski, D. M., Bride, B. E., & Bryant, C. M. (2023). Marriage and family therapists’ exposure to trauma, access to support, and intention to leave: It takes a village. International Journal of Systemic Therapy. Advance online publication. https://doi.org/10.1080/2692398X.2023.2223119
Focus:
Mental health
Other
Population:
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Armes, Stephanie E.; Seponski, Desiree M.; Bride, Brian E.; Bryant, Chalandra M.
2023
Secondary traumatic stress (STS), or experiencing trauma through exposure to clients’ traumatic stories, occurs across helping professions. No studies have focused solely on STS in Marriage and Family Therapists (MFTs). In a sample of MFTs (N = 201), this study hypothesized that exposure to trauma through therapeutic work would be associated with STS and MFTs’ intentions to leave their job. Findings indicated trauma exposure was positively associated with STS (β = .33, p < .001) and intention to leave (β = .18, p < .001). STS partially mediated the association between MFTs’ exposure to trauma in their work and intention to leave (β = .06, p < .05). Compassion satisfaction (β = −.49, p < .001) and organizational commitment to resilience building (β = −.26, p < .001) were negatively associated with intention to leave. The final model accounted for 58% of the variance in intention to leave. Prevention implications are discussed.
Making sense of changes in military partners’ post-deployment adjustment concern: Turning points, trajectories, and accounts
APA Citation:
Dorrance-Hall, E., Gettings, P., Wilson, S. R., Hintz, E., & Vidal, A. (2023). Making sense of changes in military partners’ post-deployment adjustment concern: Turning points, trajectories, and accounts. Journal of Social and Personal Relationships, 40(11), 3679-3702. https://doi.org/10.1177/02654075231187700
Focus:
Deployment
Couples
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Reserve
Guard
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
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Research & Summary
Dorrance-Hall, Elizabeth; Gettings, Patricia; Wilson, Steven R.; Hintz, Elizabeth; Vidal, Ana
2023
Reintegration after a military service member returns home from deployment is a time of uncertainty that requires adjustment by all family members. Building on accounts (i.e., story-like constructions that help make sense of stressful events) scholarship, this study documents (a) turning points and (b) patterns in partners’ levels of concern about post-deployment adjustment and investigates (c) how romantic partners account for why changes in adjustment concern occurred. Findings from interviews with 26 military partners reveal that accounts (a) involve multifaceted explanations spanning many domains of life, (b) explain why certain TPs increased and/or decreased concern, and (c) engage the meaning of time in varied ways. The importance of integrating an account-making framework with the TP methodology, theoretical implications for relational turbulence theory, and practical suggestions are discussed.
The impact of changes in family communication on sustained mental health symptom improvement in parents/caregivers following a military family intervention
APA Citation:
Wasserman, M., Dodge, J., Barrera, W., Alaris, H., Woodward, K., & Lester, P. (2023). The impact of changes in family communication on sustained mental health symptom improvement in parents/caregivers following a military family intervention. Military Behavioral Health. Advance online publication. https://doi.org/10.1080/21635781.2023.2221473
Focus:
Mental health
Parents
Programming
Branch of Service:
Multiple branches
Navy
Military Affiliation:
Active Duty
Population:
Preschool age (2 -5 yrs)
Adolescence (13 - 17 yrs)
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Wasserman, Melissa; Dodge, Jessica; Barrera, Wendy; Alaris, Hilary; Woodward, Kristen; Lester, Patricia
2023
A key mechanism of resilience, family communication, is examined in relationship to sustained improvement in parent/caregiver mental health. Service delivery data was utilized from parents/caregivers who participated in Families OverComing Under Stress. Data were analyzed for parents/caregivers indicating clinically meaningful symptoms of depression or anxiety at baseline and who completed measures of family communication each session and follow-up. Results found that family communication improvement from Baseline-Exit was significantly associated with sustained improvement in anxiety (p = .0223) and depression (p = .0349). Improvements in family communication may be critical in sustaining mental health symptom improvement among parents/caregivers.
Resources and support for sexual assault survivors receiving services from the U.S. Air Force: What survivors say they need for recovery
APA Citation:
Spencer, C. M., King, E. L., Foster, R. E., Vennum, A., & Stith, S. M. (2023). Resources and support for sexual assault survivors receiving services from the U.S. Air Force: What survivors say they need for recovery. Violence and Victims, 38(3), 414–434. https://doi.org/10.1891/VV-2021-0132
Focus:
Mental health
Trauma
Physical health
Branch of Service:
Air Force
Military Affiliation:
Active Duty
Reserve
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Spencer, Chelsea M.; King, Erika L.; Foster, Rachel E.; Vennum, Amber; Stith, Sandra M.
2023
Sexual assault (SA) is a serious challenge faced by the U.S. military. Participants in this study included men and women who volunteered in response to a call for survivors of SA. Participants included active duty and reserve U.S. Air Force (USAF) members, spouses of service members, or civilian employees for the USAF (beneficiaries). The primary research question was, “if you could design the perfect response system to support survivors, what would be included in this system?” The research team conducted in-depth interviews with nine survivors. Next, 82 survivors completed a survey agreeing or disagreeing with strategies identified by interview participants to improve services for survivors and offered additional suggestions. Analysis revealed survivor recommendations to improve SA services.
7 Upstream suicide prevention in the U.S. Army: Noncommissioned officers’ perspectives
Upstream suicide prevention in the U.S. Army: Noncommissioned officers’ perspectives
APA Citation:
Ayer, L., Holliday, S., Beckman, R., Jaycox, L. H., Elinoff, D., Ramchand, R., Agniel, D., Hoch, E., & Wagner, L. (2023). Upstream suicide prevention in the U.S. Army: Noncommissioned officers’ perspectives. Psychological Services. Advance online publication. https://doi.org/10.1037/ser0000788
Focus:
Mental health
Other
Branch of Service:
Army
Military Affiliation:
Active Duty
Guard
Reserve
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Ayer, Lynsay; Holliday, Stephanie; Beckman, Robin; Jaycox, Lisa H.; Elinoff, Daniel; Ramchand, Rajeev; Agniel, Denis; Hoch, Emily; Wagner, Lisa
2023
The goal of this study was to examine the factors associated with Army noncommissioned officer (NCO) experiences, attitudes, and behaviors in their role of identifying potential suicide risk factors in their fellow soldiers. To better understand the perspectives of NCOs, an anonymous survey was administered to 2,468 Army NCOs. Descriptive statistics and linear regressions were conducted to compare subgroups of NCOs. Most (71%) Army NCOs have received many (11 or more) hours of suicide prevention training, but training in soft skills that may be important for the gatekeeper role was less consistently reported. Active Component soldiers reported greater confidence in their intervention skills (Cohen’s d = 0.25) and fewer logistical barriers (e.g., time and space to talk) to intervening with at-risk soldiers (Cohen’s d = 0.80) compared to Reserve and National Guard soldiers. Formal coursework in mental health areas like psychology or chaplaincy was associated with a greater level of confidence in intervention skills (Cohen’s d = 0.23) and in more frequent intervention behavior (Cohen’s d = 0.13). Army NCO trainings should be modified to better equip soldiers with the soft skills (e.g., active listening skills and verbally and nonverbally conveying nonjudgment/acceptance and empathy) needed to have effective conversations with soldiers about suicide risk factors and other sensitive topics. Strategies used within mental health education, which appears to be a strength for NCO gatekeepers, could be used to achieve this goal. Reserve and Guard NCOs may need additional supports and tailored trainings to better fit their operational context. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Barriers to and facilitators of military spouses’ recovery from perinatal mental health disorders: A qualitative study
APA Citation:
Nguyen, M. H., Semino-Asaro, S., Reminick, A. M., Rukaj, A. T., & Connelly, C. D. (2023). Barriers to and facilitators of military spouses’ recovery from perinatal mental health disorders: A qualitative study. Journal of Military, Veteran and Family Health, 9(4), 77-87. https://doi.org/10.3138/jmvfh-2022-0067
Focus:
Mental health
Parents
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Nguyen, My Hanh; Semino-Asaro, Semira; Reminick, Alison M.; Rukaj, Amber T.; Connelly, Cynthia D.
2023
Perinatal mental health disorders (PMHDs) are a common complication of child-bearing that affect about one in seven mothers in the United States. Military life often involves recurring separations from family as a result of deployments. Although much research has focused on how PMHDs affect military families, little is known about military spouses’ experiences in recovering from PMHDs. This qualitative study centred on barriers to and facilitators of PMHD recovery among U.S. female military spouses. Semi-structured focus groups revealed five main barriers (stigma, impacts on servicemember’s career, lack of support, accessibility, practical and logistical concerns) and three main facilitators (solid support structure, encouragement to seek help, practical and logistical facilitators). Identifying specific barriers to and facilitators of PMHD recovery among military spouses promotes military family psychological health and wellness.
A pilot of couple HOPES within the U.S. Veterans Affairs Healthcare System: PTSD and relationship outcomes in veteran couples
APA Citation:
Morland, L. A., Wachsman, T., Webster, K., Fitzpatrick, S., Valela, R., Crenshaw, A. O., Monson, C. M., & Knopp, K. C. (2023). A pilot of couple HOPES within the U.S. Veterans Affairs Healthcare System: PTSD and relationship outcomes in veteran couples. Psychological Services. Advance online publication. https://doi.org/10.1037/ser0000773
Focus:
Veterans
Programming
Mental health
Couples
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Morland, Leslie A.; Wachsman, Tamara; Webster, Katelyn; Fitzpatrick, Skye; Valela, Robert; Crenshaw, Alexander O.; Monson, Candice M.; Knopp, Kayla C.
2023
Conjoint interventions for posttraumatic stress disorder (PTSD) offer an opportunity to target symptoms’ broader social impact, including couples’ relationship satisfaction. Technology-assisted interventions may help overcome access to care barriers for couples. Couple Helping Overcome PTSD and Enhance Satisfaction (HOPES) is a coached internet-based couples’ intervention for PTSD adapted from cognitive behavioral conjoint therapy, an evidence-based dyadic therapy for PTSD. This pilot study examined the implementation feasibility, acceptability, and preliminary efficacy of Couple HOPES in a sample of 15 United States veterans with PTSD and their romantic partners within a Veterans Affairs (VA) Medical Center setting. There were significant improvements in veterans’ PTSD symptoms (self- and partner-reported) and both veterans’ and partners’ relationship satisfaction, though the effect sizes were small (all g’s < .40). Importantly, the 73% retention rate and participant feedback at postassessment suggest this online adaptation may help couples overcome barriers to accessing care. More broadly, this pilot study helps answer questions regarding where digital health interventions fit into the continuum of PTSD care within the VA system. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
10 Welcome to the U.S. Army: A qualitative examination of the Army’s reception of new soldiers
Welcome to the U.S. Army: A qualitative examination of the Army’s reception of new soldiers
APA Citation:
Kintzle, S., Schnyder, L. P., Alday, E., Gonzalez, L. A., Barak, M. M., & Castro, C. A. (2023). Welcome to the U.S. Army: A qualitative examination of the Army’s reception of new soldiers. Armed Forces & Society. Advance online publication. https://doi.org/10.1177/0095327X231170837
Focus:
Other
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Share the article
Research & Summary
Kintzle, Sara; Schnyder, Leslie P.; Alday, Eva; Gonzalez, Lindsey Alas; Barak, Michàlle Mor; Castro, Carl A.
2023
Joining the Army, a new installation or a new unit are times of significant stress for Soldiers. Support provided during these transitions can affect unit cohesion, Soldier well-being, retention, and mission readiness. This research aimed to explore how Soldiers experience the Army onboarding process as well as perceptions of the welcome experience. Nineteen focus groups were conducted with 120 Soldiers using a semistructured interview protocol. Thematic analysis of focus group transcripts revealed two major themes, varied welcome experience and an inconsistent Total Army Sponsorship Program. Soldiers reported varied transition experiences ranging from positive, neutral, nonexistent, to negative. Results indicate that Soldiers welcome experience was dependent on the specific installation, leaders, and unit. Findings demonstrate that at the installation and unit level, the Army currently lacks standardized processes for onboarding new service members. We note the research limitations and offer several recommendations that can be drawn from the present findings.
Feasibility and acceptability of a virtually delivered mindfulness-based intervention for post-9/11 veterans
APA Citation:
Shue, S. A., Do, A., & Brosmer, J. (2023). Feasibility and acceptability of a virtually delivered mindfulness-based intervention for post-9/11 veterans. Military Behavioral Health. Advance online publication. https://doi.org/10.1080/21635781.2023.2221469
Focus:
Programming
Mental health
Veterans
Branch of Service:
Multiple branches
Air Force
Army
Marine Corps
Navy
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Shue, Sarah A.; Do, Annie; Brosmer, Jayme
2023
This pilot study examined the feasibility and acceptability of a virtual mindfulness-based intervention known as RECLAIM (Reconnecting to Civilian Life using Activities that Improve Mindfulness). RECLAIM is a multi-component intervention that is aimed at post-9/11 veterans to strengthen skillsets (e.g., goal setting, energy management) and protective factors (e.g., sense of purpose, social connection) that can mitigate challenges associated with the reintegration process. Feasibility and acceptability outcomes were study enrollment and intervention completion rates. Participants also completed outcome assessments at baseline and postintervention to facilitate a preliminary exploration of the impact of RECLAM participation on several outcomes of interest (e.g., psychosocial functioning, facets of mindfulness). We also conducted qualitative interviews with participants to elicit additional information about feasibility, acceptability, and the outcomes of interest. Eighteen of the thirty-five (51%) eligible participants contacted by phone enrolled. Sixty-one percent (n = 11) completed the intervention (
Use of food distribution resources among military families with young children since the COVID-19 pandemic
APA Citation:
O’Neal, C. W., Lucier-Greer, M., Lewis, C., & Farnsworth, M. (2023). Use of food distribution resources among military families with young children since the COVID-19 pandemic. Public Health Nutrition, 26(10), 1968-1975. https://doi.org/10.1017/S1368980023001738
Focus:
Physical health
Programming
Parents
Couples
Children
Branch of Service:
Army
Air Force
Multiple branches
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
O’Neal, Catherine W.; Lucier-Greer, Mallory; Lewis, Crystal; Farnsworth, Meredith
2023
Objective:The present study examined military families’ use of food distribution resources and military (e.g., rank) and non-military (e.g., race/ethnicity) characteristics associated with using food distribution resources.Design:Secondary data analyses from a cross-sectional survey in the first six months of 2021.Setting:A national sample of eligible families completed an online survey.Participants:8,326 enlisted military families with an active duty service member in the Army or Air Force who applied for supplemental childcare funding distributed by National Military Family Association.Results:13.2% of the families reported utilizing a food distribution resource in the past 12 months. Those with lower financial well-being were more likely to utilize such resources. Older (OR=1.04, 95% CI=1.02, 1.05, p<.001), single-earner (OR=.73, 95% CI=.61, .89, p=.001) families with a lower rank (OR=.69, 95% CI=.64, .75, p<.001) and Army affiliation (compared to Air Force) (OR=2.31, 95% CI=2.01, 2.67, p < .001) were more likely to utilize food distribution resources. Members of certain racial/ethnic minority groups were more likely to utilize food distribution resources than White respondents (OR from 1.47 for Multi-racial to 1.69 for Asians), as were families with more dependent children (OR=1.35, 95% CI=1.25, 1.47, p<.001).Conclusions:These results identify the extent of food distribution resource utilization in military families with young children approximately one year into the COVID-19 pandemic. The results also identify characteristics associated with their use of food distribution resources. Findings are discussed with an emphasis on prevention and intervention implications for military families.
