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Military REACH Publications
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Award Winning Publications
1.Why veterans choose VA versus non-VA emergency care: A qualitative study
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2.Veterans’ experiences with accessing community emergency care
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3.Emerging adults in the military and college: An examination of group differences in identity development, transdiagnostic processes, and attitudes toward risk and suicide
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4.Emergency departments treating veterans for suicide: Ensuring quality care for veterans outside of department of veterans affairs health care facilities
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5.Investigating the association between veteran status and rate of emergency department visits
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6.Emergency department imaging of pediatric trauma patients during combat operations in Iraq and Afghanistan
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7.A thematic analysis of perceptions of VHA emergency care and suicide risk assessment among Veterans experiencing homelessness
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8.Exploring the utility of the emerging adulthood theory among military members and veterans with risky substance use
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9.Veterans finding community and a “home” within an emergency housing environment
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10.Culturally informed interventions for military, veteran and emergency service personnel: The importance of group structure, lived experience facilitators, and recovery-oriented content
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11.A qualitative study to investigate the psychosocial effects of operational deployments on Medical Emergency Response Team (MERT) personnel
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12.Complementary and alternative medicine practices in military personnel and families presenting to a military emergency department
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13.Adapting and implementing Caring Contacts in a Department of Veterans Affairs emergency department: A pilot study protocol
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14.The impact of medical school on military physicians’ readiness for their first deployment
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15.Emergency department visits, inpatient hospitalizations, and non-fatal and fatal drug overdoses during COVID-19 among veterans with opioid use disorder
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16.The role of basic psychological needs in determining well-being: A study of diverse samples of emerging adults
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17.Experiences of parental PTSD for children aged 9–17 in military and emergency first responder families
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18.Who sees the chaplain? Characteristics and correlates of behavioral health care-seeking in the military
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19.Factors associated with a lack of healthcare utilization among veterans after a positive suicide screen in the emergency department
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20.Advancing prevention research on child abuse, youth violence, and domestic violence: Emerging strategies and issues
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Research summaries convey terminology used by the scientists who authored the original research article; some terminology may not align with the federal government's mandated language for certain constructs.
A SALUTE TO OUR WOMEN SERVICE MEMBERS FOR WOMEN’S HISTORY MONTH
Women have supported the U.S. Military since our country was founded with the Revolutionary War (1775–1783), although they weren't formally recognized as Service members until 1948. Over time, women’s roles to serve our country have evolved over time, but their capability has never wavered. In this piece, we will explore the roles of women throughout our military history related to varying policies, their contributions to our country, and discuss recent research findings about women Service members. During the Revolutionary War, women found unique ways to aid in the war effort, such as mending clothing, tending to wounds, foraging for food, cooking, cleaning both laundry and cannons, and traveling alongside different militias. In addition, some women disguised themselves as men to fight on the front lines (DeSimone, 2022). Similarly, while women were not allowed to enlist in the Civil War (1861-1865), approximately 1,000 women across the Union and Confederate armies fought while disguised as men (DeSimone, 2022). One of these revolutionary women, Margaret Corbin, was the first woman to receive a military pension (Michals, 2015). In fact, throughout the Civil War, a further 20,000 women served in other ways (e.g., growing crops, sewing, laundry, collecting donations, running fundraising campaigns). But their greatest contribution was serving as nurses for the Union Army. One such volunteer, Clara Barton, went on to found the Red Cross, an influential relief organization to this day (American Red Cross, 2023). During the 20th century, women experienced a shift in the recognition of and allowance for their military service. 1901 saw the start of the U.S. Army Nurse Corps, with a total employment of 403 nurses; by 1918, that number had grown to 3,000. At the same time, a shortage of men available for clerical “yeoman” duties, such as operating telephones and radios and acting as translators, led the Navy to recruit women for these jobs. The first “yeomanettes” served the Navy between 1917 and 1918 (during WWI [1914–1918]; DeSimone, 2022). By WWII (1939–1945), the military enlisted women across all branches. The Army had the Women’s Army Auxiliary Corps and the Army’s Women Airforce Service Pilots. The Navy had Women Accepted for Volunteer Emergency Service. The Marine Corps had the Marine Corps Women’s Reserve. And the Coast Guard’s Women’s Reserve was called Semper Paratus (“Always Ready”). This was a huge victory for women during this time. Throughout WWII, some 350,000 women served the United States in non-combat roles. These roles were not without risk, though: 432 women gave their lives during the war, and a further 88 were taken as prisoners of war (DeSimone, 2022). It wasn’t until 1948 that President Harry S. Truman signed the Women’s Armed Services Integration Act into law, allowing women to serve as full, permanent Service members across the entire military. (The same year, President Truman also issued an executive order integrating the Armed Forces; in addition to desegregating the military, this order also allowed Black women to serve in all branches.) While President Truman’s order was an important step for women, it was still not a complete victory for equal opportunity; women were allowed to comprise only 2% of each branch, and there were limitations on how many women could become officers. Shortly after these acts and orders became law, U.S. involvement in the Korean War (1950–1953) saw 120,000 women serve in two types of positions: (1) those similar to the positions they served in in the past or (2) in active-duty, non-combat positions, such as military police officers and engineers. The U.S.’ involvement in the Vietnam War (1955–1975) resulted in nearly 11,000 women stationed in Vietnam, 90% of whom were nurses in the Army, Navy, and Air Force. It was during this war that President Lyndon B. Johnson allowed women to be promoted to general and flag ranks, and, by 1972, women were able to command units. And the following year, the Pentagon announced that women could remain in the military even if they were pregnant (DeSimone, 2022). Following the Korean and Vietnam Wars, women continued to pave their way in the U.S. Armed Forces, such that during the Gulf War (1990-1991), over 40,000 women deployed to combat zones, although they were still unable to serve in direct combat. Then, in 1994, President Bill Clinton rescinded the “Risk Rule,” which restricted women from serving in roles that would expose them to risks associated with direct combat (e.g., hostile fire, capture) (DeSimone, 2022). This meant that women could now serve in thousands of new positions, even those that could expose them to these risks (e.g., bomber pilot, fighter pilots) (McGrath, 2001). From the late 20th century to today, there has been a lot of progress for women in the United States Armed Forces, as well as a lot of firsts. The following is just a partial list: In 1975, Commander Paige Blok became the first woman Navy fighter pilot (Eckstein, 2019). Army Sargent Leigh Ann Hester was the first woman Soldier to be awarded the Silver Star, for bravery during a 2005 enemy ambush on her supply convoy in Iraq (DeSimone, 2022). In 2008, General Ann Dunwoody became the first woman four-star general, which happened to be for the Army (Lopez, 2012). And in 2013, Chief Karen Voorhees was the first woman Aviation Survival Technician to become Chief of the Coast Guard history (Booker, 2021). In addition to these noteworthy firsts, 2013 was also the year that Defense Secretary Leon Panetta announced the end of the ban on women in combat and that women Service members would be allowed to serve in direct ground combat roles. These changes took effect in 2015; women became eligible for thousands of military jobs as a result. Since then, over 100 women have graduated from the Army’s ranger school (DeSimone, 2022) and 8 have participated in the Navy SEAL officer assessment and selection process (Kime, 2022). The history of women in the U.S. Armed Forces speaks for itself, but it is worth noting that there are more women in the Forces than ever before. Since 9/11, more than 300,000 women have served in Iraq and Afghanistan since 9/11, and over 9,000 have earned Combat Action Badges. Today, women make up approximately 16% of our Armed Forces (DeSimone, 2022). The increase in women Service members makes it important to recognize not only their effects on the history of the military but also the unique experiences and challenges that women face while serving our country. One way to better understand these experiences is through research; luckily, Military REACH has an arsenal of it on women Service members. What we see in the research is similar to the history: though women are strong and resilient, they continue to face gendered challenges and have to advocate for themselves. One related and important note is that research is intended to help answer questions or find solutions to problems; therefore, research typically takes a deficits-based approach (Shea, 2021). Please keep this in mind when reading literature on the topic of women Service members. Across the literature, we have seen: Women reporting challenges to relationships, family life, marriage, pregnancy, and parenthood (Erwin, 2022; Leslie & Koblinsky, 2017; Lawrence et al., 2022). Women Service members affected disproportionately by intimate partner violence, sexual assault, sexual harassment, and military sexual trauma (Portnoy et al., 2020; Dichter et al., 2018; Breslin et al., 2022; Dardis et al., 2017) Women facing health challenges, such as posttraumatic stress disorder, emotional reactivity, depressive disorder, anxiety disorder, chronic health conditions, increased tobacco and alcohol use, and obesity (Lehavot et al, 2012; Portnoy et al., 2020; Leslie & Koblinsky, 2017) Women reporting challenges to career development and navigation within the military (Erwin, 2022). However, even in the face of these challenges, Servicewomen still have positive things to say about their military experience, including their service attributing positive meaning to their lives (Leslie & Koblinsky, 2017). Military REACH in particular has heard first-hand perspectives of women in the military through the interviews we compiled in the Research-In-Action article, “Perspectives of Service among Women Service Members and Veterans.” Clearly, women are a force to be reckoned with, and I am proud to see the progress women have made and the barriers they have overcome to serve our country! Happy Women’s History Month, Servicewomen – and, most importantly, thank you for your service.
WHAT ARE ADVERSE CHILDHOOD EXPERIENCES (ACES)?
Trauma is a word that you have probably heard before – but what about adverse childhood experiences (ACEs)? A growing area of research is distinguishing ACEs from the more general term trauma and examines why this type of trauma may be particularly important to examine. This article will outline what ACEs are and why they matter for military families. A landmark study was published in 1998 that described ACEs as exposure to seven types of abuse and household dysfunction (i.e., physical, sexual, and psychological abuse, parental substance misuse, parental mental illness, mother treated violently, and parental incarceration) prior to age 18 (Felitti et al., 1998). Since then, others have called for the expansion of ACEs to include experiences such as neglect, socioeconomic status challenges, parental absence or separation, and removal from the family home (Bruskas & Tessin, 2013; Tyler & Schmitz, 2013; Wade et al., 2014). Unfortunately, ACEs are quite prevalent. When using the originally defined ACE categories, around half of the adults in the U.S. report at least one ACE (Bethel et al., 2014; Campbell et al., 2016; Felitti et al., 1998). This number is likely higher when you start to consider more expanded definitions of ACEs. The researchers who originally introduced ACEs also demonstrated that experiencing four or more ACEs puts individuals at risk for several leading causes of death (Felitti et al., 1998). ACEs have also been linked to myriad negative outcomes across the lifespan that are more common among military members, such as substance misuse, depression, and posttraumatic stress disorder (PTSD) (Campbell et al., 2016; Felitti et al., 1998; Hovens et al., 2017; Huges et al., 2017). What does this mean for military families? There is evidence that ACEs are more prevalent among military service members (Blonich et al., 2014; Kanton et al., 2015). Further, emerging research demonstrates approximately one in five service members have experienced moderate to high levels of ACEs (Reed-Fitzke et al., 2022; Reed-Fitzke et al., under review). Some suggest these higher levels exist because volunteering for military service may be seen as an opportunity to leave an adverse childhood environment and improve one’s circumstances (Blosnich et al., 2014; Kanton et al., 2015). Although that may be true, those who enter service with a history of ACEs may be at-risk for health concerns if exposed to military-related trauma. There is a growing body of evidence indicating that service members who report ACEs are more likely to report postdeployment mental health concerns compared to service members with similar military-related trauma without childhood adversity (LeardMann et al., 2010; Morgan et al., 2022; Sareen et al., 2013; Reed-Fitzke et al., under review). As you might expect, ACEs have been connected to various difficulties within interpersonal relationships, although much of this research has been conducted within the broader population. Most notably, ACEs have been connected to both intimate partner violence victimization and perpetration, relationship distress and instability, and lower relationship satisfaction (Friesen et al., 2010; Hughes et al., 2017; Wheeler et al., 2019). Among military couples, there is some evidence to suggest a similar pattern of ACEs and relationship challenges exists, as well as a possible connection between service member ACEs history and partner mental health (Khalifian et al., 2022; Miller et al., 2013). Additionally, active-duty service members with higher ACEs have been found to be more likely to report family characteristics that are indicative of problematic functioning (Oshri et al., 2015). Unfortunately, the majority of what we know regarding the impact of ACEs on military families is limited to how ACEs impact the service member, particularly in regard to their mental health. Since this area of study is relatively new, that means there is still a lot we do not know. Given what we do know about ACEs, there may be a connection between ACEs and challenges in separation and reintegration, as well as relocation. Despite the challenges that ACEs may cause, individuals and families can be adaptive. It may be that certain individuals and families have learned to be flexible and face challenges head-on due to their past experiences of adversity and may handle military related stressors with ease. We still have much to learn about how ACEs might impact the nature of military family life. So is it all bad news? Fortunately, the answer to that question is no! Although there is certainly an impact of childhood adversity that persists into adulthood, service members with ACEs and their families can be resilient – and resilience is something that can be fostered (Lamson et al., 2020; Oshri et al., 2015; Reed-Fitzke et al., 2022. Service members with ACEs may benefit from engaging in resilience training, such as the Master Resilience Training Course offered by the Army. Additionally, bolstering social support may be a way to protect individuals and families against the negative impact of future military trauma, as strong support systems have been shown to help buffer against military stressors (Han et al., 2014; Reed-Fitzke & Lucier-Greer, 2020; Zalta et al., 2020). Families with a history of ACEs, just like all military families, may benefit from getting connected to their local Family Readiness Systems.
FINANCIAL READINESS FOR MILITARY FAMILIES
My family and I recently went on a road trip. As we loaded up our car, my husband asked, “Is everybody ready?” With excitement, my kids yelled back, “Yes, dad! Let’s go!” But have you ever thought about what it means to be “ready”? In terms of our road trip, it meant that we had all our necessities, along with a plan and directions to get us where we wanted to go. When it comes to being financially ready, we can think about our financial journeys in the notion of preparing for a road trip. In that case, ask yourself: What does it mean to have financial readiness? What is Financial Readiness? The Office of Financial Readiness defines the term as "the state in which successful management of personal financial responsibilities supports Service members' ability to perform their wartime duties." For military families to be financially ready, each family member must participate equally and engage actively with financial responsibilities. This means – but is by no means limited to – saving for emergencies, paying bills on time, and living within your means. What Does it Mean to be Financially Ready? When military families feel confident about their personal finances, they can better focus on their day-to-day tasks (i.e., work duties, household responsibilities) and minimize financial stress. Families equipped with the latest financial information can make responsible, educated decisions regarding their financial readiness. Put simply, being financially ready means that Service members and their families are prepared for whatever lies ahead. It means they have: • The ability to respond to new financial opportunities. This might include purchasing a home, starting a new business, or going on a dream vacation. • The flexibility to make financial decisions for the future as well as the present (e.g., saving for child’s college fund, investing in a retirement account); • The tools to remain stable and equipped for unforeseen emergencies (e.g., unexpected medical expenses, replacing flooring in your home after a flood). Why does Financial Readiness Matter? Financial readiness matters because it can directly impact the entire military family. Unresolved financial issues can place significant stress on personal and familial relationships. A lack of financial preparedness may limit Service members’ and their families’ ability to achieve both short- and long-term goals, especially as they transition from the military into civilian life. Furthermore, Service members and their families distracted by financial problems lack the ability to plan for and complete their missions. For example, financial difficulties are considered “an indication of poor self-control, a lack of judgement, or a disregard for rules and regulations” and an overall detriment to the mission of a “ready military.” This means that Service members with a poor financial history (e.g., unpaid debts resulting in collections, excessive gambling, living beyond one’s own means) are a higher security risk. Thus, Service members with financial problems may find security clearances difficult to obtain, or have clearances revoked altogether. Takeaways Helping professionals might ask Service members and their families to think about their financial journey as a road map. To illustrate, consider these steps as you assist military families to achieve financial readiness: 1. Allow family members to share a vision of how their financial journey ends. This is a creative way to get them thinking about the opportunities their financial future might hold. You might ask, “What is your financial end goal?” 2. Assist military families in establishing financial [SMART] goals. Grounded in personal and financial values, each family member shares their financial goal. 3. Co-create mile markers that lead military families to their financial destination. Each family member can be actively involved and have an equal say in the financial decision-making process – generating a plan to achieve financial readiness one step at a time. 4. Share current education and resources on financially relevant topics. Provide military families with tools for navigating their financial road map. Is financial education outside your professional scope? Refer Service members and their families to a Personal Financial Counselor. 5. Finally, follow up: Plan weekly or monthly check-ins. Achieving big goals means completing plenty of small ones. Scheduling pit stops with Service members and their families helps ensure they reach their mile markers. Without pit stops, families may get discouraged and wander off the map.
PANDEMIC BLUES AND GRATITUDE NEWS: EMERGING RESEARCH ON FAMILY LIFE AND COVID-19
Hard work by scientists around the world has focused on understanding the COVID-19 pandemic from a medical perspective, such as how it is spread and how that spread can be mitigated. Although you’re less likely to see it in the news, there is also research being done about how the pandemic has influenced family life. What they have found so far may match up with your experiences during the pandemic. If your heart rate is already increasing just thinking about the stress your family has been carrying since the start of the pandemic, here is the short and sweet version of what you’re about to read: - You are not alone; families across the nation have faced significant challenges. - That being said, families have showcased their resilience amidst their challenges. If your family struggled during the pandemic, that’s completely normal! A study conducted during April 2020 highlighted some of the changes parents saw in their children. Even this early on (only a few weeks after COVID-19 was declared a pandemic), parents saw behavioral changes in their kids (e.g., whining, bickering, acting out) and noticed that they seemed more anxious and depressed. Anxiety in kids was especially likely when their parent was also experiencing anxiety, under a lot of stress, or recently lost a job. In seeing these changes, parents expressed an awareness that kids didn’t just need entertainment and social opportunities, they needed increased emotional support during these tough transitions. Parents were also concerned about the changes in their children’s schooling, especially because kids now had limited opportunities for social interactions and exercise. Overall, switching to home-based education felt more challenging when parents were already under duress (i.e., experiencing high stress or depression). Additional research from summer of 2020 highlighted that a key source of this stress for parents was managing multiple competing roles (e.g., parent, partner, employee, teacher). From children’s point of view, they tended to miss school and have difficulty adjusting to home-based education. Their self-reports confirmed poorer mental health, especially in terms of worrying about family members’ health, missing other family members (e.g., grandparents), and feeling like family was tense when everyone was cooped up together all the time. However, even when families were struggling, there were silver linings! Most parents reported some positive changes amidst the stresses of adjusting to pandemic life. More than 65% of parents said they were playing games or watching media with their kids more often during the pandemic changes. Over half said they did more activities together with their children, including hugging and giving physical affection, reading books, going on walks, or playing with toys. Children reported positives too, including enjoying more time for leisure activities, learning new things while at home (e.g., how to ride a bike), and growing closer to family members. Another study examined how thoughts and feelings about the pandemic might be intertwined, from the perspective of a group of over 50 parents and their children (ages 6 to 17, average age 10). All family members completed surveys where they reported on their emotions - positive and negative. Then, they spent 5 minutes writing about their deepest thoughts and feelings specifically related to the pandemic. Right after the writing activity, they reported again on how they were feeling. Interestingly, parents who included expressions of gratitude in their writing activity tended to then report fewer negative emotions right after. The focus of gratitude ranged from simple things like good health and stable family finances, to pandemic-specific changes such as not having a work commute, having closer family relationships, and pride in their family’s ability to adapt to the changes brought on by the COVID-19 pandemic. Takeaways So there were a lot of great finds in the research, but what would actually be helpful for you to remember once you’re done reading this? 1) If you struggled early in the pandemic or continue to feel overwhelmed now, give yourself grace. Many people are in the same boat as you. (That means there might be room in your social circles to validate the struggles and triumphs of others and receive the same support in return! #connection #empathy #buildingstrongcommunities) 2) If you want a specific activity that might help alleviate some of the stress of pandemic life, consider adding some new #gratitude practices! - The University of California, Berkeley has more specific information on what we mean by gratitude, and a reader-friendly explanation of how gratitude works - such a simple practice can have such big impacts on people who use it! - Check out this list of 10 ways to practice daily gratitude and tips for sharpening each of those into a great tool for mental wellness.
SUICIDE PREVENTION
This article is about suicide. If you or someone you know is having thoughts about ending their life, you can call 911 or access the resources in the table below. Each resource will connect you with confidential, qualified crisis counseling 24/7. Organization Phone Text Live Web Chat Military/Veteran Crisis Line Call 1-800-273-8255, Press 1 Text 838255 https://www.veteranscrisisline.net/get-help/chat National Suicide Hotline Call 1-800-273-TALK (8255) - https://suicidepreventionlifeline.org/chat/ National Alliance on Mental Health Call 1-800-950-NAMI (6264) Text NAMI to 741741 - Crisis Text Line - Text HOME to 741741 - September has been named National Suicide Prevention month because suicide is sadly a pervasive issue throughout the country. Below you will find guidance about language, risk factors, and warning signs related to suicide. Next, and more importantly, you will find actions you can take in response to a crisis suicide situation, as well as steps you can take in your everyday life to prevent this growing problem. Use Words Carefully Be thoughtful about the language you use when discussing suicide. A common, problematic term that is used is “commit.” People commit crimes and sins, and these describe actions that are willful acts against society and religious beliefs. If we use the same word to describe the actions of a person who feels they have no viable alternatives, it will only be more difficult for that person to seek help. To learn more about this idea, read the thoughtful article on Dictionary.com, “Why the phrase “commit suicide” isn’t the right way to talk about suicide” or the reader-friendly research summary from the National Elf Service, “Language matters: How should we talk about suicide”, which notes alternate wording you can try out, such as “died by suicide.” Understand the Facts In the United States (according to the CDC and the National Alliance on Mental Illness or NAMI): ● The rate of deaths by suicide has increased by 31% in the past two decades. ● Suicide is relevant across ages. “It is the 2nd leading cause of death for people ages 10-34 and the 4th leading cause of death for people 35-54.” (NAMI) ● Suicide is relevant across genders. Women attempt suicide more than men. However, men are around four times more likely to die by suicide (75% of people who die by suicide are men). ● 54% of people who die by suicide do not have a diagnosed mental health condition. However, about 90% of these people still show identifiable symptoms prior to their death (see “Recognize Warning Signs” section below). Specifically in the US military (according to the Department of Defense or DOD suicide event report): ● The most common mechanism for death by suicide among Service members is a personally owned firearm (not a military-issued firearm), accounting for 66% of suicide deaths in this population. ● The most common mechanism for suicide attempts among Service members is alcohol or drug use, accounting for 56% of suicide attempts in this population. ● Similar to the larger US population, 51% of Service members who die by suicide did not have a documented mental health diagnosis (e.g., depression). To truly understand facts, remember to stay abreast of research that continues to examine evolving trends in suicide among Service members and effective treatments. Know the Risk Factors “Risk factors are characteristics that make it more likely that someone will consider, attempt, or die by suicide. They can't cause or predict a suicide attempt, but they're important to be aware of.” (NAMI) Some important risk factors, according to Military One Source and NAMI, include: ● Demographic: being a young and unmarried male ● Military: having recently returned from deployment, or having combat-related injuries (mental & physical) ● Career: job loss, lack of advancement, a sense of a loss or honor, or disciplinary actions ● Social: feeling isolated, lacking social support, relationship problems or ending of a significant relationship, grief from loss of a loved one ● Psychological: lack of access to mental health services, ongoing mental health difficulties (even without an official diagnosis), enduring prolonged stressful experiences, impulsive and/or aggressive tendencies, negative attitudes toward asking for help ● Health: lack of healthcare access, ongoing medical issues, heavy drinking, or other substance use problems ● History: previous suicide attempt(s) or family history of suicide, experiences of trauma or abuse Recognize Warning Signs According to Military One Source, NAMI, and the Suicide Prevention Lifeline, the behaviors, expressions, and emotions below are all possible indicators that a person may be having suicidal thoughts or planning to attempt suicide. ● Behaviors: ○ Isolation: distancing themselves from their loved ones, community, or unit ○ Risk taking: seeking or obtaining means of self-harm (e.g., guns, pills), increasing alcohol or drug use, unusual spending ○ Preparing: drafting a will, giving away possessions, making arrangements for pets ○ Sudden changes in sleep (too little or too much) ● Expression & Emotions: ○ Talking about wanting to die/hurt themselves, having no reason to live or being a burden on others ○ Intense mood swings (e.g., from being more anxious or agitated to being in an extremely good mood) ○ Feeling hopeless, trapped, or like a burden, experiencing unbearable pain, having intense rage or a desire for revenge Plan How You Will React in a Crisis If you suspect that someone you care about is experiencing ongoing thoughts about suicide (aligning with warning signs above, or your own intuition), here are steps you can take. See Suicide Prevention Lifeline for more info. 1. Ask: Directly inquire with the person if they are thinking about suicide. * You may want to remind them that you are a trustworthy person that cares about them and wants to help and is not here to judge them. Asking this question will not increase the chances they will attempt suicide or “give them any ideas.” It will help you detect how risky the situation is and direct the person to appropriate resources. 2. Be There: Respond in a way that clearly shows your support, whether verbally or physically. Don’t shy away from the topic or shame the person for having these thoughts. Listen to what the person believes will be helpful or help them brainstorm here if they are having difficulty. 3. Help Them Connect: You are valuable as a social support, but chances are that you are not a professional. Direct the person to relevant resources that can help them manage these thoughts long term. Resources such as Real Strength, Project R.E.D. Team (through Hope for the Day), and In Transition may also be particularly relevant, as they are designed for Service members and families. *You may want to remind them that you are not recommending services because they are broken or crazy. Rather, they deserve an opportunity to process their experiences in an environment that is safe, productive, and focused on their unique needs. If someone you care about intends to cause themselves immediate harm (according to Military One Source): ● If you’re on the phone, try to keep him or her on the line while you or someone else calls 911 or one of the crisis resources mentioned at the top of the article. Keep talking until help arrives. ● If you are with the person, stay until help arrives. (Never leave a person experiencing suicidal thoughts alone.) Remove any means of self-injury (e.g., weapons, drugs) from the area. ● If the person is unwilling to accept help in either situation, contact emergency services or command, if they are a Service member. If you are interested in additional information on how to be most helpful in a crisis situation surrounding suicide, consider the trainings listed on the Speak Up Reach Out website. Remember that Suicide Doesn’t Just Affect the Person Who Passed Away If someone you care about dies by suicide, there are resources available to help you. Taking active steps in caring for yourself is important, and healing is very much possible. The Tragedy Assistance Program for Survivors (TAPS) provides support services for military-linked survivors of suicide. Read TAPS article “10 things we know to be true” to learn about facts for survivors of suicide loss. Be Preventative! Remember that suicide affects all kinds of people across ages, genders, ethnicities, jobs/ranks, and education levels. What is common across most people when they begin to contemplate suicide is that they are undergoing stressors in their life that deplete their ability to feel hopeful about their own futures. The best way to prevent suicide is to help people address those stressors and maintain their wellbeing far in advance of any suicidal thoughts. Think about the examples below when trying to prevent suicide among people in military families: ● Not being able to access physical and mental health care are significant risk factors for suicide. In addition, finances, housing, and food insecurity are major life stressors. ○ Take note of the needs in your community and find small ways to support those facing challenges. ■ Volunteer your skills as a medical or mental health professional in military communities. ■ Connect with other military families to create a network of social support. ■ Offer to help a fellow military family with transportation to and from healthcare services. ■ Patron businesses that hire veterans and military spouses. ■ Start a community garden in your area to help those who are food insecure to access nutritious fruits and vegetables more easily. ■ Pick up extra supplies on your shopping trip and share them with a fellow military family in a tight financial spot. ○ Be aware of organizations that target these problems, refer families to them, and support them! ■ Donate goods to charities or food banks that serve military communities. Refer military families to Military One Source and Operation We Are Here for financial resources. ■ Encourage engagement with organizations that provide free or low-cost, easily accessible mental health services and resources to military families. Consider supporting these organizations with financial contributions if you are able. Some examples include: ● Treatment Works for Vets ● The Psychological Health Center for Excellence ● In Transition ● Project R.E.D. Team ● Real Strength ○ Support legislation that addresses the financial stability of military families and makes healthcare more accessible to them. Talk with your local representatives about these initiatives and vote in favor of them when the time comes. See our article about voting in the military for more information. ● Loneliness and isolation are highly relevant risk factors. ○ Connect with other military families on a regular basis. Schedule monthly dinners together or participate in mutual activities that can support mental health, such as a group exercise class. ○ Encourage your fellow military families to attend local events. Invite them personally, give them a reminder when the event is approaching, and, if they come, be enthusiastic about them joining! ● Big family transitions are normal sources of significant life stress. ○ Check in with families undergoing transitions such as welcoming a new baby or having a Service member return from deployment. Help them with small everyday stresses by mowing the lawn a few times or making dinner and sending it over. Sometimes it is better to come ready to help, even before it is requested. This article is about suicide. But it is also about the many ways we can create communities that nurture members and provide safety nets for those who may struggle. Together, we can all make small efforts to address suicide in a way that is informed, empathetic, and likely to change our nation for the better. References: Military OneSource. (2019, December 21). Suicide Awareness. Military OneSource. https://www.militaryonesource.mil/health-wellness/mental-health/suicide/suicide-awareness?utm_campaign=mos-enews-sept2020&utm_content=html&utm_medium=email&utm_source=govdelivery&fbclid=IwAR05ph5sngElTInbRHxXAjs1JtGVkRrcg8vshAK2csCOw7u_S24Lmf5DHzI National Alliance on Mental Illness. (n.d.). Risk of Suicide. National Alliance on Mental Illness.https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Risk-of-Suicide National Alliance on Mental Illness. (n.d.). Suicide Prevention Awareness Month. National Alliance on Mental Illness.https://www.nami.org/Get-Involved/Awareness-Events/Suicide-Prevention-Awareness-Month Stayton, L. E., Martin, C. E., Pease, J. L., & Chard, K. M. (2019). Changes in suicidal ideation following cognitive processing therapy in a VA residential treatment program. Military Psychology, 31(4), 326-334. https://doi.org/10.1080/08995605.2019.1630230 Tucker, Jennifer. (2019, July 17) 2017 DoD suicide event report: Key findings about suicidal behaviors among Service members. Psychological Health Center of Excellence. https://www.pdhealth.mil/news/blog/2017-dod-suicide-event-report-key-findings-about-suicidal-behaviors-among-service-members
MILITARY CHILDREN: BRAVE, COURAGEOUS, AND RESILIENT
When you think of military children, you probably think about how tough their lives must be. And sure, things such as deployments and frequent relocations are difficult. However, would you be surprised to learn that recent research showed that 95% of children with a deployed parent were able to maintain a stable household routine? Would you also be surprised to learn that more than 60% of these children stayed well-connected with their deployed Service-member parent and that they had an easy reconnection once their parent returned from deployment? A key takeaway from these findings is that being a military child requires strength, courage, and sacrifice. So, this month we honor military children for the important role they play in the armed forces community and their resiliency. To do this, we connected with six children who grew up in military families to learn about what military life was like for them. Some common themes emerged like the joy of meeting and making new friends, the pain of leaving close friends, and all military families do not share the same experiences and challenges. Once you read this piece, our hope is you are inspired to have thoughtful conversations with military-connected children and families that help them feel welcome and supported in your communities. What are some of the pros and cons of growing up in a military family? I grew up as part of a National Guard/Reserve family. One pro was that I got to tag along with my parents to work when I was younger just to see what they did. My parents always had time off around major holidays and could usually take the day off for my birthday. The main con of military life was dealing with parental separations such as when my parent was deployed. Another disadvantage, particularly related to being part of a National Guard/Reserve family, was that I didn’t have a lot of other military kids to interact with or relate to. – Killian, Army Guard & Reserve The pros were getting to move and live different places! It forced me to step out of my comfort zone and learn how to interact with people I’d never met before. The cons were also moving because of the constant changing schools where the kids had already grown up together and had their set friend groups. – Natalia, Air Force Pros of being a military child were making new friends all the time and the unique life experiences. The cons were that sometimes life is not certain; there can be a lot of worrying about the state of political affairs, wars, etc. – Moira, Navy The pros were being able to travel the world, having good health insurance, and the sense of pride that your father/mother serves their country. The primary con was that because we were a military family, my parents worked odd hours. – Hannah, Air Force A pro would be the people you meet, and a con would be having a parent that is absent at times. I was around 6 years old when my dad first deployed to Iraq, and around 9 years old when he went again. – Kinsey, Marines How many times did you move growing up? What were some of the highs and lows of moving around? I moved four times. I was born at Tyndall AFB, FL then moved to Colorado, Wisconsin, Oregon, and back to Florida. The highs were living in a new house in a new neighborhood and hoping the neighborhood had a lot of kids! The low was every time I finally felt like I had made friends, I had to move and start over. – Natalia, Air Force I only moved four times across the country. The highs of moving were always getting to make new friends and getting to redecorate a room. However, the lows were the inevitable loss of long-established friends, teachers, Girl Scout troop leaders, etc. Also, your stuff gets lost in the move! – Moira, Navy I moved 7 times. The highs were seeing new places and getting to meet new friends, whereas the lows were being either behind or ahead in school because things are taught in different orders in different states/areas. For instance, I never learned capital letters in cursive because in Virginia we learned lower case first, then we moved, my new school did upper case first. So, I learned lower case twice...This is part of the reason why I decided to homeschool my children who are being raised in the military. – Heather, Marines Our family lived in Jacksonville, North Carolina for twelve years because I had medical problems at a young age and was part of the EFMP program (special needs program now). While growing up, my dad would hop from all the bases in the area and did two 1-year tours to Japan. We did not make a major family move until I was in high school. Since I was a unique military child who didn’t move around multiple times before high school, moving in high school was a hard adjustment. But I’m so glad I experienced it! – Kinsey, Marines What were your family’s special traditions when your Service member parent returned from a deployment? My family’s thing would be a big trip to Disney World! It was always nice to celebrate being reunited in the most magical place on earth. – Killian, Army Guard & Reserves We loved getting to have dinner all together again, that was the main tradition, just a big meal. – Natalia, Air Force I remember big celebrations in air hangars in preparation for arrivals and getting to stay up late with other squadron kids. I also remember one time my best friend’s family came with us to Disney World when her dad was deployed and mine had just gotten back. – Moira, Navy What advice would you give to other military children who may be struggling to adapt to the military lifestyle? I would say to focus on the positives and try not to get too caught up in worrying about the situations your parent(s) may be in. It was always comforting to me when I thought of the good times and about what we were going to do when my parent(s) returned from deployment. – Killian, Army Guard & Reserve My advice is that it is in your best interest to be personable and outgoing (even if you have to fake it a little) for the first couple of weeks when you move somewhere new because things are so much easier once you find new friends and your niche! – Natalia, Air Force I would say always be open to new experiences. The flower of military children is the dandelion because of its ability to put roots down anywhere and thrive. People will always be interested in you and your unique perspective, and you should cherish those who support you when times are tough. Also, read a lot— it provides a convenient escape when times get tough and literary friends you’ll never lose. – Moira, Navy Although moving around a lot is tough, the bright side is that you can make friends all over the world and be introduced to so many different cultures and experiences you would’ve never had if you stayed in one area your whole childhood. My advice is to be thankful that your parent(s) is willing to sacrifice their life in service to their country. Hopefully, they can teach you the same values that have been instilled in them by being in the military. – Hannah, Air Force Be flexible and go with the flow; it’s actually a good lesson to learn for the adult world. Adjusting to change makes military children well-adjusted adults. – Heather, Marines I would tell them that it seems hard now, but it only helps you to grow, and, in the future, you will view those hard times as life-changing moments. Another thing is that it’s okay to miss your old friends and it takes time to get used to new people and a new area, but you don’t have to change who you are to do that. – Kinsey, Marines Military REACH would like to give special thanks to Killian, Natalia, Moira, Hannah, Heather, and Kinsey for sharing their stories and experiences growing up in military families.
CONNECTING WITH VETERANS AND MILITARY FAMILIES
November is Veterans and Military Families Month, so we connected with active duty and Veteran families to gain insights into their lives. Common themes emerged, such as how military life has aided in the development of stronger familial bonds, lifelong friendships, and, ironically, more stability. Next time you meet a Veteran or military family, don’t be afraid to stop and say “hello” and thank them for their service; you never know what you may learn by opening the door to a conversation. 1. What do you want people to know about life as a military family? It isn’t easy, but it is rewarding. You get to explore places you would never otherwise see, make friends that last a lifetime, and grow strong as a family unit as oftentimes all you have is each other. You have to be able to adapt quickly as life goes on no matter where you are sent/what the situation. There may be new customs to learn and the internet is your friend. I would do it all over again. – Jan L., Virginia, 24-year spouse of a Veteran Military life is a good life, but it is a hard life. Over the last 24 and a half years that my husband has served in the military, we have had a roller coaster of a ride. From babies being born overseas to attaining the impossible all three kids get to graduate from the same high school. We have been blessed beyond what words can say. – Beth F., Wyoming, 24-year military spouse The military has a lot of positive sides, but of course, it has some downfalls, too. You get to travel and see the world! But, you can’t forget that the job always comes first. So, sometimes you have to spend holidays alone while your spouse is working or you have to cancel that trip last-minute because he has to come into work. You will (most of the time) be at a duty station for four years and whenever you’ve finally found your tribe or your so called “family away from family,” it is very hard to leave and say your “see your laters” again. – Paula R., Wyoming, 5-year military spouse Life as a military family is an amazing adventure and not for the faint of heart. The life of a military family is different for each family and we are all unique. My family has lived in Jacksonville, FL; Guam; Washington, D.C.; and now Naples, Italy. We have been fortunate to live in places where we can be together as much as possible, I have found employment, and we have been able to travel. – Alysen W., Italy, 10-year military spouse Life as a military family is unpredictable, and it can be stressful. Deployments are hard and moving to places with no job opportunities for spouses can be tough! But, it is also an opportunity to experience different places and meet all sorts of people! I take it as a gift, and it has improved my adaptability skills. – Margherita L., Alabama, 5-year military spouse 2. Do you have advice for military families new to military life? Don’t be afraid to ask for help. Try to get involved with the local community as there is a wealth of knowledge waiting to be shared. Don’t worry about the little things. – Jan L., Virginia, 24-year spouse of a Veteran For those of you who are new, my favorite phrase for dependents is to be the independent dependent. Ask all the questions! Start that college course you have been wanting to take. Join the spouses’ club to make new friends. Build your tribe because you will need them. Start a new hobby or learn how to make that fancy dish you saw on Pioneer Woman. If you wait around to get things done, time will pass you by quickly and before you know it, there won’t be any time. Lastly, make the most of where you are. I completely understand, people from Florida may not like the mountains and altitude of Wyoming, but there is much to do and see. Find those little hidden treasures. – Beth F., Wyoming, 24-year military spouse You have to be open to new experiences, new friends, new foods, new lifestyles. You need to have an open mind and positive attitude whenever you move or even when you have to stay! You should always try to make the best out of everything! – Paula R., Wyoming, 5-year military spouse Change is inevitable with the military lifestyle, so be f lexible, have realistic expectations, and communicate with your spouse/ family. Having open communication can help to strengthen your relationship. As a family, discuss the changes occurring in your family’s daily life, such as work schedules, school changes, moves, promotions, etc. It can help to ease tense times by being on the same page as a family and ensuring all voices in the family are heard and respected. – Alysen W., Italy, 10-year military spouse I did not expect having no control over where we go and what we do with our careers. I expected it to be more like a regular job, at least when my husband does not deploy, but it is a 24 hours job. If they need him, he goes. – Margherita L., Alabama, 5-year military spouse 3. How did you imagine military life before your partner joined (or before you were married to your Service member-partner)? How did your perceptions change upon your partner joining the forces (or you marrying your Service member-partner)? I grew up near 2 USAF bases and was around military members from a young age. I don’t think I really had any preconceived ideas of what being a military spouse would be like. I did think that I would be able to travel home a lot more often. Homesickness is a real thing. – Jan L., Virginia, 24-year spouse of a Veteran Our story is a little different. We were married and had a baby when my husband joined in 1996. He went to basic, tech school, and then we headed to Italy as our first duty. He worked long days and we had two more babies while we were there. I didn’t really have a preconceived notion of what to expect, I just jumped in with both feet. Since that time, I have learned much about how the service works and most definitely much about myself. – Beth F., Wyoming, 24-year military spouse I am very happy and lucky to live this life with my family! I never imagined my life away from home but am happy to explore and see different cultures, cities, and countries. I never expected that military life could be so lonely; of course I have friends, family, and my daughter, but when your spouse is away for six-month deployments or weekly tours, it gets very lonely and it never gets easier. – Paula R., Wyoming, 5-year military spouse Before marrying my husband, I imagined military life as long deployments overseas, separation from family, and honestly, that is about it. I didn’t really know much about military life or military families. My husband was already in the Navy when we met, so I had to learn quickly! My perception of military life now is unique, tough, fun, unexpected, rewarding, and full of pride and passion. – Alysen W., Italy, 10-year military spouse Try not to stress too much about the future and enjoy the ride! – Margherita L., Alabama, 5-year military spouse 4. How has being in a military family improved your life? The military provided a stable paycheck and healthcare. I am still in contact with military friends from nearly 40 years ago. Having to be independent as a family and having nobody else when first PCSing brought us very close together. – Jan L., Virginia, 24-year spouse of a Veteran We have been afforded opportunities that not many people get. Not only have we always had a roof over our head and food on our table, but we have always been able to provide for our family. I have completed two Bachelor’s Degrees and am currently working on a Master’s. We have traveled all over the world and have seen and experienced many great things and cultures. – Beth F., Wyoming, 24-year spouse military spouse Financially, our family is doing great, and the stability of the job is always nice! Because we are so far away from our families, we became closer as a family! You see, the most important thing is that “it doesn’t matter where we are in the world, as long as we are together.” – Paula R., Wyoming, 5-year military spouse I have learned to embrace change as it occurs daily in our lives now. Plans that we make always have an invisible asterisk beside them as they are understood as “subject to change.” I have made lifelong friends with people who are now a part of my family. I have traveled to places I never could have imagined! When we arrived in Italy last summer, we took a two-week road trip exploring central and northern Italy, France, and Monaco. I never would have imagined 15 years ago that this would be my amazing life today! Alysen W., Italy, 10-year military spouse Military life has improved my adaptability skills and has given me a chance to reinvent myself professionally very often. – Margherita L., Alabama, 5-year military spouse 5. Is there anything else you would like to share about being in a military family? You are not alone. There is a big family willing to help, so just ask. Get a hobby as there will be many hours when your spouse will not be there. Join your base social media pages. It goes by faster than you can ever imagine, so take advantage of any and all opportunities that may present themselves. – Jan L., Virginia, 24-year spouse of a Veteran Military life has made me the individual I am today, and I wouldn’t trade it for anything. We raised three strong, independent girls. We grew stronger as a couple. Is it easy? No. But, is it worth it? Yes! – Beth F., Wyoming, 24-year military spouse Be happy, make memories and whenever you feel down, you are not alone! – Paula R., Wyoming, 5-year military spouse Being a military family can be very difficult and the only certain thing is change. If you know a military family, please be understanding of them. They are always trying to do what is best for their country, family, and themselves. If you have never talked to a military family, you should; I think we are pretty fun people to get to know! – Alysen W., Italy, 10-year military spouse Honestly, the Service member does the hard work. We [the spouses/families] are the support system, and it is hard at times. But, I always try to remember that he is the one sacrificing the most. – Margherita L., Alabama, 5-year military spouse
WHAT IS ASYNCHRONOUS COUNSELING?
Our team recently examined the current research on asynchronous counseling. Asynchronous counseling is delayed communication that does not occur face-to-face between clinicians and clients throughout the course of treatment. The two primary forms of asynchronous counseling are chat-based counseling and self-guided modules. In chat-based counseling, clients and clinicians participate in chat exchanges. When using self-guided modules, clients complete modules, and their clinician provides feedback. All forms of asynchronous counseling include the client and clinician choosing when it is most convenient for them to interact. Because asynchronous counseling does not occur face-to-face, it is sometimes referred to as technology-based counseling, as clinicians and clients rely heavily on emails, text messages, or instant messages on a website or app to communicate. The convenience of asynchronous counseling allows clinicians to treat clients that would not typically participate in face-to-face therapy, which is discussed in more detail below. Particularly, amid the coronavirus pandemic, asynchronous counseling offers a unique approach for clients to seek treatment while also maintaining their health and safety. In our recent report, we gathered existing research on the effectiveness and benefits of asynchronous counseling and considerations for its implementation. Asynchronous Counseling: Effectiveness and Benefits Regardless of the type of asynchronous counseling, most research indicates that it is an effective form of treatment. More specifically, asynchronous counseling has been able to help people with a variety of presenting problems such as depressive symptoms, anxiety symptoms, problems with cannabis use, and gambling. Researchers and clinicians expect that one reason why asynchronous counseling is beneficial to clients is because of the time delay between responses, giving both the client and clinician time to create thoughtful and deliberate responses. Like other mental health services, however, effectiveness can vary based on a variety of factors. Factors that can impact the effectiveness are the severity of symptoms, readiness for change, level of comfort with using technology, and level of education and literacy. Therefore, it is important to discuss such considerations before committing to treatment. There are many reasons why an individual would benefit from utilizing asynchronous counseling as an alternative to face-to-face treatment. One reason asynchronous counseling may be beneficial compared to face-to-face treatment is that it accommodates clients who cannot attend in-person treatment or are not near a treatment center. For instance, some clients may not have reliable transportation or may live too far away to attend face-to-face treatment. Alternatively, others simply cannot find the time to attend treatment. Additionally, clients who value privacy throughout their treatment process may prefer asynchronous counseling as opposed to attending in person. By participating in treatment online, clients can eliminate potential stigma of seeking treatment and receive the assistance they need from the comfort of their own home. Asynchronous counseling offers a solution to each of these barriers. By utilizing it, clients can access treatment from anywhere, avoid stigma, and have a convenient treatment option. Considerations for Implementation As with any mental health service, there are considerations for implementation. Some of the most primary concerns are that of safety, privacy, and technological issues. Clients who experience a crisis or emergency may not have access to immediate assistance when participating in asynchronous counseling. However, clinicians can provide clients with resources within their community to assist them in an urgent situation. In addition, client privacy is essential in all mental health services. To maintain privacy and confidentiality in asynchronous counseling, encr ypted messages and password protected communication are utilized. A lthough these precautions ca n decrease the likelihood of a breach of privacy, like most technolog y platforms, clinicians cannot guarantee total security. Technology makes asynchronous counseling possible, but it can also pose a challenge to receiving services if the client or clinician have technical problems. Clinicians cannot guarantee problem-free treatment, but clients and clinicians can create a contingency plan to handle technological issues when they arise. For example, clinicians and clients can figure out an alternative timeframe, or method of communication (e.g., switching from email to text messages) if any technology issues arise. It is important for clinicians to have conversations with their clients about safety, privacy, and technology concerns prior to beginning treatment. By discussing the possible issues and creating contingency plans, both clients and clinicians will be prepared if a problem arises. During these unprecedented times, asynchronous counseling is extremely valuable for individuals who need to access mental health services from home. Asynchronous counseling offers a different avenue for clients to access mental health services while maintaining their safety and still overcoming barriers. Existing research suggests that asynchronous counseling is an effective mental health treatment option under certain conditions. Military REACH’s report on asynchronous counseling provides additional information on current research, suggestions for best practice, and considerations for implementation. Read the Military REACH team’s full report on asynchronous counseling, Understanding asynchronous counseling: A review of effectiveness and implementation considerations, to access the citations used in this piece and to learn even more on the topic.
I WON’T BE HOME FOR CHRISTMAS
I WON’T BE HOME FOR CHRISTMAS By Lucy Nichols, MS Military REACH Military life does not take time off for the holiday season. Military families across the globe experience numerous holidays, which are meant to bring families together, separated from the ones they love most. In this article, we go straight to the source and share recommendations from families who have experienced holiday seasons away from their loved ones due to military life. Military REACH connected with several military family members to ask a few questions about how they handled the holiday season. Themes emerged such as being intentional, planning ahead, and building community wherever you are. What advice do you have for other military families who will not be together during the holiday season (e.g., deploy-ment, PCS, on-call)? – Karen, Navy Spouse: Don’t wait to be included. Plan your own event and invite others. It is important to surround yourself with people and stay busy during the holidays. For on-call or duty days, visit your service-member, if allowed. The kids loved eating on the ship or meeting Dad at the McDonald’s across the parking lot. It was a special treat to see him at work and the opportunities were rare which made them extra special. – Bryant, Army Veteran: Focus on the good. Enjoy whomever you are with. Be upbeat when your military person calls. – James, Air Force Veteran: My biggest piece of advice would be to not underestimate the power of a hand written letter. Regardless of whether you are on the sending or receiving end, letters can be uplifting. Even though we have a lot of electronic technology, there is something different and warming about having a letter in your hands that you can tangibly hold from someone you care about. You would be surprised at how quickly the mail service moves back and forth even if you are some-where like Iraq. In fact, I still have some of my letters in a scrapbook box. – Laurie, Army Spouse and Mom: Get with people who feel like family and make the best of what you have. – Davina, daughter of an Army Special Forces Veteran: I recommend planning for flexibility in your family traditions in advance! My family has multiple family traditions at each holiday, so if my dad was ever going to miss out on a holiday due to his service, we would look at each tradition and pick which ones we really wanted him to be part of and postpone those, so he could participate. Some things he encouraged us to do in his absence, and others we would specifically wait to do until he returned home or was available via video chat. We might also adapt one tradition so it accommodated his work schedule. For instance, we might open all of our Christmas gifts except the ones from him and wait until he was home to open those, as well as give him our gifts. That way, we got to enjoy some of our usual Christmas activities and still were able to save some special traditions to specifically do with him. – Emi, daughter of a Green Beret, sister to an Infantryman: Just be there for your friends, hang out with someone who you care for. – David, Navy Veteran: Plan ahead. Prior to deployments (even months ahead) parents can shop for kids’ presents together and save them for Christmas. Plan on a time (with backups) to communicate on or near Christmas. Many military commands hold a special holiday meal, served by senior leaders, on Thanksgiving or Christmas Day for those personnel on-duty who must remain on the base or ship. Often, family members are invited to join them. This provides a great opportunity for everyone to spend at least a little time together. – Connor, Army Veteran and Son of Army Veteran: Make the best of it!! What have others done to support you during the holiday season that was helpful? – Davina, daughter of an Army Special Forces Veteran: My mother was always great at providing me and my siblings with options and choices when it came to celebrating holidays when my father was working. She would offer to do lots of fun things with us, like shop for an Angel Tree or attend a holiday show, which was great for keeping us distracted from focusing on the negatives. At the same time though, she was always accepting if any of us weren’t feeling up to being busy and just wanted to spend some quiet time at home, and would instead facilitate a Holiday movie night with just the family. She was always working to stay in tune with us and genuinely let us make our own choices. – Connor, Army Veteran and Son of Army Veteran: We hung out and tried making new traditions. – Bryant, Army Veteran: We created traditions amongst us; we told stories of family memories. – Karen, Navy Spouse: …everywhere we moved we met amazing people. Others have fed me, watched my children, celebrated holidays with us, sat patiently with me in waiting rooms while my kids had medical procedures, taken me for medical procedures, lifted us up when we needed it and let us cry when we needed that too. Our family would have never survived 30 years of Navy life without the support of others. The value is immeasurable. – David, Navy Veteran: If possible, spending time with family during the holidays is a way to alleviate some of the stress of separation. [However,] that’s easy to say if you’re deployed and don’t have to drag 2-3 toddlers through airports to go see Grandma and Grandpa all that way across the country. If traveling to existing family is not an option, form a ‘new family’ around you. – Laurie, Army Spouse and Mom: Included me and my family in their own traditions. – James, Air Force Veteran: Honestly, a big thing that friends and family would do for me that was helpful during the holidays was to send me packages that had homemade desserts/snacks that I was familiar with. Even if it wasn’t technically a holiday food. The fact that someone would send me something (like homemade oatmeal raisin cookies or homemade peppermint bark) that I could eat and also hand out to my fellow service members really helped me feel like I wasn’t completely missing holiday traditions or gatherings while I was gone.
SORTING THROUGH THE PILE: THE HELPFULNESS OF THEORY IN RESEARCH
When I was an undergraduate student, I had little interest in the role of theory in research. Honestly, it felt like a waste of time. Theory seemed like a bunch of old thoughts, all proclaiming obvious things about human experiences. “Yes, of course stress can lead to crisis,” I would think. “Why does anyone need to make a ‘Family Stress Theory’ to describe something so basic?” However, over time I have grown to see the invaluable utility of theory and its application to scientific study. Here, I will discuss the importance of theory because of its commonality in human experience and the power of theory to organize, explain, and predict phenomena. Theory development and application are nearly universal human experiences. People have been developing formal and informal theories about life for virtually all of recorded history. Consider the old adage: “Where there’s smoke, there’s fire.” Essentially, this statement is a theory about where fires can be regularly located. Consider how the originators of this statement may have developed this expectation about the correlation between smoke and fire. Evidence was acquired: “I see smoke over there.” This evidence was blended with other observations: “Every time I see smoke, there has been some kind of fire.” Theory was developed from these observations: “Where there’s smoke, there’s fire.” This is a simple illustration, but the point is that theory development is ingrained in human experience. We want to understand the world, and theory aids us in that understanding by providing a mental framework to organize evidence and use that evidence to explain and predict phenomena. One of the primary ways that theory assists with understanding is by providing a frame or map to organize available data. Imagine you are going to a department store to buy a new set of pajamas. Unfortunately, when you get to the store you are dismayed to see that all of the clothes, shoes, jewelry, and appliances have been thrown into a large pile in the middle of the floor. Instead of trying to dig through the pile, you decide to try a different store. There, you find that all of the items have been neatly organized by sex, age, and type. As a result, it is easy to navigate the clothing sections and find your new favorite pair of pajamas! This is similar to the organizational clarity that theory provides academic research. Theory groups information in a systematic, understandable way. When new information is generated about a topic, it can be organized into its appropriate theoretical category to assist with understanding the phenomena as a whole. Additionally, aspects of the topic can be further clarified through explanation and prediction. Theory organizes information into a coherent story that can be used to explain and predict phenomena. Using an example from earlier, a theory would help us know to expect smoke from fire, and may eventually explain why fire causes smoke. In another example related to human sciences, let’s consider why some families seem to struggle with stressful events more than other families. The Family Stress Theory (Hill, 1949) was developed to accomplish this very task, and it organizes data into four basic categories: stressor events, resources, perceptions, and crises. The theory suggests that these various factors influence one another to produce different outcomes for families dealing with stress. When new data emerge through scientific study, the information can be organized into these categories, and used to better understand what kinds of families are most likely to adapt or experience a crisis. Ultimately, theory used in this way helps us predict human experiences with greater clarity, which assists with general understanding and can be transformed into practical use through application. Over time, I have grown to see theory as a vital aspect of scientific work. Theory is a basic aspect of the human experience that assists with our understanding of the world around us. Theory helps us better clarify phenomena and develop meaningful applications to adequately address important needs. Without theory in research, readers are less informed about how each piece of data fits into the broader whole and may be left to sort through a disorganized pile of evidence to find needed information. Reference Hill, R. (1949). Families under stress: Adjustment to the crises of war separation and reunion. New York, Harper & Brothers.
THE IMPORTANCE OF CREDIBILITY IN RESEARCH DESIGN, IMPLEMENTATION, AND EVALUATION
In 1971, Philip Zimbardo and his team conducted the Stanford Prison Experiment to see what happens when ordinary people are put in an extraordinary situation. Eighteen college-aged men were randomly assigned a role: prison guard or inmate. The study examined the influence of the presumably evil prison environment, testing if simply being in the environment would turn typical people into harsh, power-abusing people. Shortly, the “guards” became cruel and even abusive to the “prisoners” to the extent that the study was shut down after six days (11 days early) due to the chaotic and traumatic nature of the experiment. The study is regarded as one of the most infamous scientific experiments in modern history. Despite being partially responsible for the establishment of ethical considerations in human sciences study, it is also a sterling example for why credibility should be evaluated when interpreting research. Credibility refers to how much a person can trust the findings of a research study, based on how carefully it was designed, implemented, and evaluated. A variety of areas should be considered when determining credibility, usually with emphasis on the study’s methodology. Methodology includes factors, such as the appropriateness of the study design, the representativeness of the sample, and the analytic approach. Credibility is important to evaluate because poor methodology can lead to poor results, which influence real life implications. Consider the Stanford Prison Experiment as an example. First, consider the recruitment process. The experiment recruited participants using a newspaper advertisement to request subjects for a “psychological study of prison life.” However harmless as this may sound, this phrasing could have attracted certain people to the study. In 2007, a study was conducted on sample selection that made two similar newspaper advertisements: one included information about being a prison study and the other did not. The ad that included the prison information yielded a sample of people with higher levels of aggressive and socially domineering personality traits than the ad without prison information. This suggests that Zimbardo’s sample may have been more aggressive than the average individual, potentially explaining the hostile behaviors observed in the experiment. Second, Zimbardo was a biased study participant, instead of an objective investigator. He posed as the prison superintendent and created an environment where the prisoners felt powerless and humiliated. The study team coached the participants and described the prison environment as “evil,” thus, calling into question the results that emerged. Imagine you are trying to measure taste preferences for a soda. Your test subjects try the drink, and then are only asked to list the things they didn’t like about the drink. The only data you will gather will be about people’s negative reactions because of the biased nature of the study’s design. In a similar way, the prison experiment was designed to produce abuses of power, and the results demonstrate that finding. Hopefully, at this point the argument for evaluating credibility is becoming clear. Because of the methodological issues of the study, the findings were skewed and lacked trustworthiness. Unfortunately, they were applied to influence real life implications. Shortly after the study, the results were used to influence Congressional prison reform policy and had an impact on the national narrative of prisons and human reality as a whole. The effects have been far reaching and all based on biased, highly questionable findings. Research is regularly utilized to inform local and national policy, as well as to inform practice; however, it can also be an illustration for the old saying: With great power, comes great responsibility (phrase commonly attributed to both FDR and Spider-Man). Researchers have the responsibility to produce sound science, and careful evaluation of research is necessary to ensure that findings are trustworthy. Without such rigor, the mistake could be costly for decades to come. Military REACH regularly summarizes and evaluates newly published research in, what we call, TRIP reports. Credibility is a key dimension of evaluation. See our library to understand how we measure credibility, and stay tuned in the coming months to learn about our other dimensions of evaluation - contributory and communicative.
"WE HAVE NO CHOICE BUT TO ACCEPT THE PARADOX OF MILITARY LIFE"
The Military REACH team at Auburn University is on a mission to connect with military families. When I accepted their invitation, I was already an avid REACH fan. I discovered Military REACH two years ago and instantly appreciated their mission – to make research about military families accessible and practical. Their monthly newsletter and the included TRIP (Translating Research into Practice) reports provide smart and succinct summaries of current military family research. Readers also get an objective evaluation of the research and a snapshot of the implications for military families and those who support them. Each month I find information that resonates with issues I see daily in my work with military families and even in my own family. The work of Military REACH helps illuminate a clearer line of thinking and formulates ideas for tackling tough military family issues. If you do not already [subscribe to the newsletter](https://militaryreach.auburn.edu/Updates), I recommend you start today. The Military REACH team’s emerging effort to connect with military families adds exponentially to the importance and value of their work. To explain, I’ll share my experience as a military spouse. My name is Lauren O’Donnell. I am a proud military spouse of nearly 30 years. My daily work involves advocating for military families by listening and learning, referring to resources, and influencing decisions in the interest of military families. I work to build community among military families wherever I am, encouraging other military spouses to step into the responsibility and privilege of building relationships and guiding and supporting other military families. My husband is an active-duty Army officer serving in units at the tip of the spear in support of our national defense. In June he returned from a five-month deployment with the 82nd Airborne Division, his eighth deployment. I proudly supported him by managing the decisions and the work at home while also supporting other spouses of deployed Soldiers. I have two children, 20 and 17, who are resilient and proud of their father’s service. They embrace military life and identify as military children. We are an Army family and the military mentality of strength, courage, perseverance, and service runs strong in our blood. I am also Lauren O’Donnell, a driven professional frustrated by an inability to reach career goals thwarted by frequent military moves. I empathize with military families who struggle to overcome the tough obstacles of military life such as constant relocations, separations, disconnection, and danger. I mourn the strained relationships, the divorces, the identity crises, the injuries to body and mind, the exhaustion of caregiving, and the pain of losing a loved one. I feel guilt when passing the yoke of volunteer expectations to other spouses because they are tired of the tremendous sacrifice those expectations require. I worry about my husband and the toll the military’s relentless pace has on his body and mind. I am exhausted by the thought of continued service -- more deployments, more responsibilities, more “going it alone.” I am concerned about the effects of this lifestyle on my children, who lack educational continuity, the steady support of a two-parent home, and a friend-group that shelters them from feeling isolated and alone. I believe that our military mentality is not always understood or appreciated by our civilian family members, neighbors, and communities. This causes anxiety for me as our family looks ahead to assimilation into a civilian community after leaving the military. Like most military families, my family lives, works, plays, and plans in this antinomy between pride and frustration, courage and fear, strength and exhaustion, and togetherness and isolation. To continue, we have no choice but to accept this paradox of military life. After 30 years, I see clearly that military families cultivate a tolerance for this discomfort and accept this unending tension. We learn to sacrifice, compromise, and adapt to the pervasive push and pull of military life. We accept the challenge, lean on one another, and hope that others, especially those entrusted with supporting military families, recognize, understand, and help us overcome the challenges inherent to military life. Thankfully, a growing effort is underway by government, research institutions, think tanks, military-connected organizations, non-profits, and corporations to better understand and act on the needs of our Service members, Veterans, their families, and our military communities. From health care to employment to education to civilian-military connection, there is a continued "WE HAVE NO CHOICE BUT TO ACCEPT THE PARADOX OF MILITARY LIFE" commitment to address problems faced by military families. The rigorous efforts of these entities to produce worthwhile data, formulate solutions, and generate results to improve the lives of military families is tremendous. As someone who has experienced military life firsthand for over 30 years, I also sense a tension between the binary outcomes of data collection and the multi-layered personal stories of military life. I wonder if the research is getting to the heart of the perspective we need. The truth is, the research often leaves me feeling boxed in, left out, and misunderstood. As I’ve learned from my military lifestyle, the best solution to this tension is the hope that we can work together to find a better way. The Military REACH team is intent on achieving this goal. In their work to elevate current research about military families to something more meaningful, useful, and transformative, they want to link research with experience, data with stories, and those who analyze data with those who contribute their lived experience. Through this undertaking and connection, we gain greater perspective and a deeper understanding of military culture, military life, and the needs of those who serve and their families. The knowledge from both research and experience will lead to new and better-informed ideas to create ground-breaking change in the lives of military families. Military REACH is taking substantive steps towards this goal. Let’s join them. If you are a military family member who would like to connect with the Military REACH team, [complete this brief survey](https://auburn.qualtrics.com/jfe/form/SV_2lf4hvgJuQhg4YZ). [Subscribe to the REACH newsletter](https://militaryreach.auburn.edu/Updates) to get their important work delivered right to your inbox. You can also follow Military REACH on [Facebook](https://www.facebook.com/MilitaryREACH/) and [Twitter](https://twitter.com/MilitaryREACH), or visit the [Military REACH website](https://militaryreach.auburn.edu/).
Auburn University Research Symposium
This month, Auburn University hosted its annual research symposium. The goal is for students to have the opportunity to present their research and scholarly discoveries to their peers and colleagues. Among the presenters were two members of the Military REACH team, Emily Hanson and Melike Coskun, PhD students. Read about their presentations below. What matters and for whom? Risk and protective factors associated with food insecurity severity among military-connected families Presenter: Emily Hanson, PhD Student and REACH Research Associate Abstract: Recent evidence suggests that Service members experience food insecurity at nearly twice the rate of civilians. Indicators of financial instability tend to explain many antecedents to food insecurity among civilians, yet risk factors of food insecurity may be different for military-connected families (active duty and Veteran). Active-duty families have access to a regular income and other resources positioned to promote economic stability. However, for these currently serving families, the military lifestyle can also be highly mobile, introducing unique barriers to stability (e.g., spouse unemployment). For formerly serving (i.e., Veteran) families, differences in the civilian job market and community systems at play may impact employment and access to resources, all possible risk factors of food security and resource utilization. There are also unique facilitators that can bolster well-being among this population, such as shared culture and social support. The primary objective of this study is to determine the prevalence and predictors of food insecurity among 1,304 military-connected families – both active duty and Veteran – who participate in Blue Star Families, a nonprofit with the mission of strengthening military families by creating communities of support. Multinomial logistic regression models identified risk (e.g., unemployment, number of children) and protective factors (e.g., nonprofit support) associated with the severity of food insecurity. These models were fit separately based on military status, specifically, active-duty Service members, active-duty spouses, Veterans, and Veteran spouses. Findings are positioned to advance the conversation on the prevalence of food security, assist in the screening and identification of families at risk of food insecurity, and enhance understanding of how nonprofits can support at-risk families. Exploring prenatal predictors of childhood obesity in a comprehensive literature review Presenter: Melike Coskun, PhD Student and REACH Graduate Research Assistant Abstract: Childhood obesity is a significant health issue in the U.S. According to the Centers for Disease Control and Prevention (CDC), data from 2017 to 2020 show that almost 1 in 5 children and adolescents were obese. In Alabama, the CDC reported that in 2023, nearly 2 in 5 people (39.2%) had obesity, ranking Alabama as the fifth highest state for obesity. Childhood obesity is linked to a wide range of health problems, including stroke, high blood pressure, diabetes, sleep apnea, asthma, depression, anxiety, chronic diseases, and increased morbidity later in life (Ayine et al., 2020). In 2019, the medical cost of obesity among children was $1.3 billion US dollars. Therefore, identifying the early life risk factors for childhood obesity is essential to implementing effective prevention. Most research has focused largely on identifying the risk factors for childhood obesity during early and late childhood, including high birth weight, excessive weight gain, shorter breastfeeding duration, problematic eating patterns, poor nutritional diet, lack of physical activity, poor sleep, and sociodemographic factors. However, emerging evidence highlights the importance of identifying the risk factors as early as prenatal periods. The primary aim of this literature review is to explore the perinatal risk factors for childhood obesity, with a specific focus on the mother’s gestational weight gain or prior obesity, tobacco use, poor maternal nutrition and diet, sleep problems, lack of physical activity, and maternal psychological problems during pregnancy (Baidal et al., 2016; Córdoba-Rodríguez et al., 2022; Sacco et al., 2013; Qureshi et al., 2018). The literature review will be guided by the Developmental Origins of Health and Disease (DOHaD) framework, which suggests that environmental factors during early life can permanently affect the onset of health problems by increasing the risk of diseases in later life (Lacagnina, 2019).
HALEY SHERMAN: CINDY WINTER SCHOLARSHIP AWARD RECIPIENT
Congratulations to Haley Sherman who received the Cindy Winter Scholarship Award! This award honors leadership excellence within the National Council on Family Relations (NCFR) and the overall discipline of family science. Haley was selected as the award winner because of her exceptional leadership, specifically during her time as an undergraduate student and during her graduate career. During her undergraduate program, Haley: Was on the president’s and dean’s list several times Received honors from the National Society of Collegiate Scholars and university awards for academic competence Was inducted into a leadership society called the Seminole Torchbearers Launched the Family and Child Sciences Club in her department: This required petitioning her department, the college, and Student Affairs to create a Family Science professional development organization, and then recruiting students and following the required steps to establish a Registered Student Organization During her master’s degree program, Haley: Developed 5 community-facing articles focused on translating Family Science into tangible takeaways for the Extension community, military policymakers, and families in transition Co-created 6 regional and national research-focused presentations Completed a multi-study thesis focused on the intersections of stress, coping mechanisms, and well-being Became a Certified Family Life Educator Became a member of the AU HDFS Graduate Student Organization Joined NCFR and assumed leadership roles in the department, the university, and the profession: In the department, she served as secretary of the Graduate Student Organization At the university-level, she served as a mentor for first year graduate students and was recognized for her accomplishments via the Graduate First-Year Experience Mentor Award Regarding the profession, Haley was appointed the Graduate Student Advisor for the regional NCFR affiliate, the Southeastern Council on Family Relations (SECFR) During her doctoral degree program, Haley has… Contributed to 2 grant proposals submitted (one funded!) 4 peer-reviewed publications (2 as first author and several more in the pipeline) 18 research-based presentations to include 5 at NCFR and 4 at SECFR (11 as first author) Continued investing in others and the HDFS discipline. She: Serves as a mentor for the university for the first-year graduate students (and she won another mentoring award!) Served as secretary then treasurer of the Graduate Student Organization Mentored an HDFS undergraduate research fellow throughout their research process (from proposal development to publication), and her mentee even had the chance to present at a national conference! Haley Sherman is an exceptional student and professional. She has a drive to develop sound scholarship and has a focus on leadership, engagement, and outreach to equip communities with research-based solutions. As an emerging scholar, she understands that being part of a discipline, especially Family Science, is seen as a give-and-take relationship – such that she learns from others as they invest in her and her future, and in turn, she invests in others as they learn from her. Haley is a fourth-year doctoral candidate in Human Development and Family Science. Among many things, she is a Graduate Research Assistant for Military REACH and assists with completing research summaries on the well-being of military families and research reports for the Department of Defense.
COLLEGE OF HUMAN SCIENCES RESEARCH SYMPOSIUM
Several Military REACH students presented at the Auburn University College of Human Sciences Research Symposium. From left to right: Allison Tidwell and Brianna Gordon: Poster titled "Choosing helping hands: Examining patterns of help-seeking from mental healthcare providers among soldiers experiencing stress" Using data from 9,236 Soldiers who participated in the Army Study to Assess Risk and Resilience in Servicemembers, the current study describes patterns of past-year help-seeking from mental healthcare providers among active-duty Soldiers. Findings inform efforts to increase mental healthcare utilization by understanding who Soldiers turn to when experiencing stress. Haley Sherman: Presentation titled "Examining the dimensionality of a Combat Experiences Scale and examining if religion/spirituality buffers the impact combat exposure has on mental health symptoms" Through the lens of religious coping theory, the aims of this study were multifaceted. First, the dimensionality of a Combat Experiences Scale, the measure used in the Army STARRS dataset, was examined among a sample of 13,155 Soldiers. Next the direct effects of combat exposure on anxiety and depressive symptoms were examined. Then, a Latent Profile Analysis (LPA) was conducted to examine whether different groups of Soldiers emerged based on indicators of religiosity, spirituality, and religious attendance. The final analysis examined if the LPA groups moderated the relationship between combat exposure and the mental health symptoms. Sheila Sjolseth: Poster titled "Back-off pressuring schools: A systemwide structure to meet the child mental health crisis" School-based mental health (SBMH) programming intends to increase mental health services; however, the current structure cannot meet the rising need. This analysis reviewed the empirical literature on SBMH programming, COVID-19 stressors, and child mental health policies. Results call for a multi-tiered system, informed by experts across disciplines, and served by multi-sectors of the community. Continue reading to learn more about the other research presented at the symposium: http://humsci.auburn.edu/research/grs_abstracts_2023.php