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Military Culture and Post-Military Transitioning Among Veterans: A Qualitative Analysis

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Abstract

While a considerable amount of theoretical literature has explored core values and characteristics of the U.S. Armed Forces, limited empirical research has examined veterans’ accounts of military culture. To elucidate military culture and help inform ongoing efforts to incorporate military culture into the provision of healthcare services for veterans, seven focus groups (n = 44) were conducted with diverse groups of veterans to provide their first-hand accounts on these topics. Content analysis of their responses yielded four broad clusters: (1) descriptions of military culture and values (e.g., patriotism, camaraderie, discipline), (2) conflict with values during military service (e.g., betrayed by politicians/bureaucracy, internal conflict of killing), (3) cultural changes post-military service (e.g., continuity of military values/culture, disparate from civilian culture, interpersonal difficulties), and (4) communication with non-military connected persons (e.g., I do not talk about military experiences, I only talk with other veterans). The results expand upon prior conceptualizations of military culture and provide preliminary implications for integrating military culture into healthcare service provisions for veterans. Furthermore, this study highlights the need for further empirical research on the internalization and longer-term impact of military culture to better address the needs of those who served in the U.S. Armed Forces.
Military Culture and Post-Military Transitioning Among Veterans: A Qualitative
Analysis
Wesley H. McCormick, Joseph M. Currier, Steve L. Isaak, Brook M. Sims, Brett A. Slagel, Timothy D.
Carroll, Karl Hamner, & David L. Albright
Abstract
While a considerable amount of theoretical literature has explored core values and characteristics of
the US Armed Forces, limited empirical research has examined veterans’ accounts of military culture.
To elucidate military culture and help inform ongoing efforts to incorporate military culture into the
provision of healthcare services for veterans, seven focus groups (n = 44) were conducted with
diverse groups of veterans to provide their first-hand accounts on these topics. Content analysis of
their responses yielded four broad clusters: (1) descriptions of military culture and values (e.g.,
patriotism, camaraderie, discipline); (2) conflict with values during military service (e.g., betrayed by
politicians and/or bureaucracy, internal conflict of killing); (3) cultural changes post-military service
(e.g., continuity of military culture, disparate from civilian culture, interpersonal difficulties); and (4)
communication with non-military connected persons (e.g., I do not talk about military experiences, I
only talk with other veterans). The results expand upon prior conceptualizations of military culture
and provide preliminary implications for integrating military culture into healthcare service
provisions for veterans. Furthermore, this study highlights the need for further empirical research on
the internalization and longer-term impact of military culture to better address the needs of US
military veterans.
Keywords: Service members, Veterans, Military Culture, Post-Military Transition
Introduction
The importance and troubling nature of the cultural gap between American civilian society and its
military are longstanding (Feaver & Kohn, 2000). Despite the longstanding recognition of the gap as
a problem and calls for action to reduce it, the gap has, if anything, increased over time. A large
percentage of veterans returning from Operation Enduring Freedom/Operation Iraqi Freedom
(OIF/OEF) report serious struggles with their transition to civilian life, and the culture gap plays a
significant role in creating those struggles (Pease, Billera & Gerard, 2016). Developing clear
understandings of military culture is crucial for honoring veterans’ core values and beliefs in the
delivery of healthcare services. Military culture represents the value structure that guides conduct in
the military and promotes expressions of collective identity (Brim, 2013; Wilson, 2008). However,
the intersection of this encompassing value structure with individual veterans’ values is much more
complex. Indeed, military culture exists both in the tenets espoused at the group level as well as the
distinctive, idiosyncratic level of the individual veteran. To help enhance current theoretical
conceptualizations of military culture, the current investigation utilized veterans as cultural
informants to elucidate military culture and the role it plays in military-to-civilian transitions.
Consisting of both explicit (e.g., organization, roles, rituals, creeds, and symbols) and implicit
(e.g., values, ideals, discipline, and etiquette) elements (Brim, 2013), military culture is characterized
by unique norms, philosophies, customs, and traditions that differentiate the United States (US)
Armed Forces from other organizations (Collins, 1998). Being inculcated through a hierarchical,
authoritarian structure with clear order and repetitious responsibilities, military culture promotes
cohesive identity among service members (SMs) and ensures mission readiness (Hall, 2013; Soeters,
Poponete, & Page, 2006; Wilson, 2008). Furthermore, to fulfill its unique role of serving national
interests through the enactment of war (Dunivin, 1994), the military strives to immerse SMs into its
particular way of life by having SMs train, work, and often live in isolation from civilian culture
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(Collins, 1998; Hall, 2011; Redmond et al., 2015; Soeters, Winslow, & Weibull, 2003). Nevertheless,
the military must execute its mission while remaining consistent with the beliefs and values of the
larger society it is entrusted to serve (Riccio, Sullivan, Klein, Salter, & Kinnison, 2004; Soeters et al.,
2003). Considering the potentially arduous task of balancing military and civilian cultures, further
research is needed to delineate the characteristics of military culture while exploring veterans’
experiences with military culture during and after service in the US Armed Forces.
Efforts exist to increase awareness and sensitivity toward military culture in healthcare and
mental health professions (e.g., Canfield & Weiss, 2015; Kuehner, 2013). For example, the
Department of Veterans Affairs (2018) and Center for Deployment Psychology (2018) have each
developed training programs to promote competence regarding military culture and encourage
healthcare providers to assess for military cultural factors that may impact receptivity to and
engagement with healthcare services. Notwithstanding these efforts, empirical research is needed to
advance conceptualization of military culture from veterans’ perspectives. Such empirical research
could augment the growing literature (e.g., Lancaster, Kintzle, & Castro, 2018) by promulgating the
firsthand perspective of key stakeholders in military culture.
Possessing distinct attributes from civilian culture, military culture requires special
consideration to facilitate cultural competence during the provision of healthcare services for
veterans. However, current understandings of military culture are primarily theoretical and limited
information is available regarding how military culture may affect veterans, over time. Thus, two
research questions were developed for the current study: 1) How do veterans, as primary
stakeholders, define military culture, and 2) how might military culture affect individuals over time?
In striving to answer these questions empirically, the current study uses veterans’ self-reports of
intra- and inter-subjective experiences to describe military culture and explore veterans’ perceived
continuity with military culture during and after their military service.
Methods
Participants and procedures
Data for this phenomenological study were collected as part of a needs assessment project
conducted to determine perceived gaps in services and unmet needs among veterans and their
families in an eight-county region in Southwest Alabama. (See Albright et al. [2018] for a detailed
account of project.) Following approval by an institutional review board, focus group interviews
were conducted with distinct cross-sections of the overall veteran population in this region.
Participants for the focus groups were recruited from veteran organizations (e.g., Veterans of
Foreign Wars, Student Veterans of America) in the study region. In total, seven focus groups
(ranging from three to 13 participants) were conducted with 44 veterans. These veterans were
predominantly men (81.4%), Caucasian (57.1%), and ranged from 25 to 72 years of age with a mean
age of 50.57 years (SD = 14.54). The largest proportion served in the Army (42.5%) with
representation from the Navy (27.5%), Air Force (17.5%), and Marine Corps (12.5%).
Qualitative interview
Each focus group was conducted by one or two members of the research team and lasted 45
to 120 minutes. The research team was intentional about developing rapport and collaborative
relationships with the local veteran organizations prior to the interviews, including discussions of
personal (e.g., veteran status of some research team members) and professional (e.g., specialization of
research team members in veteran health) motives in developing the project. The interview format
was semi-structured, consisting of open-ended questions with prompts to encourage elaboration
and/or clarify responses (e.g., “Please say more about that.”). When requested, explanations of
terminology used in the questions were provided to the focus groups. The current study examined the
focus groups’ responses to seven items:
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What does “military culturemean to you?
What are the values or beliefs that you associate with the military/military service?
How did the most difficult aspects of your military service conflict with these values and
beliefs?
How do you experience daily personal life since exiting the military?
How has your sense of cultural identity changed since exiting the military?
When considering the most difficult aspects of your military service, how have your
relationships and well-being been affected?
Military service may entail witnessing or doing things that might be misunderstood or viewed
as wrong. In reflecting on your own experiences, how have you addressed these possible
conflicts with persons outside the military?
Data analytic plan
The focus groups were audio recorded and transcribed by a professional transcription service.
Content analysis (Creswell, 2007) was conducted to derive a comprehensive list of themes discussed
across the focus groups. A formal code was developed by condensing similar themes into
parsimonious categories. The transcripts were then independently coded (k = 0.76) in NVivo 11 by
two psychology graduate students, and discrepancies were resolved via consensus method.
Results
In total, 10 superordinate categories and 41 themes were nested into four broad clusters: a)
descriptions of military culture and values, b) conflicts with values and beliefs that occurred during
military service, c) changes or difficulties that were encountered after military service, and d)
communication of military experiences with non-military persons. Descriptions of themes within each
superordinate category are provided below, and a comprehensive list of qualitative themes with their
respective extensiveness (E) statistics can be found in Table 1 (see appendix).
Descriptions of military culture and values
Individual character. Nine themes were identified that described what military service meant
to the participants. The most common theme, Patriotism/Service to Country, was used 15 times
across the focus groups. Responses were often succinct, such as “patriotism” or “honor, duty,
country.” One Army veteran stated, “Being a soldier, the patriotism is there. The love for our country
is there. Like I said, the discipline that you have to be a good citizen.” Other prominent themes
included Honor/Integrity (E = 10), Discipline/Hard Work (E = 17), and Pride (E = 9). Responses
often included various combinations of the three. For example, a veteran in her late 20s stated,
“Honor. Pride. A team, a unit, working together, having pride in your work. Always working hard.”
Participants also discussed the themes of Courage/Confront Mortality (E = 10; e.g., acceptance of
potential death in the line of duty and/or willingness to face exceptionally difficult, often life-
threatening situations) and Mission First/Overcome Adversity (E = 6; e.g., persevering in the midst
of suffering; prioritizing the mission over self).
Relational character. A single theme, Camaraderie, captured the essence of relational
character within the military. This theme was identified 75 times across the focus groups, capturing
an appreciation for mutual trust, friendship, and individual differences between members of the US
Armed Forces. Within this theme, there was also an emphasis on developing camaraderie, trust, and
respect. For example, an Army veteran in his late 40s stated, “I was taught there is no race;
everybody is related. Everybody’s your brother, because at that time, you don’t know who’s gonna
save your life, so we are all the same.”
Systemic character. Four themes described organizational facets within military culture.
Order, Structure, and Training was a common theme within this category, being used 19 times across
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the focus groups. A response from an Air Force veteran in her 30s particularly captured this theme:
“Just the military way of doing things, from the uniform to the core values that each service has, their
own traditions, the language, the heritage, and ways of doing things.” The theme of Generational
Differences was used 32 times but was only discussed in two of the focus groups, which were
composed mostly of older veterans. This theme captured the difference between being drafted and
volunteering for military service, in addition to divergence of values and training between service
eras. Two focus groups also discussed systemic issues regarding sexism in the US Armed Forces (E =
7), describing how women were treated differently from men and/or experienced hostile work
environments without institutional support.
Conflict with values during military service
Betrayals. Three themes were identified that described how veterans might feel betrayed by
their government, military leadership, and society during their military service. The most common
theme, Betrayed by Leadership/Superior Officers, was used 19 times across the focus groups. An Air
Force veteran in her 50s stated, “Our site commander wanted us to do something that was not
according to our regulation. Because four or five of us chose not to participate, we were disciplined.
We knew it was wrong and were not going to participate.” Another common theme, Betrayed by
Politicians/Bureaucracy, was used 17 times across the focus groups. One Marine veteran in his 70s
stated, “The man in combat hates war worse than anybody.… They’re fighting for Chevron. They’re
not fighting for any other purpose. If they grew carrots over there, we wouldn’t be going.”
No conflict. Three themes were identified that captured how veterans might not perceive any
betrayals or transgressions from their military service. The most common theme, Denial of Conflict,
was used 10 times across the focus groups. Examples of this theme were typically succinct with
participants stating they did not experience any conflicts of values or beliefs while in the military.
Others described not experiencing conflicts with their values or beliefs because they were doing what
was necessary to accomplish the mission. An Army veteran in his 70s stated, “I never had any
conflicts whatsoever. You fight a war to win, and in Vietnam, we never had a mission that was not
complete, and we never lost a battle.”
Transgressions. The two themes of Internal Conflict of Killing and Incongruent Behavior
with Values captured how veterans might perceive violations of values or beliefs while in the military.
Both themes were equal in prevalence, each being used six times across the focus groups. A veteran
in his 70s described the conflict of killing by stating, “It took me 20 minutes to squeeze the trigger on
the very first person I shot, because those thoughts are going through your mind. This is somebody’s
son. This is somebody’s father, brother. I mean, all this and, ‘Thou shalt not kill.’” Some of the focus
group members also noted perceived transgressions of/or lackadaisical adherence to military
standards for behavior. For example, an Air Force veteran in her 30s recounted difficulties
addressing behavioral issues with servicemembers under her command: “As a leader, it kind of ties
your hands because, this airman or sergeant or whatever it is, has been disrespectful, has no honor
for the uniform that they’re wearing.”
Perceived changes post-military service
Personal struggles. Nine themes captured how veterans can experience struggles as they
reintegrate into society. The most prolific theme, Disparate from Civilian Culture, captured how
civilian society possesses different values, character, and ways of living from the military. This theme
was identified 76 times across the focus groups. One Army veteran in his 50s stated, “The civilian
world, it’s getting away with what you can. In the military, it’s perform because you have other
people counting on you. It’s some kind of gap when you get out.” Other themes included
Interpersonal Difficulties (E = 38) and Divorce (E = 10). These themes captured how veterans can
struggle to reintegrate into their families and communities after military service, becoming socially
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isolated and struggling without the camaraderie they enjoyed in the military. Mental Health Issues
were also common, being identified 31 times across the groups. A Marine veteran in his 70s
illustrated the themes of Interpersonal Difficulties and Mental Health Issues by stating, “A person
close to you dies, and you can’t grieve because you’ve got all this grief. Then all of a sudden, you get
smacked between the eyes with PTSD and it about destroys your family. Like I said, I nearly lost my
wife.”
Personal growth or continuity of military culture. Six themes captured veterans’ perceived
continuity of cultural identity or increased well-being after military service. The most common theme,
Continuity of Military Culture, was used 34 times across the groups. A veteran in her late 20s
emphatically stated, “I’ll always be a veteran. I’ll always live by their standards as much as I possibly
can. It will never change.” Additional themes included Appreciation of Cultural Support for the
Military (e.g., “The people are behind us. That’s making us feel better.”), Altered Existential Values
(e.g., “I think once you face death, your whole value of life changes.”), and Improved Interpersonal
Relationships (e.g., “I think that my military experience has strengthened my relationship with all of
my family.”).
Communication with non-military connected persons
Limited communications. Two themes described how veterans struggle to talk about their
time in the military with civilians. The most prominent theme from this category, Civilians Do Not
Understand, occurred 36 times across the focus groups. One veteran stated, “It’s hard to adjust to
civilian life after you get out. Your family, even though they are a military family, don’t go through
what you’ve been through. They don’t know how to ask you what’s wrong or get help.” Additionally,
I Do Not Talk About Military Experiences was used 18 times across the focus groups, often
consisting of simply “I don’t” when asked how they discussed their military experiences with
civilians.
Limited help sources. Two themes captured how veterans might consider only a few help
sources to discuss their time in the military. Both themes (Only Talk to Other Veterans, E = 7; Talk
to Mental Health Professional(s), E = 3) were used sparingly. An Army veteran in his 30s stated, “I
don't have anyone, outside of people I knew over there, that I can speak with because they won't
understand what I just went through or they'll worry too much. So, you don’t want that burden to be
put on them, as well.”
Discussion
Recent training initiatives (e.g., the Department of Veterans Affairs, 2018; Center for
Deployment Psychology, 2018) address a need to provide culturally informed care to veterans.
Seeking to bolster these programs, the current study examined qualitative descriptions of military
culture and post-military transitioning across distinct cross-sections of veterans in Southwest
Alabama. Across seven focus groups, veterans’ responses coalesced into four distinct clusters of
superordinate categories, providing preliminary empirical footing for defining key aspects of military
culture that could equip providers to honor veterans’ post-military values and beliefs.
The veterans of this study described their perception of military culture in the first cluster of
themes. Many of the identified core qualities and values aligned with prior conceptualizations of
military culture (e.g., Brim, 2013; Siebold, 2006). For example, patriotism was pervasive in veterans’
responses, embodying a sense of nationalistic pride and belief that enlistment in the military enabled
them to serve something greater than themselves (e.g., defense of Constitutional rights). Camaraderie
was also highly prevalent in the group discussions, highlighting a sense of responsibility within the
military to work together, regardless of differences in individual cultures or personal beliefs, to
protect one another and accomplish mission objectives. The values and characteristics identified by
the focus groups provide an empirical foundation for understanding how the “average” veteran may
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perceive and define military culture. Furthermore, the themes’ extensiveness statistics, derived from
the qualitative analyses, provides insight into the potential prioritization of military values among
veterans.
Integrating these military values into the provision of services could lead to improved
outcomes from various programs and treatments. Indeed, therapeutic paradigms, such as Acceptance
and Commitment Therapy, emphasize the importance of understanding client values to foster value-
centered living as targets in treatment (Hayes, Follette, & Linehan, 2011). In medical care, increasing
attention is focused on tailoring the patient-centered medical home (PCMH) to vulnerable
populations to reduce the amount of time spent in an inpatient setting and lower costs associated with
emergency care (O’Toole et al., 2011). Of note, assertive community treatment (Stein & Test, 1980;
Bond & Drake, 2015) has demonstrated considerable effectiveness for veterans who live in
moderately structured communities as part of their care delivery (Mohamed, Neale, & Rosenheck,
2009), perhaps, in part, due to the shared values with other members of the community and provider
immersion within that community.
In considering assertive community treatment and tailoring the PCMH to veteran
populations, heeding the values engendered by prior military service may be as important in fostering
interpersonal connectedness and rapport with providers as in identifying targets of treatment. Along
these lines of interpersonal connectedness and building on the core value of camaraderie articulated
by veterans in this study, community-based interventions that incorporate veteran peers may be an
important strategy to improve mental health outcomes. For example, research supports the unique
benefits of veteran peer support specialists as an integrated component of treatment, with veterans
reporting increased social and emotional support, stigma-reduction, and adherence (Hundt,
Robinson, Arney, Stanley, & Cully, 2015). In addition, recent findings have indicated that veteran
peer contact is associated with higher attendance and lower dropout during psychotherapy among a
sample of 102 Post-9/11 treatment-seeking veterans (Goetter et al., 2018). Taken together, using peer
supports within the context of a value-directed treatment approach may be a key for cultivating a
community of recovery.
The second cluster of themes entailed military experiences that conflicted with the individual’s
or military’s core values. Within this cluster, the veterans described experiences where they felt
betrayed (e.g., betrayed by politicians/bureaucracy or leadership/superior officers) and/or perceived
transgressions of values or beliefs by self and others (i.e., internal conflict of killing, incongruent
behavior with values) during their military service. Such descriptions align with the emerging
construct of moral injury. Within the moral injury literature, morally injurious experiences (MIEs)
are defined as “perpetrating, failing to prevent, bearing witness to, or learning about acts that
transgress deeply held moral beliefs and expectations” (Litz et al., 2009, p. 700). Furthermore, Shay
(1995, 2014) has contributed a three-part definition of MIEs, suggesting these experiences consist of
“(a) a betrayal of ‘what’s right’; (b) by someone who holds legitimate authority; (c) in a high-stakes
situation” (2014, p. 183). Evidence suggests MIEs can lead to intra- and interpersonal distress
(dysphoric moral emotions [e.g., guilt, shame, and anger] and negative cognitions [e.g., self-blame,
distrust of others]; Currier et al., 2018) and impair psychosocial functioning among veterans (e.g.,
Farnsworth et al., 2014; Jinkerson, 2016; Kopacz et al., 2016). Veterans struggling from experiences
that conflicted with deeply held values and beliefs may be reluctant to engage in help-seeking
behaviors due to perceiving themselves as undeserving of “getting better” (shame-based cognitions)
or mistrust of authority (e.g., US Department of Veterans Affairs, healthcare providers). By being
aware of and sensitive to these types of intra- and interpersonal struggles among some veterans,
healthcare providers could improve upon their customer service, promote development of outreach
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programs that encourage help-seeking behaviors, and increase implementation of motivational
interviewing techniques which foster medical compliance (Rollnick, Miller, & Butler, 2008).
The third cluster of qualitative themes captured veterans’ changes while transitioning to
civilian culture post-military service. The veterans in the current study described a variety of
examples for how they experienced personal struggles, personal growth, and continuity of military
culture after separating from the US Armed Forces. Their descriptions of growth provide positive
insight into post-military changes, including increased interpersonal relationships and/or more
gratitude for their life after military service. However, several veterans also discussed a perceived
disparity between themselves and civilian culture or reported interpersonal difficulties post-military
service. Such struggles have been noted as impediments to successful reintegration post-military
service (Sayer et al., 2010; Koenig, Maguen, Monroy, Mayott, & Seal, 2014). For healthcare
providers, helping veterans navigate perceived cultural conflict and develop interpersonal
relationships might foster adaptive transitioning post-military service. One targeted intervention to
address these concerns may be encouraging veterans to engage in volunteer service activities within
their community. Volunteerism has been shown to associate with decreased feelings of depression
and increased help seeking behaviors among veterans enrolled in postsecondary education (Albright
et al., 2019). Some work has also been done suggesting that mass media provides a narrow
representation of what it means to be a veteran (Parrott, Albright, Dyche, & Steele, 2018; Parrott,
Albright, Steele, & Dyche, in press), perhaps further creating barriers to successful integration. By
increasing their activity and exposure in the community, veterans may promote community members’
awareness of military culture and encourage more accurate perceptions of military culture in the
community at large. Furthermore, assisting media outlets in providing more accurate portrayals of
veterans and their experiences, as exemplified by organizations such as Got Your 6
(www.gotyour6.org), might foster wider acceptance and understanding of transition-related
challenges many veterans experience.
Finally, consistent with prior research on help-seeking behaviors (e.g., Currier, Deiss, &
McDermott, 2017; Currier, McDermott, & Sims, 2016), the fourth cluster suggested that veterans
experience considerable ambivalence toward help-seeking, often preferring not to disclose military
experiences with individuals who have not personally served in the US Armed Forces. The focus
groups expressed that individuals without military experience are often unable to understand the
experiences of veterans due to disparity between military and civilian life. Furthermore, our veterans
expressed a willingness to seek help from mental health professionals due to the perception that they
are professionally trained to understand and address military-related problems. These results
highlight veterans’ desire for healthcare providers to demonstrate military cultural competence.
When veterans perceive providers as lacking competence of military culture, they may not seek
treatment or discontinue services due to fear of stigma and/or perceived inability of others to
understand their experiences. For example, Greene-Shortridge, Britt, and Castro (2007) outlined
how cultural barriers and stigma, including societal and self-directed stigma, may interact to create
circumstances wherein SMs and veterans are less likely to seek help.
Indeed, the American Psychological Association Task Force on Evidence-Based Relationships
and Responsiveness highlights the considerable empirical support for attending to the psychotherapy
relationship and matching appropriate interpersonal approaches in conjunction with evidence-based
treatments (see Norcross & Lambert, 2018; Norcross & Wompold, 2011). Relatedly, a recent meta-
analysis on patients’ reactance level (low versus high avoidance/resistance) suggests therapy
effectiveness is associated with clinicians’ corresponding level of directiveness (Beutler, Edwards, &
Someah, 2018). When considering the findings of the present study concerning possible situational
and/or dispositional resistance towards treatment among some veterans, maintaining an open,
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reflective, collaborative, and transparent therapeutic posture (as opposed to more directive and/or
structured approaches) may increase engagement and/or improve therapy-related outcomes.
Moreover, conveying cultural competence could foster empathic understanding from civilian service
providers, promoting rapport development with military veterans (Martin, Albright, & Borah, 2017).
By providing education and resources to veterans for addressing perceived discrepancies between
civilian and military cultures (Pease, Billera & Gerard, 2016), a two-fold approach could be enacted
whereby collaborative healthcare is promoted and veterans’ needs are addressed in a more effective
manner.
The narratives collected from the veterans illuminate specific areas where healthcare service
provision could be improved through consideration and integration of military culture. Nevertheless,
this investigation had several limitations that need to be considered. First, the qualitative analyses
provide preliminary insight into the components of military culture but do not support definitive
theoretical or clinical implications. Additional research is needed to evaluate the effectiveness of
integration strategies and treatments. This may include exploring providers’ perceptions of military
culture and tactics for improving awareness of mental health concerns among veterans. In turn, this
could shed light on cultural misunderstandings that may exist between healthcare providers and the
veterans they serve. A second limitation is generalizability. Because the focus groups were conducted
with veterans living in Southwest Alabama, the results might not generalize to veterans in other
regions. Notwithstanding these limitations, the current study provides initial practical implications to
improve culturally competent care and tailoring services in the civilian sector. It is hoped these
findings can support a foundation to meet the needs of those who have taken an oath to guard their
nation and its way of life.
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Wesley H. McCormick1,
Joseph M. Currier1,
Steve L. Isaak1,
Brook M. Sims1,
Brett A. Slagel1,
Timothy D. Carroll1,
Karl Hamner2,
& David L. Albright3
1University of South Alabama, Psychology Department, Mobile, AL
2University of Alabama, College of Education, Tuscaloosa, AL
3University of Alabama, School of Social Work, Tuscaloosa, AL
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298
Table 1
Frequency and Extensiveness of Categories and Subordinate Codes
E
E
Cluster 1: Descriptions of Military
Culture/Values
Transgressions
Individual Character
Internal Conflict of Killing
6
Discipline, Hard Work
17
Incongruent Behavior with Values
6
Patriotism, Service to Country
15
Cluster 3: Changes Post-Military
Courage, Confront Mortality
10
Personal Struggles
Honor, Integrity
10
Disparate from Civilian Culture
76
Pride
9
Interpersonal Difficulties
38
Mission First, Overcome Adversity
6
Mental Health Issues
31
Leadership, Assertiveness
4
Increased Irritability
31
Theistic Belief
3
Divorced
10
Humility
2
Struggle Without Structure
10
Relational Character
Grief
4
Camaraderie
75
Medical Issues
3
Systemic Character
Behavioral Inactivity
2
Generational Differences
32
Continuity of Military Culture/Personal Growth
Order, Structure, Training
19
Continuity of Military Culture
34
Sexism
7
Appreciates Cultural Support for Military
12
Distinct Way of Life from Civilians
7
Happier/“Life Is Good”
5
Cluster 2: Conflicts with Values/Beliefs
Empathy for Military Personnel
4
Betrayals
Improved Interpersonal Relationships
4
Betrayed by Politicians/Bureaucracy
19
Altered Existential Values
3
Betrayed by Leadership/Superior Officers
17
Cluster 4: Communication with Non-Military
Persons
Societal Disrespect of Veteran(s)
6
Limited Communication
No Conflict
Civilians Do Not Understand
36
Denial of Conflict
10
I Do Not Talk About Military Experiences
18
Acted Appropriately to Complete Mission
6
Limited Help Sources
Values/Beliefs Congruent Pre-Military
3
Only Talk to Other Veterans
7
Talk to Mental Health Professional(S)
3
Note. E = Extensiveness of category/code
... Consistent with the second step of 3ST (connectedness), transitioning veteran suicide-related outcomes are significantly associated with self-stigma, connection to military identity, community integration, social support, and disruptions to interpersonal relationships (Edwards, Coolidge, et al., 2023;Edwards et al., 2024). Similarly, in qualitative studies of recently discharged veterans, difficulties reintegrating into civilian society and navigating differences between military and civilian cultures often emerge as salient contributors to transition stress and suicide (Brenner et al., 2008;Lusk et al., 2015;McCormick et al., 2019). ...
... However, participants in the study were not explicitly recruited on the basis of suicidality nor was suicidality assessed as part of the study protocol. Other qualitative investigations highlighted the salience of transition stress among recently discharged veteran participants (Albright et al., 2018;McCormick et al., 2019;Shue et al., 2021). However, again, these investigations did not explicitly sample veterans at risk for suicide nor assess for suicidal ideation and behavior among participants. ...
... Observed themes were largely consistent with those identified in other qualitative studies focused on the experiences of transitioning Veterans. Multiple qualitative studies, for example, have highlighted feelings of unpreparedness during the military-to-civilian transition, disparities between military and civilian culture, feelings of disconnection from civilians, and the salience of social support, identity, and purpose as central to transition experiences (Albright et al., 2018;McCormick et al., 2019;Shue et al., 2021). Of note, however, none of these other studies focused on transitioning Veterans' experiences of suicide nor explicitly sampled for Veterans at risk for suicide-related behaviors. ...
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... Civilian employers report concerns for hiring veterans because they can be too rigid, too authoritative, excessively hypervigilant, or have difficulty adjusting to new coworkers (McCormick et al., 2019;Rausch, 2014;Stone et al., 2018). These character traits are likely attributed to veterans' exposure to the armed forces' military culture, which prioritizes collectivism, intense training, and preparation for combat (McCaslin et al., 2021;McCormick et al., 2019;Rose et al., 2017). Importantly, these characteristics are prescribed with little regard for the job specialty, service branch, rank/responsibilities, years of service, or combat/deployment history. ...
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... Transition can involve significant readjustment due to the difference between who someone knew themselves to be as a military person and who they are in civilian society [2]. Differences arise due to incongruence between individualistic societal values and collectivist military values [3,4] and removal from a highly structured environment, containing routine, comradeship, loyalty, mutually dependent task performance and common purpose [5,6]. Many veterans experience transition difficulties [3,7,8]. ...
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The present study examined the psychometric properties of a measure of military identity in a sample of U.S. military members. Confirmatory factor analysis provided additional support for the multidimensional nature of military identity. Correlational analyses indicated that the domains of military identity were strongly related to postdeployment adjustment as well as other indicators of psychosocial health. Of importance, the relationships between the subscales of identity and the outcome variables differed in strength and direction depending on the form of identity, which supports a multidimensional structure of military identity. Additional research is necessary to identify the most salient domains of identity as well as the clinical and theoretical implications of identity in the functioning of veterans.
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he purpose of this brief report was to ascertain student veterans' patterns of help-seeking from professional, informal, and religious sources. In total, 350 veterans from an academic institution on the Gulf Coast completed assessments of help-seeking intentions from a range of potential sources in their communities. Analyses revealed that veterans had a neutral probability to seek help from professional sources (e.g., physicians and psychologists) but were likely to pursue informal sources (e.g., partner/spouse, friend) in a psychological/emotional crisis. However, when compared with their nonclinical counterparts, veterans with a probable need for treatment for PTSD and/or depression generally reported less probability to seek help from informal and religious sources. In addition, sex, ethnicity, and religious background each contributed a significant influence in shaping preferences for seeking help for psychological or emotional concerns. Given unmet mental health needs of student veterans, findings highlight the importance attending to help-seeking preferences in this growing population.
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Like members of any culture, Service members, Veterans, and their families have a right to feel understood and respected and to have their problems readily identified and addressed in an effective, safe, and timely manner. It is only through actively seeking knowledge in the military culture that health-care professionals can accurately assess and accommodate for the ongoing impact of military service on their patient’s lives, well-being, and treatment.