Service Members’ Perspectives on Treatment: Bridging the Military-Civilian Divide

The difficulties some service members have reintegrating into and reconnecting with civilian society are well established across the literature. Despite the veteran’s voices describing these struggles to connect with civilians and the current zeitgeist in psychotherapy on the therapeutic relationship and multicultural competence, little attention has been given to the implications of the civilian military divide in therapy. This study used a mixed method approach to conduct an exploratory study of 70 service members’ perceptions of working with a civilian and active duty or veteran therapist and what factors contribute to therapeutic alliance. Of interest are service members’ beliefs about what knowledge about the military is important for a therapist, what makes for a good first encounter, and what they look for to determine trust. Statistical analyses looked to explore the impact of combat, homecoming, and military experiences on Working Alliance Inventory scores for an imagined veteran and civilian therapist. Content analysis was used to analyze qualitative data to look for basic themes within service members’ responses. Results indicated no difference between a civilian and active duty/veteran therapist, a strong emphasis on being understood by their therapist, and that interpersonal negative homecoming experiences decrease therapeutic alliance. Based on these findings and the clinical literature, guidelines are proposed for effective ways to work with service members