Post 9/11: Returning Veterans and the Challenges They Face With Returning to Civilian Life

Post 9/11: Returning Veterans and the Challenges They Face With Returning to Civilian Life BY flor25 Post 9/1 1: Returning Veterans and the Challenges They Face With Returning to Civilian Life A Research Proposal Presented Fiordaliza Mena and Tiffani Sylvain SWK 380 Research Methods Salem State University School of Social Work Dr. Stefan Battle, Ed. D. , MSW, Assistant Professor November 7, 2012 Introduction The research proposal that is about to be presented is intended to discuss the various challenges and adjustments that post 9/1 1 veterans face when transitioning back into civilian life post-deployment.

The purpose of this study is to discover the transitional issues that these veterans are faced with when returning home to their loved ones and families. When members of our society decide that they want to serve their country and Join a branch of the military, they automatically assume a new identity for themselves. They Join and as soon as they start military basic training, they adapt a whole new identity which encompasses the same identity that their fellow peers eventually adapt when in the military.

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In fact, they no longer belong to themselves but to their perspective military branch and buy into a certain ilitary philosophy. Nevertheless, when they return back to Join their families and adapt back into civilian life, they often find themselves in a physical, emotional, and cultural shock. It is important to explore this topic and understand the challenges that veterans face in order to implement practices to help them overcome these challenges.

It is unethical to subject a person to such traumatic circumstances for certain periods of time and expect a smooth transition when they are thrown back into their natural environment, without assistance. It is crucial to understand the hallenges that these individuals face when returning home in order to better suit the services that are necessary to reintegrate these individuals back into their natural society.

Veterans often encounter challenges that can either be related to tnelr pnyslcal aDllltles, mental/emotlonal aDllltles, and/or tnelr capaclty 0T a0Justlng back into their lives as men and women of our society. Many of them come back suffering from psychological as well as physical wounds. For example, many return suffering from various mental illnesses such as post traumatic stress disorder (PTSD), hile others experience life difficulties as a result of physical or emotional wounds.

Others return to Join their loved ones but many experience certain difficulty in giving up their military identity and general transition back into the civilian lifestyle. It is often difficult for them as well as for their families to transition together into a positive and functioning environment. There are researchers who have conducted studies involving adjustment problems, substance abuse problems, externalized behaviors, and social environment problems when post 9/1 1 veterans return from deployment.

Some of these key researchers such as those who published Posttraumatic Stress, Family Adjustment, and Treatment Preferences Among National Guard Soldiers Deployed to OEF/OIF, have conducted and published a study assessing demographics, PTSD symptoms, relationship satisfaction, concerns about relationships and mental health care (Khaylis, Polusny, Erbes, Gewirtz, & Rath 2011) We have chosen this particular topic on veterans because it involves the military which is very broad and we as a social work major’s believe that there is a vast population that deserves and are entitled to the services that are provided by elping professionals such as social workers.

We are interested in learning about the roles that social workers have within the department of veteran affairs. Moreover, we chose this particular topic because we became interested in gaining knowledge on the veteran population and how we, as a future social worker’s, can help. We also felt it was important to conduct this study because we personally know an individual who has been struggling with transitioning back into civilian life after being deployed in Afghanistan. To develop our topic, we will be using various methods to obtain data. We intend to discover what challenges post 9/1 1 veterans face when transitioning back into civilian life from deployment.

Lastly, the research proposal will also intend to provide a response and test our hypothesis. This research proposal will be developed throughout the fall semester to be completed by the end of it. Literature Review wrlg nt, I-oran, wood, EcKTora, ana McC5ur (2012), conauctea a study wnlcn examlnea whether “externalizing behaviors” could be explained by “internalizing symptoms (depression, anxiety, and PTSD symptoms) and health of the social environment” (782). The externalizing behaviors that were looked at in this study included alcohol abuse, aggression issues, etc. The participants in this study were active duty servicemen who were already deployed.

The study was conducted “four to nine months” post-deployment via survey. Wright used several scales to measure the problems that veterans faced when these surveys were conducted in the months following their deployment. Some of the scales that the researchers used to measure were “combat exposure and social environment” (787). The results of the study concluded that the sample experienced post-deployment issues. 67. 3% of the sample endorsed aggressive behavior in the past month and 28. 7% reported some problems related to their drinking behaviors” (789). Wright also found that these behaviors and issues continued to remain stable over the entire nine month period that the samples were being analyzed.

The study found a “direct effect of combat exposure in predicting externalizing behaviors” (793). The results of this study show evidence that there is a connection between combat exposure and externalizing symptoms. These include aggression, alcohol problems, and socialization problems among others. In conclusion, this study has evidence those veterans who are returning home from deployment, have transitional and adjustments issues that they face post-deployment. According to an article found on Employmentspectator, Veterans Say Finding a Job Hardest Part of Returning to Civilian Life,” over two-thirds of the post-WI 1 generation feels that acquiring a Job is the most difficult challenge in their lives.

Forty four percent of the respondents of the Veterans’ Employment Challenges Study, operated by Prudential financial, said they are not prepared to transition to life as a civilian. Of those who said they were not prepared for the transition, half of them said they need more technical training or education. The study also found that veterans who face mental-health or physical problems are twice as likely as indicate that they are not prepared to transition. The chief policy officer for Iraq and Afghanistan Veterans of America, Tom Tarantino, said that unemployment is still a problem for post-WI 1 veterans. In the other hand, respondents in the same study said that veterans’ second largest issue is telling employers how their military experiences can be used in civilian life or particular work fields.

As a response to these employment challenges, in 2011, The Veterans Opportunity to Hire Heroes Act was signed to find out how military skills can be translated into civilian skills. Of the respondents, 58 percent said that they worry when it comes to translating their skills to the business world. Half of the respondents said that they are concerned that supervisors who are not veterans might not understand their personal formation in military. “Among the challenges this research confirms for employers and veterans is the need to bridge the perception gap between the skills veterans offer and what employers are looking for,” aid the vice president for veteran’s initiative at Prudential Financial whom provided some funding for the survey.

Another survey is one by the National Council for Community Behavioral Healthcare which reported that veterans continue to encounter barriers when accessing mental health and substance use treatment. The survey asserts tnat tnls Is nappenlng even arter tne veterans Mental Healtn Act was signed more than a year ago. The Act requires the US Department of Veterans Affairs (VA) to partner with community behavioral health centers to increase capacity and expand mental health services to include marriage and family counseling. According to the survey, veterans and their families experience long delays to get initial appointments for people in crisis and excessive waits in between appointments.

In addition, veterans often travel long distances to the VA or a military base while these travel times can be as long as five hours. Others, because of physical and mental limitations, do not have access to a vehicle or public transportation. These may be unable to drive or take public transportation. Another barrier is stigma. Many veterans are bothered that seeking treatment from the VA or military will be noted in heir personnel records, negatively impact their careers, and label them as “weak,” “crazy,” or extremely “dangerous and violent. ” And lastly, though the Act specifically includes marriage and family counseling, few family members are involved in treatment. Respondents suggested these services are either not being provided or have not been widely promoted.

The survey also reported that some of the consequences of not meeting the needs of veterans, service members and their families is one of the main causes for suicide attempts. During the first six months of 2009, Indiana received 69 calls from returning de-activated soldiers that involved uicide attempts. Six of those returning service members ultimately died. Respondents in other states reported problems of domestic violence, divorce, homelessness, unemployment, and criminal Justice system involvement. The article by Khaylis, Polusny, Erbes, Gewirtz, and Rath (201 1), Postraumatic Stress, Family Adjustment, and Treatment Preferences, presents a study in which it was reported that over 1. million troops have served in Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom COIF]) Wich nearly half of these troops were active members of the National Guard and Reseerve (NGR) component of the military. With the historically unprecedented deployment of NGR, over 2. 7 million families have been affected by their service members’ deployments to OEF or OIF (126). In their article by Khaylis, Polusny, Erbes, Gewirtz, & Rath (2011) report that with previous eras of combat veterans, OEF or OIF veterans seeking VA health care frequently report post-deployment mental health issues and concerns. Analysis of VA administrative data from over 100,000 OEF or OIF veterans shows that post traumatic stress disorder (PTSD) was the most common mental health diagnosis among those eterans seeking help.

These problems appear to escalate further during the months of reintegration following deployment. To better explain, PTSD symptoms have proven to lead to an array of challenges, with implications for veteran’s environment, spouses, children, and their society. For instance, this is why veterans with PTSD and their partners report significantly more relationship distress, difficulties with intimacy, parenting and social relationship problems (126). Research found in the article by Khaylis, Polusny, Erbes, Gewirtz, & Rath (2011) explains that PTSD symptoms mong veterans are associated with greater marital distress such as higher rates of intimate partner violence and higher rates of divorce.

Research has also suggested that veterans with PTSD symptoms experience difficulties with parenting satisfaction ana a decreased quallty 0T parent-cnlla relatlonsnlps. A primary source 0T social support for veterans is spouse and family relationships. If lacking, it may then contribute to the effects of PTSD symptoms. It is also possible that conflict within families, both between partners or with children, may serve as a source of stress for eterans with PTSD and increase its effects (126). Khaylis, Polusny, Erbes, Gewirtz, & Rath, (201 1), present an analysis of VA administrative data from over 100,000 OEF or OIF veterans that shows that PTSD was the most common mental health diagnosis among veterans seeking help.

These problems appear to escalate further during the months of reintegration following deployment (126). PTSD symptoms lead to an array of challenges for veterans as these are associated with greater marital distress, higher rate of intimate partner violence, and higher rate of divorce (127). Veterans ith PTSD and their partners report significant more relationship distress, difficulties with intimacy, and relationship problems (127). In addition, research has shown that veterans with PTSD symptoms have a significant negative influence on their children and parenting styles: “Children of veterans with PTSD tend to experience greater rates of behavioral problems, academic difficulties, and social impairments” (127).

For instance, research has suggested that veterans with PTSD experience low parenting satisfaction and demonstrate low quality of parent-child relationships. In his book, Fields of Combat: Understanding PTSD Among Veterans of Iraq and Afghanistan (201 1), Erin P. Finley also highlights another challenge faced by veterans when returning back to civilian life. The new challenge involves the pressure based on the expectations of the military, the society, and the family on soldiers after deployment. Such challenge faced by post-deployed soldiers prevents us from improving mental health and decreasing stigma in returning veterans. Opposing forces to veteran’s adaptability and reintegration to civilian life is therefore not only a responsibility of the returning soldier and the U. S military.

It is also a responsibility shared with all members of our society and its institutions, mainly including the family. The U. S. Army’s current system of Combat and Operational Stress Control (COSC) is a combat stress control units, composed of army psychiatrists, and other mental health professionals (93). It is intended to remain mobile through the combat zone and to provide combat stress support to soldiers and higher leadership members wherever necessary, available, or on demand (94). The COSC is thus intended to provide strategies for the prevention and treatment of combat stress reaction which are not he same reactions experienced by symptoms of PTSD.

So, when managing combat stress symptoms in soldiers, individuals for the most part, get examined by the COSC unit or other available mental health personnel. These individuals are provided with twenty-four-top-twenty-hour “restoration” treatment and “slow-to-improve cases may be held for four to twenty-eight days and give additional treatment. In the cases of more severe symptoms, individuals may get evaluate for additional treatment and/or evaluation by professional from Europe or the United States (94). The COSC is then, dentified as unit that serves active soldiers who are or have experienced symptoms of combat stress with personalized treatments and professional care.

In addition, the COSC also provides predeployment and post-deployment mental health screening, a system of mental health surveillance, a multilevel management of stress by individual service members, other unit members, and higher leadership (93). c system Is already In place to support active ana non actlve soldiers and military members, it represents enough of an attempt by the American Military to protect and provide for its members. Finley emphasizes that the military s an institution much like a veteran’s family, which is responsive for perceiving crisis or acting out that may result if service members’ post-combat and post-deployment struggles are left without appropriate attention (106).

This leads us to conclude that the crisis faced by veterans within their families and civilian life are very independent from the military. Therefore, as presented above, there may be concerns faced by families and society about their deployed members. Some family member of the deployed soldier or veteran many believe that they will become more troubled over time with potentially tragic results. These include as suicides, high levels substance abuse, and homelessness. Or perhaps, particularly their families may believe that they will be unable to live up to their expected role as a parent, partner, or provider (106). To support this statement, in his book, Finley reports those families as well as the military do not always act in total and effective support of its members.

He states that families sometimes lash out at veterans rather than supporting them while military leadership sometimes directly contributes to mental and physical health problems for their troops by continually sending them into onflict on battle field ignoring sighs of combat stress among them (107). This is what he calls the top-down pressure that prevents post 9/1 1 veterans from improving mental health and decreasing stigma. In his book, Finley also talk about other pressures that work to continue the stigma in veterans around combat stress. He presents this particular pressure to be the socialization that service members are given upon their entry into the military (107).

Anthropological research among active- duty military personnel in the United States, Bolivia, Israel, and Australia, to name a ew, have found that state militaries make use of a variety of socialization practices to foster a sense of shared culture among soldiers. This socialization usually takes place during some form of basic training and is intended to serve several purposes (107): First, it supports the group cohesion, and bonding that are considered essential for maintaining trust and efficiency in combat settings. Second, it support the internalization of a disciplinary hierarchy in which orders will be followed without questions, even under conditions of crisis and threat. Third, socialization instill ervice members with the values total institution and is thus intended to overcome previous institutions in which individuals live, work, and play a role in.

This military specific and strict form of socialization implies that the military is exclusively a male institution which naturally embraces aggressive masculinity within its culture. This is, individuals who sign up for military service may already relate to certain type of hypermasculine identity which causes self-conscious aggressive masculinity. Anthropologists have suggested that Joining the military serve as a male “rite of assage” to a culturally authorized way of “becoming a man. ” This is mainly because being part of the “normal” military conduct or culture involves toughness and cultivates authority and leadership over others (107). Sociologist and anthropologist strongly believe that many veterans have been strongly socialized by the military culture.

Finley aescrlDes mllltary soclallzatlon as an ongoing process, contlnually re- created in the often highly valued relationships between service members and those closest to them in the rank hierarchy, their immediate peers, and experiences shared y service members (108). In support of the previous statement and as a final reference to the challenges veterans face when returning to civilian life, In his book, Finley talks about deployed members and/or veterans who have internalized powerful messages from peers or supervisors they admire. In other words, veterans report that they wanted to live up to the particular example and legacy of even those who have even been injured or killed in the line of duty (108).

As an example, veterans such as former army sergeant, Jose, says that he still Judges his own worth n relation to what he knows a perfect soldier should be and tries to live as one. Certainly This is why people who are not familiar with the military often find it very strange that these men that are thought to kill should be so loyal and should look out for and look up to one another so intensely (109). Addtional challenges to those that result when hen transitioning to civilian life including family reintegration, parenting, marital relationship, unemployment, substance abuse, and mental and physical illnesses, veterans also encounter and face emotional, identity, and socialization challenges.

According to Finley, it is difficult to overstate the closeness between service members particularly between those who have been through combat together. In addition, the unavoidable military socialization that veterans receive since the moment they start basic training shapes their identity as a militarily figures and enables them to behave accordingly. However, there are no individual more deeply aware of the complex morality of war time actions than veterans (109). Having seen how high veterans and deployed members of the military value their fellows “comrades in arms” and “arm of brothers” t could be said that with the same intensity they may find difficult to match in civilian life.

Methods The research design that we will be using for this study will be descriptive. We will be using the descriptive research design because we will be observing the transitional issues and adjustment that OEF/OIF veterans are faced with when they return home from deployment. We will then record the data that we observe or collect. For this study, we will be using a qualitative approach. We believe that in using a qualitative approach, we will be gathering data on a personal level with the research participants. We believe that the data we collect will provide an accurate portrayal of the adjustment and transitional issues that OEF//OIF veterans are faced with when they return home from combat.

The sampling frame that we are using in our research design is purposive sampling. We have decided upon this sampling frame because we will be directly targeting a specific sample of participants. We are only using participants who attend the Boston VA hospital. The sample size for our research design will consist of 100 research participants. The sample section of our research study includes the participants of the study nd the demographics of these participants. The participants in the research study wlll Include veterans wno served ana were deployed overseas In operation Enduring Freedom and Operation Iraqi Freedom. All of the participants in our study will be post 9/1 1 combat veterans.

Our participants are Army National Guard soldiers. The research site that we will be using for our research design will be the Boston VA Hospital located in Boston, Massachusetts. We will be using this location because it is readily accessible to the researchers and provides an array of veterans from the area and surrounding cities and towns. This location allows us to create a sample of participants who come from all over the state of Massachusetts as opposed to a particular region. The demographics of our participants that we will be using for our research study will be 100 Army National Guard soldiers who have returned home from OEF/OIF deployment in the past twenty-four months.

These participants will be males ranging from the ages of 18-25 years old. The participants will be Massachusetts residents. In regards to ethnicity, we will be using 100 of the first participants who agree to participate in our study; no particular ethnicity will be targeted. The 100 participants will be individuals who are receiving or are seeking services by the Boston VA hospital. The instrumentation that we will be using for our study is a questionnaire format. The questionnaire will be handed out to the first 100 participants who receive or seek services at the VA hospital in Boston. Informed consent will be waived when the questionnaire is filled out and returned.

We chose this instrumentation because of the advantages that it presents for our overall study. We believe that this data collection method will produce honest and accurate responses from the participants ecause it will anonymous. This data collection method is also more convenient and less time consuming for both the researcher and more importantly the participants. The questionnaire that we will be issuing to the participants is reliable in that everyone participant will receive the same questions. The data collection method is also valid in that the questions on the questionnaire are posed to discover the transitions and adjustments that these participants were faced with when they returned home from deployment.

The participants who do not wish to partake in our study have no obligation to do o. They can simply decide to not return the questionnaire, waiving their participation from the study. The participants who do wish to participate in the study as mentioned previously, informed consent is waived when they return the anonymous questionnaire completed. When we hand out the questionnaire to the potential participants, we will set a return by date to one month after it is handed out. We have decided upon a one month completion time in order to give our participants enough time to accurately complete the questionnaire and feel neither pressured nor rushed.

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