In my role at the Center for Deployment Psychology (CDP), I was recently asked about transitioning from military service to civilian life. The specific question asked was how case managers can identify a normal reaction to mourning the loss of identity due to leaving military service versus behavior that could be indicative of a clinical problem/disorder. I think it is a great question and one that many case managers, providers, and even Service members may have.
Transitioning from military service to civilian life is a major life change. It can also be challenging for some service members, regardless of the amount of time served. Many of us working at CDP have served in the military previously and some of us have even shared our transition experiences in past blog entries. With this entry, I plan to discuss some common stressors/difficulties with transitioning to civilian life, review some of the factors that may make the transition more difficult, and discuss signs/behaviors that are indicative of possible clinical problems. I will also share some great resources for providers, Service members, and Veterans.
Some potential stressors for Service members transitioning to civilian life are: deciding where to live; career exploration; returning to college; moving away from friends/family; decreased income; changes in medical care; and family system challenges. There may be increased challenges if the separation/retirement is involuntary (e.g., medical retirement, administrative separation, or a consequence of force shaping) versus voluntary. Regardless of the type of separation/retirement, no two individuals will have the same experience and not all stressors can be averted.
Some common difficulties with transitioning to civilian life are: being undecided about future life/career goals; struggling with the lack of structure in the civilian world; missing the adrenaline rush that can often come from military experiences; worrying about finances; pushing oneself to be perfect; becoming more easily annoyed with others who are too laid-back or see the world differently; and feeling isolated and alone (Make the Connection, n.d.).
A recent Pew Research Center survey of 1,853 veterans looked at factors that predict an easy or difficult re-entry into civilian life (Morin, 2011). Of the variables examined in the study, four variables predicted an easier time readjusting to civilian life and six factors were related to difficult re-entry into civilian life.
The variables related to easier readjustment were: being an officer; being a college graduate; understanding the military mission while serving; and (for post 9/11 veterans only) attending religious services frequently. The variables related to a more difficult readjustment were: having a traumatic experience while serving; having a serious service-related injury; serving in the post 9/11 era; serving in a combat zone; serving with someone who was killed or injured; and (for post 9/11 veterans only) being married while in the service.
Another study, conducted by Hourani and colleagues (2012), looked at resilience and mental health in marines leaving the military service. They found that primary risk factors for mental health problems and functional impairment following separation from military service were experiencing higher levels of pre-separation combat exposure, post-separation stress across multiple life domains, and experiencing multiple areas of pain post-separation. Protective factors for this group included having higher scores on pre-separation resilience and perceived social support at follow-up.
It is important to remember that most Veterans go through some period of adjustment following separation/retirement from the military. Being aware of common transitional stressors and issues can be helpful. It is also important to be aware of indicators that there may be more of a clinical problem. Some of these signs/behaviors are: thoughts of wanting to hurt oneself or others; feelings of hopelessness; flashbacks/nightmares; feeling on edge; concentration problems; anger/irritability; difficulty sleeping; depressed mood that lasts for weeks/months; relationship problems; social withdrawal/isolation; chronic pain or other medical issues that are not being managed; alcohol/drug problems; and engagement in reckless behaviors.
For providers, it is important to make recommendations to our patients who are in any stage of the transition process. Educating them about typical transition stressors and informing them of available resources. Encouraging them to reach out to other veterans or veterans’ groups. Educating them on the benefits of engaging in self-care to include exercising, eating healthy, getting good sleep, and avoiding unhealthy habits such as drinking alcohol, using drugs, or using nicotine. It is also important to complete a thorough assessment that addresses normal stress reactions as well as potential clinical problems related to transitioning to civilian life.
For Veterans and family members, knowing about common transitional stressors is important. Look for ways to ease the transition from military service to civilian life and be aware of signs that there may be more of a clinical problem developing.
As with any life change, having good information prior to the transition taking place is extremely beneficial. That is one reason I was excited to hear about the new transitional program in the Department of Defense called Transition GPS for Goals, Plans, and Successes (Military.com, n.d.). Transition GPS replaces and transforms the previous Transition Assistance Program. Transition GPS is a mandatory, one-week course that has been redesigned to be more in-depth to help Service members transition back into civilian life. The course provides tools for seeking jobs, pursuing education, and managing day-to-day issues such as finances. The course also provides information on VA benefits and offers a brief Labor Department workshop. In addition to the core curriculum, Service members also have the option of attending an additional career specific track (i.e., an Education track, a Technical and Skills Training track, or an Entrepreneurship track). I encourage providers, Veterans, and family members to find out more about Transition GPS as well as other transition guidance at www.taonline.com.
Another website that I find extremely beneficial is the Make the Connection website www.maketheconnection.net. The website was developed for Veterans; however, there is a lot of useful information for family members and providers as well. Make the Connection provides shared experiences and support for Veterans and allows users to customize the site based off of their military experience (e.g., era they served, service branch, gender). The website has a video gallery with Veterans sharing their experiences. There is also good information on life events and experiences as well as more specific information on signs and symptoms of potential clinical conditions. Veterans can also take a self-assessment and request VA information and resources.
See below for a list of resources related to transitional issues:
• Make the Connection (www.maketheconnection.net)
• Transition Assistance Online (www.taonline.com)
• GI Bill Website (www.gibill.va.gov)
• Moving Forward (www.veterantraining.va.gov/apps/movingforward/index.html)
• inTransion (www.health.mil/inTransition/default.aspx)
• Military One Source (www.militaryonesource.mil/transition)
We would love to hear your thoughts on this topic. Are there additional resources or additional information you would like to share with others? If so, please feel free to share your thoughts on our blog.
Dr. Lisa French is the Assistant Director of Military Training Programs for the CDP.
Hourani, L., Bender, R.H., Weimer, B., Peeler, R., Bradshaw, M., Lane, M., & Larson, G. (2012). Longitudinal study of resilience and mental health in marines leaving military service. Journal of Affective Disorders, 139, 154-165.
Make the Connection (n.d.) Transitioning from service. Retrieved from http://maketheconnection.net/events/transitioning-from-service
Military.com (n.d.). New GPS program transforms transition assistance. Retrieved from http://www.military.com/military-transition/new-transition-gps-overview....
Morin, R. (2011, Dec 8). The difficult transition from military to civilian life. Pew Research Center. Retrieved from http://www.pewsocialtrends.org/2011/12/08/the-difficult-transition-from-...