Translating Discovery Science. Fostering relationships: Service provider perspectives on community building among veteran families

• Published date: 01 July 2023
• Author: J. Kale Monk,Lauren Ruhlmann,Briana S. Nelson Goff,Matthew Ogan,Mary Beth Miller
• Date: 01 July 2023
• DOI: http://doi.org/10.1111/fare.12724

BRIEF REPORT

Translating Discovery Science.

Fostering relationships: Service provider perspectives

on community building among veteran families

J. Kale Monk

1

|Lauren Ruhlmann

2

|Briana S. Nelson Goff

3

|

Matthew Ogan

1

|Mary Beth Miller

4

1

Department of Human Development and

Family Science, University of Missouri,

Columbia, MO

2

Department of Human Development and

Family Science, Auburn University,

Auburn, AL

3

Department of Applied Human Sciences,

Kansas State University, Manhattan, KS

4

Department of Psychiatry, University of

Missouri, Columbia, MO, United States

Correspondence

J. Kale Monk, Department of Human

Development and Family Science, University

of Missouri, 104 Gwynn Hall, Columbia, MO

65211, USA.

Email: monkj@missouri.edu

Funding information

MU Research Council; National Institute on

Alcohol Abuse and Alcoholism, Grant/Award

Numbers: K23AA026895, R21AA025175

Abstract

Objective: We sought to identify the social process through

which communal support can be established among vet-

eran couples and families.

Background: On the basis of the social organization theory

of action and change, a sense of community is crucial for

military veterans’well-being and may serve as a resource

for intervention.

Method: We interviewed service providers (n=8) and cor-

roborated their perspectives by triangulating evaluations

from veteran family participants (n=143). Data were ana-

lyzed using grounded theory techniques.

Results: Providers suggested promoting a sense of commu-

nity in prevention and intervention programming by

(a) establishing a safe and empowering space, (b) bridging

existing gaps within family and community systems, and

(c) encouraging interpersonal healing by promoting con-

nection and facilitating the sharing of common experi-

ences. Providers also described challenges to facilitating

the program, including logistics, time, and funding

constraints.

Conclusion: According to our results, fostering community

among veterans and their family members may be

achieved by applying an integrative approach that goes

beyond siloed individual, couple, and group therapy

orchestrated by practitioners.

Author note This research was partially supported by the University of Missouri Research Council. Investigator effort was also

supported by research grants from the National Institute on Alcohol Abuse and Alcoholism (K23AA026895 and R21AA025175, PI

Miller). The National Institutes of Health had no role in the study design, collection, analysis, or interpretation of the data, writing the

manuscript, or the decision to submit the paper for publication.Ethical approval for this project was given by the Institutional Review

Board at the University of Illinois at Urbana-Champaign (ref. no.16561) and the Committee on Research Involving Human Subjects at

Kansas State University (ref. no. 8143).

Received:23January2021 Revised:4February2022 Accepted:25April2022

DOI: 10.1111/fare.12724

© 2022 National Council on Family Relations.

Family Relations. 2023;72:1351–1367. wileyonlinelibrary.com/journal/fare 1351

Implications: We recommend multicomponent interven-

tions that create synergy between different levels and

forms of social support. Providers recommended being

intentional about the program structure to focus on com-

munity strengths and shared connection.

KEYWORDS

close relationships, couple/marital/romantic relationships, family life

education, grounded theory, military families, qualitative research,

veteran families

Most military and veteran families are resilient in the face of great demands (e.g., Karney &

Crown, 2007). In many cases, for example, military experience can promote growth (e.g., mastery,

social support) and healthy lifestyle behaviors (e.g., routine exercise; Spiro et al., 2016;Yaffe

et al., 2014). Nevertheless, military veterans are among those at the greatest risk for impairments in

mental health (American Psychiatric Association,2013), including posttraumatic stress disorder

(PTSD) and depression associated with military service (Fulton et al., 2015). Despite the prevalence

of distress, mental health services are underutilized among veterans for a variety of reasons, includ-

ing fear of judgment from family and friends, societal stigma, and ostracism from other veterans

(see Hoge, 2011; Monk et al., 2018). However, veterans indicate that they would be more willing to

seek help if interventions were community or family oriented (e.g., Hundt et al., 2015; Khaylis

et al., 2011), illustrating the desire for communal connection.

Indeed, supportive social relationships and a sense of community are critical for veterans and

their families as they provide a sense of belonging and numerous health benefits (Monk

et al., 2020). However, veterans experience disparities in social connection due to a sense of isola-

tion or disconnection with their civilian communities and family who do not share their experi-

ences (e.g., Ahern et al., 2015; Demers, 2011). Specifically, veterans may feel unable to connect

with civilians, especially after experiencing combat-related violence, threat of death, or other

extreme military stressors (e.g., Demers, 2011). This disconnection is particularly concerning

because veterans who are less socially integrated, on average, experience more pain intensity and

unpleasantness, a greater dependence on opioids, longer hospital stays (e.g., Mitchinson

et al., 2008), and may be more likely to return to the hospital after treatment (Mistry et al., 2001).

Furthermore, loneliness in veterans is associated with suicidal ideation, higher levels of

depression, and reductions in help-seeking intentions and the knowledge, skills, and confidence

among veterans to manage their own care (Teo et al., 2018). This is particularly concerning

because military service members and veterans without appropriate social support and encour-

agement may be less likely to seek help (e.g., Bowen et al., 2016). For example, the relationship

between PTSD symptom severity and odds of obtaining services is strengthened for service

members who experience higher relationship adjustment (Meis et al., 2010; see also Sautter

et al., 2006). As a result, scholars have turned their attention to treatments that focus on inti-

mate relationships (Monk et al., 2018; Nelson Goff & Smith, 2005) and community capacity

(Mancini et al., 2018) to foster a stronger sense of belonging among veterans.

CONCEPTUAL FRAMEWORK

Grounded in a strengths-oriented view of communities, the social organization theory of action

and change (Mancini & Bowen, 2013; Mancini et al., 2018) outlines the importance of commu-

nity building. According to this framework, community social organization reflects the multiple

contexts that surround and influence individuals and families (e.g., neighborhood, culture;

1352 FAMILY RELATIONS