Methods: A cross-sectional survey was conducted with a large network of providers who donate treatment to servicemembers and their families. Participants were recruited through an e-mail sent to the population of approximately 4000, of whom 348 completed the online survey. Participants were predominantly White, female, 50- or 60-something, working in the civilian sector. Nearly half were social workers. Military-related knowledge and experience ranged widely. Respondents rated how important various topics would be in training behavioral health practitioners to work with military-related populations. Example items included "Discussing language and patterns of socialization" and "Understanding evidence-based approaches for and specific experiences of caregivers of veterans with PTSD". Descriptive data analyses were conducted using SPSS. Subsequently, focus groups were conducted with a convenience subsample of 20 survey respondents. Loosely structured focus group questions examined reactions to the survey and curriculum topics, identification of curriculum gaps, and desired course formats and approaches. Qualitative data were content analyzed manually, relative to each predetermined topic, and for emerging themes.
Results: Ratings of proposed curriculum topics were in general agreement across respondents. Topics aimed at developing an understanding of military culture and unique experiences (e.g., "Understanding military culture such as core values and traditions or the norms of military conduct"), along with those that inform assessment and intervention (e.g., "Understanding how to assess and engage military families"), were considered most important. Focus group findings suggested the importance of applied content (a “how to” approach). Themes also emerged that confirmed the value of an emic perspective, through firsthand accounts and specific case studies, and suggested that offering an interactive means of integrating course content with real-world practice experiences might strengthen classroom training.
Conclusions and Implications: The study provided increased understanding of the specific topics behavioral healthcare providers believe should be addressed in training to work with military-related populations. Clearly, practitioners need exposure to the many facets of military culture and military life, and practical information that will inform a more culturally-competent and empirically supported approach to client engagement, assessment and intervention. Findings can be used to further develop curricula for advanced providers; curricula should then be tested to determine their effectiveness in producing more competent military behavioral healthcare providers. With regard to policy development, findings move towards ensuring that training in this area includes the essential content and is approached from an emic perspective.
