Medical Family Therapy in Military and Veteran Health Systems

Abstract

The military is the largest employer in the United States, with more than 3.5 million personnel currently serving in the Department of Defense (DoD) active duty, coast guard, and reserve (DoD, 2014a, b). As of 2017, there were 1,298,017 DoD active duty Service members, of which 1,055,972 were enlisted, 229,869 were officers, and 12,176 were cadets-midshipmen (DoD, 2017). In the reserve component, there are a total of 813,037 reservists: 131,928 officers and 681,109 enlisted (DoD, 2017). Alongside the active duty population, it is estimated that there are currently over 22 million veterans in the USA (U.S. Census Bureau, 2012). Couple these figures with the number of partners and dependents/children of current or former Service members, and the opportunity for practitioners in medical family therapy (MedFT) to extend relational care to military and veteran populations grows exponentially. To give some perspective, approximately 54% of all military personnel are married, with higher rates for men (58%) than women (45%), and just over 11% of all active duty marriages as “dual marriages” (DoD, 2015). About 45% of those in a reserve component are married, with higher percentages in the Air National Guard (56%) and Air Force Reserve (55%) than as compared to the Marine Corps Reserve (27%) (U.S. Census Bureau, 2015). Of all current veterans, about 65% of men and 49% of women identify as married (United States Department of Veterans Affairs, 2017a). Further, 2.2% of active duty men and 10.7% of active duty women identify as lesbian, gay, or bisexual (LGB) (Gates & Newport, 2012). While the true number of LGB veterans is unknown, it is estimated that 3% of all LGB Americans are U.S. veterans. Approximately 15,500 of active duty Service members identify as transgender, with at least 134,000 veterans who identify as transgender (Gates & Herman, 2014). Whether partnered or not, there are approximately 1.2 million dependent children in active duty families and almost 744,000 dependent children in guard and reserve families (DoD, 2012). Behind each of these statistics is a face that is situated within multiple relationships, and whose biopsychosocial-spiritual (BPSS) health is determined—at least in part—by their likelihood to sustain a career with the military.