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Military and Family Needs Assessment and Literature Review: Considerations for Arts Providers and Creative Arts Therapists

In 2018, Creative Forces commissioned the (External link)Institute for Veterans and Military Families (IVMF) at Syracuse University to conduct a literature review and needs assessment to understand how arts programming can effectively address the needs of various military-connected individuals. The study was conducted in three concurrent phases, including a comprehensive literature review, interviews with subject matter experts, and analysis and translation for application by community arts providers and creative arts therapists.

This report was authored by Jennifer M. DeLucia, DAT, ATR-BC, LCAT and
Rachel K. Linsner, MS; Nicholas Armstrong, PhD, MPA of the Institute for Veterans and Military Families at Syracuse University. Published June 2022.

Introduction

Current and former military service members—members of the Army, Air Force, Navy, Marine Corps, Coast Guard, as well as National Guard and Reserve members—face a multitude of challenges related to their service. These can present problems in their personal and professional aspirations and everyday interactions as they transition into civilian life. However, service members and veterans also can have a wealth of experience in community-building and collaboration and have the potential to experience more positive outcomes when they are given opportunities to use this skillset.

This report explores current and former service members’ strengths, challenges, and unique needs in order to provide information that can be used to inform more effective arts programs that respond to identified needs of service members and veterans.

Study approach

This project was completed by the IVMF (Institute for Veterans and Military Families) research team over a twelve-week period. The study was conducted in three concurrent phases, which included:

  • a comprehensive literature review,
  • interviews with subject matter experts, and
  • knowledge analysis and translation for application by practitioners.

After completing these steps, the project team synthesized and grouped findings from the literature review and expert interviews by target subgroup to summarize existing needs, approaches, gaps, and opportunities for Creative Forces service providers.

Organization of the report

This report is organized into four primary topical sections and a summary. The primary topical sections each synthesize findings from the literature and key themes from subject matter expert interviews focused on four target population subgroups: 

  1. Service members and veterans 
  2. Spouses and families of service members and veterans 
  3. Children of service members and veterans 
  4. Military caregivers 

Each topical section defines and describes the key subgroup attributes, population needs, the community needs, and challenges followed by implications and considerations for arts programming. In addition, the report includes an appendix that provides a detailed summary of findings from the subject matter expert interviews. 

Chapter summary: Service members and veterans

The U.S. Armed Forces consists of five branches of the military (Army, Navy, Marine Corps, Air Force, and Space Force) and the Reserve Component (Ready Reserve, standby Reserve, Retired Reserve). Men and women are drawn to military service for many reasons, from wanting to serve their country to seeking a steady income, affordable technical training and higher education. Despite the many benefits of serving in the U.S. Armed Forces, current and veteran service members also face many challenges stemming from their time in the military. These can present problems in both professional and personal aspirations and even everyday interactions as current service members transition to civilian life. 

This report explores the strengths, unique needs, and challenges of both current and former service members and provide guidance to help create more effective art programs tailored to the identified needs of veterans and service members. 

Key considerations

For creative arts therapists

  • Work from a strengths-focused approach. 
  • Involve the full family. 
  • Develop opportunities for peer-to-peer mentorship.
  • Use engagement with creative arts therapies to help break through barriers to treatment.

For community-based arts providers

  • Help educate service members and veterans about the different programs available.
  • Enable organizations to better create programs that combine seamlessly with other initiatives to offer comprehensive services.
  • Develop programs and resources that meet the needs of veterans in the community in a way that complements existing resources.
  • Work from a strengths-based approach.
  • Establish group art sessions to foster connection and social support among service members and veterans.
  • Use evidence-based practices and evaluate programs.
  • Increase understanding of military culture.
  • Collaborate with existing veteran or military-serving organizations, and other community-based organizations.
  • Conduct continuous outreach to military-connected participants and family members.

For community

Identification and connection
  • Holistic approaches that focus on prevention and early intervention, increased access to services, and early outreach help to promote a healthy and successful transition to civilian life.
  • Engaging service members before and after they return from deployment. 
Relationships
  • Relationships are cemented by shared experiences and emotions that are unmatched by civilian counterparts.
  • Connection to other veterans can be a strong source of social support during transition and post-deployment. 
Military to Civilian Transition
  • The military-to-civilian transition is a complex cultural transition that impacts several areas of a veteran’s life: social, family, financial, housing, occupational, and personal.
  • Shifting from military culture to civilian culture creates culture shock for many veterans.
  • The cultural loss during transition creates feelings of anxiety, frustration, and fear, and raises questions about the meaning and purpose of their lives.
  • Despite years of travel experience, leadership responsibilities, and the ability to work in highly pressurized situations, many veterans face difficulties translating their military skills and experience to fit civilian jobs creating under-employment, financial hardship, and stress.
  • Transitioning to civilian life affects the entire family: parental and gender roles need to be renegotiated and family relationships must be re-established.
Transitions for women veterans
  • Women veterans experience significantly greater financial struggles, depression, and feelings of social isolation compared to male service members.
  • On average, it takes women veterans three months longer to secure employment after transition than male veterans.
  • Women veterans face gender-specific expectations from a civilian culture that misunderstands their military experiences. 

Chapter summary: Spouses and families

A military family member is defined as any person who is the spouse, partner, parent, sibling, or child of a service member (defined above as a current member of the U.S. Armed Forces, including those who are Active Duty, National Guard, and Reserve).

In 2020, according to the demographic profile published by the Department of Defense, there were 4.7 million family members of U.S. service members across the total DoD force. The Department of Defense defined family members as spouses, dependent children, and dependent adults. Adult dependents include parents, grandparents, former spouses, siblings, and disabled older children. Nearly half of all service members were married in 2020. Roughly one-third (29.8%) of the total force was married to a civilian and had one or more children (military children are discussed in greater detail below).

This portion of the report focuses primarily on dependent family members (spouses and children) and the immediate military family as a whole or unit.

Key considerations

For creative arts therapists

  • Offer a holistic approach in serving the whole family. 
  • Use a strengths-based approach.
  • Embed evidence-based practice and evaluation in programming.
  • Use a multidisciplinary approach.

For community-based arts providers

  • Take a holistic family-based approach and use a strengths-based approach. 
  • Establish programs that focus on helping families make meaning of challenges, build social connections with other families and enhance family communication and reconnection after deployments.
  •  Establish programs that focus on military spouses, including veteran spouses, as well as spouses of service members, to increase social connections and support affirming and building self-identity. 
  • Use evidence-based practices and evaluate programs. 
  • Increase understanding of military culture. 
  • Collaborate with existing veteran or military serving organizations, and other community-based organizations. 
  • Conduct continuous outreach to military-connected participants and family members. 

For community

Identification and connection
  • Military and veteran families are often anonymous in their communities increasing service access issues, and a low sense of belonging to the community. 
  • Military spouses transitioning with alongside their veteran experience a cultural loss and a loss of services. There are very few resources, supports or programs to help them find employment, education, or navigate community-based health and other services. 
  • Military families face isolation and loneliness, especially spouses, because family and friends often live far away. 
  • Military spouse employment continues to be a top issue of concern for military spouses who face challenges finding meaningful jobs, fill resume gaps, and foster career connections for networking due to frequent moves, relocations, and service member job demands.  
Programs
  • The few programs specifically created to strengthen military families and address the challenges they face focus on resilience, improving parenting and relationship skills, developing family coping skills, and enhancing family communication—and include children in the process. 
  • There are often many programs and trainings available to service members but few that target military spouses and/or children. 
Relationships
  • Following deployment and transition out of the military, parental roles may shift and these changes have to be addressed by the couple and within the family and can be complicated if the veteran is injured or experiencing PTSD. 

Chapter summary: Children of service members and veterans

Service members are not the only individuals impacted by their service. Children of service members and veterans face their own challenges and require programs dedicated explicitly to their unique needs.

A military child is defined as the dependent child of a service member (defined above as a current member of the U.S. Armed Forces, including those who are Active Duty, National Guard, and Reserve). Nearly 1.7 million children of service members were reported in 2020 (U.S. Department of Defense 2020). A report for the Department of Veterans Affairs in 2010 found that 31% of veterans (at that time there were nearly twenty-two million veterans in the United States) reported having dependent children (Westat 2010).

While definitions and details vary by branch of service and by the administration of specific services and benefits, this report focuses on children already determined to be dependents of service members.

Key considerations

For creative arts therapists

  • Offer a holistic approach in serving the whole family. 
  • Use a strengths-based approach. 
  • Use a multidisciplinary approach. 
  • Use developmentally appropriate practice. 

For community-based arts providers

  • Design arts programs for military children that focus on their strengths, experiences, and challenges.
  • Create a family-based approach that includes community members to increase familial and community ties.
  • Provide flexibility and choice for children that is developmentally, or age, appropriate.
  • Include activities that reinforce the military child’s unique strengths while allowing them to interact with the broader community.
  • Incorporate a group or team element to strengthen peer relationships.
  • Use evidence-based practices and evaluate programs.
  • Increase understanding of military culture.
  • Collaborate with existing veteran or military-serving organizations, and other community-based organizations.
  • Conduct continuous outreach to military-connected participants and family members.

For community

Identification and connection
  • The primary challenge in improving community care and connection for military children is that most of the time military children are invisible
Transitions
  • On average, children of active-duty service members move every two to three years and may attend six to nine different schools by the time they reach eighteen years of age. Constantly being the new kid can be more difficult for younger children.
  • Although relocations provide military children with adaptive coping skills, they also impact children’s mental health leading to behavioral problems and poor adjustment. Younger children feel confused about the change in routine and older children feel frustrated about the lack of control in relocating.
  • Family reintegration after deployment shifts family dynamics and routines. Younger children may not remember their service-member parent and older children find it difficult to relinquish independence creating cumulative stress.
Separations
  • Separations happen because of training, deployment, or school and most military children experience multiple separations from their service member parent(s).
  • Younger children may experience separation as a loss, creating stress and attachment issues for children.
  • Older children express fears for the safety of the service-member parent, and many assume more responsibility at home such as caring for younger children. This parentification increases children’s anxiety and stress.
Education and understanding
  • Children are more resilient when they feel understood by those around them and can depend on others for help. Community service providers need an understanding of military culture, deployment and transitions, and terminology to close the military-civilian gap.
  • To cultivate resilience and growth in response to hardship, children need stable and positive relationships within their family, friends, and community groups.
Programs
  • Few programs directly address the needs and strengths of military children and new programs need to treat the family as a whole unit involving children, family members, and service members or veterans.

Chapter summary: Military caregivers

A caregiver is defined in the literature as a person who provides assistance to and helps manage the care of a person with a disabling injury or condition—often a relative, friend, or neighbor of the individual (Tanielian et al. 2013; Ramchand et al. 2014).

Military caregiver, as referenced throughout, is defined as a person who provides a broad range of unpaid care and assistance for, or manages the care of, a current service member or veteran with a disabling physical or mental injury or illness
(Tanielian et al. 2013; Ramchand et al. 2014). Military caregivers may be a spouse, close relative, friend, or neighbor to the veteran or service member and in the role of caregiver they take on a set of care responsibilities that can include activities of daily living, health-care assistance, navigation and coordination of services, emotional support, financial planning, and advocacy on behalf of the care recipient (Tanielian et al. 2013).In the United States, 9% of adults are caregivers and 5.5 million of those adults are military caregivers (Ramchand et al. 2014).

Key considerations

For creative arts therapists

  • Offer a holistic approach to serving the military-connected population by serving caregivers, spouses, and children.
  • Utilize a multidisciplinary approach by including several different types of therapy (e.g., music therapy, dance therapy, and art therapy).
  • Orient programming around opportunities for self-care and meaningful connection to other caregivers.
  • Provide flexibility in appointment scheduling, hours of operation, and format of service delivery (e.g. online program delivery).

For community-based arts providers

  • Focus arts programs on holistic health, ideally including the care recipient in the program when appropriate.
  • Provide flexibility in scheduling, as caregivers might not be able to participate during traditional business hours.
  • Offer programs in different formats to ease barriers to access including online programs, one-on-one classes (both on-line and in-person), and community classes with other caregivers to foster social connection, stress reduction and self-care.
  • Use evidence-based practices and evaluate programs. 
  • Increase understanding of military culture. 
  • Collaborate with existing veteran or military serving organizations, and other community-based organizations. 
  • Conduct continuous outreach to military-connected participants and family members. 

For community

Identification and connection
  • Formal and informal social support networks can help to reduce isolation and improve satisfaction associated with caregiving.
  • Improved resources and social supports for caregivers can help reduce caregiver burden and increase caregiver health. 
  • Opportunities to connect with other military caregivers helps to reduce isolation and create caregiver networks to share their experiences, coping strategies, and develop a post-military identity.
  • Online support groups like the Military Veteran Caregiver Network and Hidden Heroes can provide flexible opportunities for caregivers to engage with one another.
Relationships
  • Most caregivers are married or living with a partner and about three-quarters report caregiving placed a strain on their marriage.
  • Caregivers caring for a spouse or partner and those caring for a parent have reported feeling like they take on a parental role with the care recipient. Caregiving for a family member of any type increases the risk of depression and physical illness for the caregiver.
Children
  • When the caregiver faces stress, it is likely to affect the parent-child relationship, including children who assume caregiver roles or responsibility for younger siblings.
  • More than half of military caregivers with children reported their children have emotional or school problems.
Caregiver training
  • Caregiver training improves outcomes for caregivers and care recipients by providing caregivers with practical skills and interventions that help them feel more effective and successful.
  • Caregivers who receive training in how to support the physical and emotional needs of care recipients along with training on navigating systems of care report lower levels of depression, anxiety, and caregiver burden and higher rates of self-esteem.
Respite care
  • Respite care is short-term temporary relief care that can be provided in a care center or in the care recipient’s home to reduce intensity for caregivers and improve caregivers’ mental health.
Wellness activities
  • Activities that increase physical activity and healthy behavior can help to mitigate some of the effects of caregiver burden and stress.
Mental health services
  • Programs that focus on the meaning and benefits gained from caregiving and support healthy family relationships, communication, social connection, and self-esteem, may protect against the burden of caregiving and caregiver burnout while enhancing mental health.

Conclusion

The report determined key needs for the four target population subgroups (service members and veterans, military families, military children, and military caregivers) and identified common gaps, opportunities, and approaches for all providers to consider.

The report also determined that creative arts therapists and community-based arts providers are uniquely positioned to address the needs of military-connected populations through arts engagement and creative arts therapy. Creative arts therapy can help to address the psychosocial and mental health needs of service members, veterans, and their families, while community-based arts providers can provide meaningful opportunities for community and peer connections. Both creative arts therapy and arts engagement offer outlets for self-expression that can support an increase in self-esteem and help to cultivate a sense of purpose.

The report can be a foundation for creative arts therapists and community-based arts providers to develop a greater knowledge and understanding of the military and the needs of military-connected members. Building on this understanding, creative arts therapists and community-based arts providers can unite through collaborative and coordinated efforts to address the needs of their military-connected community members holistically.

Download the full report

Military Family Needs Report 2.41 MB

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