Symposia
Health Care System / Public Policy
April Smith, Ph.D.
Assistant Professor
Auburn University
Auburn, Alabama
Military personnel have elevated rates of various psychological disorders, including post-traumatic stress disorder, major depressive disorder, and sleep disorders, relative to their civilian counterparts (Hom et al., 2017). Additionally, suicide rates are elevated among Veterans and active duty (e.g., Anglemyer, et al., 2016). Thus, it is imperative that military personnel get behavioral health treatment when needed. Unfortunately, however, behavioral health services are underutilized in this population. Given that negative beliefs about therapy are a robust barrier to utilizing behavioral health care among military personnel (Vogt, 2011), it is important to characterize those who do versus do not find therapy helpful. In so doing, we can identify the individuals who may be most likely to drop out of treatment or decline services altogether. Thus, the purpose of the current study was to examine perceptions of psychotherapy among active duty and Veterans, as well as to identify demographic and clinical characteristics of service members who do versus do not find psychotherapy helpful. Participants (N = 287; 71.4% male, Mage=35.38, 65.2% currently serving) were recruited from military bases and Veteran online forums. Participants rated their perceptions of therapy as well as completed several questionnaires assessing psychological symptoms. Sixteen percent of participants said psychotherapy “did not help at all” or “only a little”; 16.7% said psychotherapy helped “somewhat,” and 23.7% said psychotherapy helped “quite a bit” or “very much.” There were no differences on perceptions of the helpfulness of psychotherapy on demographic variables such as age, gender, education, race or ethnicity. Further, active duty and Veterans did not differ in terms of their overall perceptions of therapy. However, several clinical characteristics were associated with finding psychotherapy less helpful. Specifically, individuals who endorsed more burdensomeness, more thwarted belongingness, fewer reasons for living, and more depression rated psychotherapy as significantly less helpful (d’s small-to-medium). Overall participants who endorsed more depression and more risk factors for suicide were less likely to find therapy helpful, which is concerning given that these clinical characteristics are associated with elevated suicide risk. Targeted efforts to engage military personnel with depression and suicidality in treatment may be needed in order for behavioral health services to be successful.