Special Operations Cognitive Agility Training (SOCAT) for Special Operations Forces and spouses.

Increasingly complex and unpredictable personnel and operational demands require Special Operations Forces (SOF) members and their families to remain flexible, adaptive, and resilient within ever-changing circumstances. To mitigate the impact of these stressors on psychological health and fitness, researchers and educators at the Uniformed Services University of the Health Sciences (USUHS) developed Special Operations Cognitive Agility Training (SOCAT), a cognitive performance optimization program supported by the United States Special Operations Command (USSOCOM) Preservation of the Force and Family (POTFF). The goal of SOCAT is to enhance cognitive agility, defined as the ability to deliberately adapt cognitive processing strategies in accordance with dynamic shifts in situational and environmental demands, in order to facilitate decision making and adapt to change. Overall, SOCAT emphasizes optimal cognitive performance across different contexts - as well as across various stages of the military lifecycle - to serve as a buffer against biopsychosocial vulnerabilities, environmental and social stressors, military operational demands, and behavioral health problems, including suicide. This paper reviews foundational research behind SOCAT, mechanisms through which SOCAT is anticipated to build psychological resilience, and describes the process of developing and tailoring SOCAT for active duty SOF members and spouses. Limitations and future directions, including an ongoing, randomized controlled program evaluation, are discussed.

Impact of the COVID-19 pandemic on the mental health and well-being of Veterans' spouses: a cross sectional analysis.

BACKGROUND: COVID-19 has negatively impacted the mental health and well-being of both Canadians and the world as a whole, with Veterans, in particular, showing increased rates of depression, anxiety, and PTSD. Spouses and common-law partners often serve as primary caregivers and sources of support for Veterans, which may have a deleterious effect on mental health and increase risk of burnout. Pandemic related stressors may increase burden and further exacerbate distress; yet the effect of the pandemic on the mental health and well-being of Veterans' spouses is currently unknown. This study explores the self-reported mental health and well-being of a group of spouses of Canadian Armed Forces Veterans and their adoption of new ways to access healthcare remotely (telehealth), using baseline data from an ongoing longitudinal survey. METHODS: Between July 2020 and February 2021, 365 spouses of Veterans completed an online survey regarding their general mental health, lifestyle changes, and experiences relating to the COVID-19 pandemic. Also completed were questions relating to their use of and satisfaction with health-care treatment services during the pandemic. RESULTS: Reported rates of probable major depressive disorder (MDD), generalized anxiety disorder (GAD), alcohol use disorder (AUD), and PTSD were higher than the general public, with 50-61% believing their symptoms either directly related to or were made worse by the pandemic. Those reporting being exposed to COVID-19 were found to have significantly higher absolute scores on mental health measures than those reporting no exposure. Over 56% reported using telehealth during the pandemic, with over 70% stating they would continue its use post-pandemic. CONCLUSIONS: This is the first Canadian study to examine the impact of the COVID-19 pandemic specifically on the mental health and well-being of Veterans' spouses. Subjectively, the pandemic negatively affected the mental health of this group, however, the pre-pandemic rate for mental health issues in this population is unknown. These results have important implications pertaining to future avenues of research and clinical/programme development post-pandemic, particularly relating to the potential need for increased support for spouses of Veterans, both as individuals and in their role as supports for Veterans.

"This is not your Life and it becomes your Life": A Qualitative Exploration of Deployment-related Stress and Support needs in National Guard and Reserve spouses who are Mothers of Young Children.

The adverse effects of deployment-related stress (DRS) on military service members, spouses, and children are well documented. Findings from a recent Consensus Report on Military Families by the National Academies of Science, Engineering, and Medicine (2019) underscore the priority of gaining a more comprehensive understanding of the diversity of today's military families and their needs and well-being. While social support is generally regarded as helpful during times of stress, it has not been studied extensively in National Guard/Reserve spouses who are parents of young children. This qualitative study of 30 women examines the unique ways in which DRS affects women who are National Guard/Reserve spouses and mothers of young children, as well as the processes through which they encountered support to manage these stressors. Salient themes spanned experiences involving deployment cycle phases of separation and reintegration and included both anticipated and unanticipated changes in family-related division of labor, dynamics, and communication patterns. These were complicated by geographic, social, and cultural isolation and misguided efforts to support spouses initiated by civilians. Women managed these stressors primarily through seeking, acquiring, and repurposing existing sources of informal social support for themselves and formal supports for their children, with varying degrees of success.

Los efectos adversos del estrés relacionado con la movilización militar en los miembros del servicio militar, las esposas y los niños están bien documentados. Los resultados de un informe de consenso reciente sobre las familias de militares realizado por las Academias Nacionales de Ciencias, Ingeniería y Medicina [National Academies of Sciende, Engineering and Medicine (2019)] subrayan la prioridad de comprender de una manera más completa la diversidad de las familias de militares en la actualidad y sus necesidades y bienestar. Si bien el apoyo social generalmente se considera útil durante los momentos de estrés, no se ha estudiado ampliamente en las esposas de integrantes de la Guardia Nacional o de la Reserva Militar que son madres de niños pequeños. Este estudio cualitativo de 30 mujeres analiza las maneras únicas en las cuales el estrés relacionado con la movilización militar afecta a las mujeres que son esposas de integrantes de la Guardia Nacional o la Reserva Militar y madres de niños pequeños, así como los procesos por los cuales encontraron apoyo para manejar esos factores desencadenantes de estrés. Los temas destacados abarcaron experiencias relacionadas con las fases de separación y reintegración del ciclo de movilización militar e incluyeron los cambios tanto previstos como imprevistos en la división de los patrones de trabajo, de dinámica y de comunicación relacionados con la familia. Estos se complicaron por el aislamiento geográfico, social y cultural y los esfuerzos equivocados que hicieron los civiles para apoyar a las esposas. Las mujeres manejaron estos factores desencadenantes de estrés principalmente mediante la búsqueda, la adquisición y la readaptación de fuentes existentes de apoyo social informal para ellas y de apoyo formal para sus hijos, con diversos grados de éxito.

Special Concerns in Military Families.

PURPOSE OF REVIEW: Military cultural competence has been recognized as an important factor to delivering effective care to service members, who are a distinct population with unique exposures, and thus with different clinical implications-though only recently has the military service been recognized as a cultural identity that can impact treatment (Meyer et al. Curr Psychiatry Rep. 18:26:1-8, 2016). Competencies within this field do not share a universal definition but have been recognized by the Center for Deployment Psychology (CDP) to include four key components: (1) military ethos, (2) organization and roles, (3) military stressors and resources, and (4) treatment, resources, and tools (Atuel & Castro Clin Soc Work J. 46:74-82, 2018). This article summarizes research literature published in the last 6 years addressing common features and health needs of military families with the goal of improving military cultural competence. This includes recognizing that (a) The military carries its own culture as evidenced by its particular traditions, beliefs, language, and set of guiding principles (Sanghera Optom Educ J Assoc Sch Coll Optom. 42:8-16, 2017) and (b) military families-defined in this paper as active duty service members, their spouses, their children, and civilian warfighters in the form of National Guard and Reservists (NG/R)-face unique stressors as they access health care either in military treatment facilities (MTFs) or in civilian settings. Given the broad and unshared definition of military cultural competence, the CDP's framework for understanding military culture helped shape the focus of our review into literature addressing military stressors and resources, with a particular interest on the impact of deployment, reintegration after deployment, interfamily relationships strained by military service, mental health concerns related to military families, and the vulnerabilities of civilian warfighters. RECENT FINDINGS: A 2018 demographics profile revealed there were 1.3 million active duty service members, with 605,677 spouses and 981,871 children (Department of Defense, Office of the Deputy Assistant Secretary of Defense for Military Community Family Policy (ODASD (MC&FP)). 2018). Concerningly, military families exhibit above-average mental health issues-defined in this review to include increased susceptibility to mental health diagnoses and hospitalizations, worse academic achievement in their children, and higher rates of child maltreatment-and challenges related to military service such as frequent relocations and deployments, geographic isolation from social/support network, financial stressors, worries about infidelity, sexual trauma, and child maltreatment. The military has been described as the most engrossing and demanding institution in American society. Our review shows that military families exhibit above-average mental health issues, thought to be related, at least in part, to the challenges of frequent relocations and deployments. The implications for this are broad, given that 8% of the USA has served in the military, and a third is directly related to a service member (Meyer et al. Curr Psychiatry Rep. 18:26:1-8, 2016) This article describes unique challenges military families face and their impact on the service member, their spouse, and their children.

Confident, valued and supported: Examining the benefits of employment support for military spouses.

Military spouses face numerous challenges in obtaining employment as a result of their connection to the military. Previous research has linked military spouses underemployment to reduced well-being and satisfaction with military life, which in turn impacts on retention of the service person. In response to this the UK Ministry of Defence (MOD) trialed a 2 year programme of employment support for spouses in 2015. This paper reports the findings of a qualitative evaluation of this programme and its impact on spouses. Interviews were carried out with 30 spouses and 23 of their serving partners to examine the benefits and impact of the support provided. The majority of spouses and their serving partners perceived the employment support as providing a positive contribution from the military to help spouses get back into employment or improve their employability. Additionally, spouses felt invested in by the military and valued as constituents in their own right. No impact of employment support for spouses on the intention to remain or leave the Armed Forces was identified. Longitudinal follow up will be required to determine any long-term impact of employment support on employment outcomes and retention.

Coping and Mental Health Differences among Active Duty Service Members and Their Spouses with High and Low Levels of Marital Warmth.

This study examined the relationship between marital warmth (e.g., openly expressing affection, supportive behaviors) and assessments of coping (i.e., challenges coping with military life and self-efficacy in the context of stress) and mental health (i.e., depressive symptoms and anxiety symptoms) in a sample of active duty men and their spouses/romantic partners (N = 234 military couples). Results from a series of multivariate analysis of variance tests indicate that service members and spouses who reported higher levels of marital warmth also reported better coping skills and mental health compared to individuals in couple relationships that demonstrated lower levels of marital warmth. Intervention and prevention implications targeting social support and marital warmth are provided.

"Everything else comes first": a mixed-methods analysis of barriers to health behaviors among military spouses.

BACKGROUND: Military spouses are integral to the health of their families, but have demonstrated elevated levels of stress, depression, and anxiety. Participating in health behaviors such as physical activity and healthy eating may have a positive impact on spouses' physical and mental health, but emerging evidence suggests spouses' participation in these behaviors is scarce. Thus, the purpose of this study was to examine the most frequently reported barriers to health behaviors among military spouses. METHODS: Military spouses were recruited to complete surveys (N = 230) or participate in focus group sessions (N = 22). On the surveys, participants indicated up to 3 of their most frequent barriers to physical activity, diet, social connection, and stress management. Responses were coded and summed to identify the most commonly reported barriers to each health behavior. Subsequently, focus group sessions were conducted to gain a more in-depth understanding of the challenges military spouses face when trying to maintain a healthy lifestyle. Focus group transcripts were coded using thematic data analysis to identify the most frequently discussed barriers for each behavior. RESULTS: On the surveys, lack of time was the most prevalent barrier for physical activity, social connection, and stress management, and the second most prevalent barrier for diet. Financial concerns were the most prevalent barrier to maintaining a healthy diet. Barriers related to parent/family responsibilities were commonly reported across all health behaviors. During the focus group sessions, the transient military lifestyle was reported to have a significant impact on all of the health behaviors. Other military-related stressors including deployments and the necessity to "do it all" alone were frequently discussed. Many participants exhibited rigid definitions of what "counts" as exercise or health eating. Overall, participants reported sacrificing participation in health behaviors to attend to other priorities. CONCLUSIONS: Military spouses reported numerous barriers to health behaviors that made it difficult for them to prioritize their own health and well-being. Although some of the barriers reported were similar to barriers reported by civilians, unique stressors associated with military life further impeded participation in health behaviors. These findings can be used to inform future health promotion interventions for military spouses.

Hazardous alcohol consumption among spouses or partners of military service personnel: a systematic review of the literature.

BACKGROUND: Alcohol misuse is particularly high among both the UK and US Armed Forces. As alcohol use among couples is associated, military spouses or partners may therefore be at a higher risk of acquiring hazardous drinking behaviours than people in relationships with other occupational groups. METHOD: A literature review using a systematic approach was undertaken in four medical databases and supplemented with hand searches of specialist publications and reference lists. The prevalence of hazardous alcohol consumption among military spouses or partners was estimated and potential sociodemographic and military factors associated with this outcome were identified. RESULTS: Nine papers met inclusion criteria, of which eight focused on female spouses or partners only. The limited evidence suggests hazardous alcohol consumption was not a common outcome among spouses or partners. None of the papers statistically compared the prevalence among spouses or partners to estimates from the general population and few reported associations with sociodemographic or military factors. Deployment abroad did not appear to be significantly associated with hazardous consumption, although increasing periods of separation from Service personnel may be associated with increased hazardous consumption among spouses or partners. CONCLUSION: Limited evidence was found concerning the prevalence of hazardous alcohol consumption among military spouses or partners or which sociodemographic and military factors might be associated with this outcome. The a dominance of US studies means applying the estimates of these outcomes to other nations must be undertaken with care due to differences in cultural attitudes to alcohol as well as differences between military structure and operations between the US and other nations.

Prevalence of Perinatal Depression in the Military: A Systematic Review of the Literature.

Objectives Perinatal depression (PND) has been widely studied in the general population, but has been under studied in military populations. This literature review evaluates studies of PND in military service women and spouses of military servicemen. Methods Articles from peer-reviewed journals published from January 2005 to September 2015 were included if they reported on US military women and/or spouses of military servicemen who were screened for PND symptoms during the prenatal and/or postpartum periods; and were available in English. Qualitative studies were excluded. Studies were compared and contrasted by screening instrument, screening time-period, study population, deployment status as a unique risk factor, and results. Results Ten articles were included. Studies varied greatly in methodology and use of screening instruments and screening time-period, but collectively indicate a wide prevalence range of PND symptoms in military populations. Studies also indicate deployment status as a unique risk factor associated with PND symptoms. Common methodological issues include excluding women at high risk for PND, and not reporting if adequate clinical resources were readily available to ensure appropriate diagnostic and therapeutic services treatment for women who screened positive for PND. Conclusions for Practice PND is receiving increasing attention and military populations should be studied more closely to identify this condition, and understand the complex interactions of unique risk factors associated with a military way of life in order to implement more rigorous screening and early, appropriate intervention strategies.

Exploring the Social Determinants of Mental Health by Race and Ethnicity in Army Wives.

OBJECTIVE: To explore the social determinants of mental health (SDoMH) by race/ethnicity in a sample with equal access to healthcare. Using an adaptation of the World Health Organization's SDoMH Framework, this secondary analysis examines the socio-economic factors that make up the SDoMH by race/ethnicity. METHOD: This paper employed configurational comparative methods (CCMs) to analyze various racial/ethnic subsets from quantitative survey data from (N = 327) active-duty Army wives. Data was collected in 2012 by Walter Reed Army Institute of Research. RESULTS: Initial exploratory analysis revealed the highest-scoring factors for each racial/ethnic subgroup: non-Hispanic Black: employment and a history of adverse childhood events (ACEs); Hispanic: living off post and a recent childbirth; junior enlisted non-Hispanic White: high work-family conflict and ACEs; non-Hispanic other race: high work-family conflict and not having a military history. Final analysis showed four models consistently explained clinically significant depression symptoms and four models consistently explained the absence of clinical depression symptoms, providing a solution for each racial/ethnic minority group (non-Hispanic Black, Hispanic, junior enlisted non-Hispanic White, and non-Hispanic other). DISCUSSION: These findings highlight that Army wives are not a monolithic group, despite their collective exposure to military-specific stressors. These findings also highlight the potential for applying configurational approaches to gain new insights into mental health outcomes for social science and clinical researchers.

Families serve too: military spouse well-being after separation from active-duty service.

BACKGROUND AND OBJECTIVES: Transitioning from military to civilian life can be challenging for families, but most research focuses only on the service member. We applied a life course model to assess spouse well-being following this important transition. DESIGN: Prospective, longitudinal survey of service members and their spouses. METHODS: We captured three spouse well-being domains: psychological health, physical health, and family relationships. We identified differences between families who separated from service and those still affiliated (N = 4,087) and assessed baseline factors associated with spouse well-being after the family separated from service (N = 1,199). RESULTS: Spouses of service members who had separated from the military (versus those who had not) reported poorer mental health and family relationship quality at baseline and follow-up. After controlling for baseline differences, spouses whose families transitioned experienced a greater increase in PTSD symptoms and a steeper decline in quality of marriage. Spouses of active-duty service members reported greater increases in work-family conflict. Among families who had transitioned, the most consistent predictor of positive outcomes was baseline well-being. Protective factors included having more psychological and social resources and less financial stress. CONCLUSIONS: Several protective and risk factors identified in the study may inform programming for families transitioning from active duty.

InDependent but not Alone: A Web-Based Intervention to Promote Physical and Mental Health among Military Spouses.

BACKGROUND: Military spouses must cope with multiple threats to their physical and mental health, yet few interventions have been developed to promote health in this population. METHODS: For this quasi-experimental study, military spouses (N = 231) received a standard educational intervention or an interactive, theory-based intervention; both were delivered online and lasted 10 weeks. The educational intervention directed participants to content on the existing website, Operation Live Well. The interactive intervention was based on Self-Determination Theory, delivered weekly content via podcasts, and encouraged participants to complete weekly challenges to improve physical activity, diet, and mental health. Linear mixed effects models were used to examine self-reported changes in stress, anxiety, depression, loneliness, self-esteem, physical activity, and diet from pre- to post-intervention. RESULTS: Significant improvements were observed for all mental health outcomes, total physical activity, and sugar consumption. However, there were no significant group by time interaction effects. CONCLUSIONS: Web-based interventions may promote positive changes in mental health and health behaviours among military spouses. In this study, an interactive theory-based intervention was no more effective than an information-based intervention. Future studies should aim to determine the minimum "dose" needed to elicit meaningful changes in this population.

Mental health outcomes and alcohol consumption among UK military spouses/partners: a comparison with women in the general population.

Background: Military families can experience unique stressors that may contribute towards poorer well-being among the spouses/partners of Service personnel. However, there is little UK research regarding mental health or alcohol consumption among this population. Objective: This study examined mental health outcomes (probable depression and post-traumatic stress disorder (PTSD)) and alcohol consumption among UK military spouses/partners compared to women in the general population. Associations with military and socio-demographic characteristics were examined. Method: Survey data from 405 female spouses/partners of current and former UK Service personnel participating in a study of military-connected children (2010-2012) was analysed. Comparisons to women in the general population were made using the 2007 Adult Psychiatric Morbidity Survey (n = 1594). Results: Compared to women from the general population, military spouses/partners were significantly more likely to meet criteria for probable depression (adj. OR 2.50 (95% CI 1.52-4.11)). There was no significant difference regarding probable PTSD. Spouses/partners were significantly more likely to meet criteria for hazardous alcohol consumption (adj. OR 2.55 (95% CI 1.87-3.47)) and more likely to report episodes of weekly, daily or almost daily binge-drinking (adj. OR 2.15 (95% CI 1.28-3.61)) than women in the general population. Binge-drinking was significantly higher among spouses/partners of Service personnel reporting family separations of more than 2 months in the last 2 years compared to those reporting no, or shorter, separations (adj. OR 1.88 (95% CI 1.08-3.27)). Conclusion: This is the first study to examine mental health and alcohol consumption among UK military spouses/partners. The significantly higher prevalence of probable depression, hazardous alcohol consumption, and binge-drinking compared to women in the general population suggests further research is needed into the drivers of poor mental health and alcohol consumption among this population and in identifying or developing prevention campaigns to reduce alcohol use and support their well-being.

Antecedentes: las familias de militares pueden experimentar factores estresantes únicos que pueden contribuir a un peor bienestar entre las esposas/parejas del personal del Servicio. Sin embargo, hay poca investigación en el Reino Unido sobre salud mental o consumo de alcohol en esta población.Objetivo: Este estudio examinó los resultados de salud mental (depresión probable y trastorno de estrés postraumático (TEPT)) y el consumo de alcohol entre las esposas/parejas de militares del Reino Unido en comparación con las mujeres de la población general. Se examinaron las asociaciones con características militares y sociodemográficas.Método: Se analizaron los datos de la encuesta de 405 esposas/parejas del personal actual y anterior del Servicio del Reino Unido que participaron en un estudio de niños vinculados al ejército (2010-2012). Las comparaciones con las mujeres en la población general se realizaron mediante la Encuesta de morbilidad psiquiátrica de adultos de 2007 (N = 1594).Resultados: en comparación con las mujeres de la población general, las esposas/parejas de militares tenían significativamente más probabilidades de cumplir con los criterios de depresión probable (adj. OR 2.50 (IC 95% 1.52-4.11)). No hubo diferencias significativas con respecto al TEPT probable. Las esposas/parejas tenían muchas más probabilidades de cumplir con los criterios para el consumo de alcohol peligroso (adj. OR 2.55 (IC 95% 1.87-3.47)) y tenían más probabilidades de reportar episodios de consumo excesivo de alcohol semanal, diario o casi diario (adj. OR 2.15 (IC 95% 1.28-3.61)) que las mujeres en la población general. El consumo excesivo de alcohol fue significativamente mayor entre las esposas/parejas del personal del Servicio que informaron separaciones familiares de más de 2 meses en los últimos 2 años en comparación con las que informaron que no hubo separaciones, o más cortas (adj. OR 1.88 (IC 95% 1.08-3.27)) .Conclusión: este es el primer estudio que examina la salud mental y el consumo de alcohol entre los cónyuges/parejas militares del Reino Unido. La prevalencia significativamente más alta de depresión probable, consumo de alcohol peligroso y consumo excesivo de alcohol en comparación con las mujeres en la población general sugiere que se necesita más investigación sobre los factores que conducen a la mala salud mental y el consumo de alcohol entre esta población y para identificar o desarrollar campañas de prevención para reducir consumo de alcohol y apoyo a su bienestar.

'It's nice to just be you': The influence of the employment experiences of UK military spouses during accompanied postings on well-being.

Repeated military relocations (accompanied postings) can have a detrimental effect on employment and well-being among the spouses and partners of military personnel. Semi-structured telephone interviews were conducted with 19 spouses of British Army/Royal Air Force personnel with recent experience of accompanied postings to explore this issue through the lens of self-determination theory; all were married women with at least one child. Participants explained how employment contributed to an independent identity, enabling social connectedness, providing a sense of self-confidence and value but limiting agency over employment decisions. Spouse employment, and therefore, well-being could be improved by the provision of better childcare access or additional support in finding employment and training opportunities.

Substance use and mental health among military spouses and partners.

Research on the behavioral health of military spouses/partners is essential, yet lacking. Data on 344 civilian spouses were drawn from a study of U.S. Army Reserve/National Guard soldier couples. This project characterizes civilian spouses' behavioral health symptoms. Regression analyses assessed the relationship between substance use and mental health symptoms. Overall, findings indicate civilian spouses had behavioral health impairments. Mental health, alcohol use, and tobacco use did not differ by soldiers' deployment history; illicit drug use and non-medical use of prescription drugs did at trend level. Support initiatives focusing on all military spouses, not just those of deployed soldiers, are needed.

Assessing the Needs of Soldiers and Their Families at the Garrison Level.

The RAND Arroyo Center conducted a 2014 formal needs assessment survey of active component soldiers at 40 installations. The original study described a broad landscape of needs in such areas as quality of life support services provided to help families cope with a variety of challenges. In this study, new analysis of those survey data explores differences at the garrison level and includes additional focus group data. The analysis suggests that resources providing one-on-one, personalized help should be given priority and it is possible that emphasizing trust between soldiers and their leaders could help fulfill this need. Providing easily accessible information online and staffing services that provide information to soldiers and their families should also be continuing priorities. In intergovernmental support agreements and other community partnership activities, Army garrisons should consider focusing more on partnerships that help meet the needs of soldiers and their families. The Army might consider a series of solutions to achieve the right balance between fostering resilience and helping its soldiers solve problems early. One solution is to expose noncommissioned officers and other soldiers earlier and more frequently in their careers to information regarding what resources are available. Another solution is to set priorities at the aggregate Army level, rather than leaving lower levels to determine how to prioritize the many requirements that are passed down. Finally, the Army should consider strengthening the "no wrong door" policy at Army Community Service and broadening the policy to help soldiers and families navigate resources.

Understanding resilience as it affects the transition from the UK Armed Forces to civilian life.

There has been growing interest among policy officials, charity representatives and academic experts in understanding the transition process of UK Service leavers. While recent evidence suggests that resilience is important for a successful transition, no systematic review has been undertaken on this topic before this study. FiMT commissioned RAND Europe to research whether - and how - resilience can affect individual transition pathways and outcomes for UK Service leavers.

A brief introduction to the military workplace culture.

BACKGROUND: Military culture and workplace are areas of interest for researchers across disciplines. However, few publications on military culture exist. OBJECTIVE: The purpose of this article is to introduce general concepts regarding the structure and culture of the United States Military and discuss how this creates challenges for reintegrating into the civilian world. METHOD: Topics that will be covered in this article include an overview of the Department of Defense (DoD) and Department of Veterans Affairs (VA), socialization to military culture, the unique features of the military as a workplace, the cultural experiences of military personnel reintegrating back into the community, and the challenges faced by military members and their spouses. RESULTS: The provided information on military culture will expand military cultural competency so that civilian employers can enhance their ability to create supportive workplaces for veterans and military spouses during times of transition and reintegration. DISCUSSION: The unique characteristics of the military culture should be understood by those who work with or plan to work with military populations.