Literature Review Synthesis

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Introduction
The problem of military reintegration has been an ongoing issue for decades. This has
been examined in many different aspects, from mental health to coping strategies of members
upon returning. Multiple studies look to further explore the mental health issues that members
suffer upon returning home and in their conclusions discuss the potential for future studies with a
focus on military leadership. While previous studies have investigated the preparation of return
to home and the aftereffects of this, they have not focused on the role of the military commander
during this time. In these studies, many have called for more support from leadership, but
minimal studies have been done on this. Military commanders play an important role in the
success of their members at home and those returning from a deployment. This literature review
strives to look at the unique challenges and begin to understand strategies that have been used to
attempt to support their members during this critical phase of their lives.
Research Strategy
The literature review focuses on the challenges of military reintegration for active-duty
personnel in the United States armed forces within the context of their families and communities.
Utilizing keywords such as ‘military,’ ‘reintegration,’ ‘family,’ and ‘deployment,’ searches was
conducted in key databases including EBSCO, APA PsycArticles, APA PsycInfo, Military and
Government Collection, and ProQuest Central. The articles are organized and annotated,
identifying key themes, trends, and research gaps. The synthesis of findings informs the
dissertation’s contribution to the understanding of military reintegration and its impact on family
dynamics. Continuous updates and revisions ensured the literature review remains current and
comprehensive.
Theoretical Foundation
Ludwig von Bertalanffy’s general system theory (GST), as explained in Drack’s (2009)
article on Bertalanffy’s early system approach, presents a robust theoretical framework that can
synergize with the insights gleaned from the discussions on reintegration preparation for military
commanders and the complexities of veterans’ identity adjustment during the reintegration
process. This approach calls for a comprehensive exploration of physical, psychological, social,
and economic dimensions, mirroring Bertalanffy’s early interdisciplinary orientation (Drack,
2009). GST’s concept of “levels of integration” is also relevant, encouraging researchers to
investigate reintegration at multiple levels, recognizing that changes at one level can impact
others. Additionally, the concept of open systems, central to GST, can be applied to understand
how military personnel and veterans interact with their external environments during
reintegration, such as social support networks and healthcare systems. GST offers a valuable lens
through which we can comprehensively examine military reintegration. This theory advocates a
holistic, interdisciplinary perspective—a fundamental principle that aligns with the multifaceted
nature of reintegration preparation and identity adjustment for veterans. Just as GST encourages
the consideration of various factors and subsystems in complex processes, military commanders
should view reintegration as a multidimensional challenge encompassing physical,
psychological, social, and economic dimensions.
GST introduces the concept of “levels of integration,” which aligns seamlessly with the
multifaceted nature of military reintegration. This notion prompts us to investigate reintegration
on various levels, recognizing that changes at one level can have ripple effects on others. Just as
Bertalanffy’s theory acknowledges the interdependence of components within a system, military
commanders must appreciate that reintegration issues are interconnected and must be addressed
comprehensively. Additionally, Bertalanffy’s idea of generalization and formalization, discussed
in his early works, can assist researchers in developing formalized models of military
reintegration. By identifying key variables and feedback loops within the system, GST enables
the creation of predictive models that enhance our understanding of reintegration dynamics. This
systems-oriented perspective can inform policymakers and practitioners in designing more
effective reintegration programs, leveraging insights from diverse disciplines to comprehensively
address the challenges faced by veterans transitioning back to civilian life (Drack, 2009).
The concept of open systems, a central tenet of GST, is directly applicable to
understanding military reintegration. Military personnel and veterans do not exist in isolation;
they interact with their external environments during the reintegration process. These external
environments encompass social support networks, healthcare systems, employment
opportunities, and more. Recognizing veterans as open systems allows for a deeper
understanding of how external factors influence their reintegration journey, and it underscores
the importance of creating a supportive and adaptive external environment. Bertalanffy’s
emphasis on generalization and formalization in his early works can be a powerful tool for
researchers and practitioners in the field of military reintegration. By identifying key variables
and feedback loops within the reintegration system, GST enables the creation of formalized
models. These models can enhance our understanding of reintegration dynamics, offering
predictive capabilities that are instrumental for policymakers and program designers. Through
these models, we can anticipate the potential challenges veterans might face during reintegration
and design proactive interventions to mitigate those challenges.
In essence, the incorporation of Ludwig von Bertalanffy’s general system theory into the
context of military reintegration preparation and identity adjustment serves as a unifying
framework. It encourages a holistic perspective, recognition of interdependencies, and the
development of formalized models to improve the effectiveness of reintegration programs. By
applying these principles, military commanders can better navigate the complex and dynamic
landscape of supporting veterans as they transition from military service to civilian life.
Reintegration Preparation
Experiences of military commanders during reintegration preparation for their members,
it’s essential to consider the tools and assessments available. Madeline Romaniuk, Gina Fisher,
Chloe Kidd, and Philip J. Batterham (2020) developed the Military-Civilian Adjustment and
Reintegration Measure (M-CARM), a self-report tool designed to assess psychological and
cultural adjustment in veterans transitioning from military service to civilian life. Their study
emphasizes the need for comprehensive assessment tools, given the association between
transitioning from military service and increased risks of psychological difficulties, psychiatric
disorders, and suicide. The M-CARM’s development and validation offer military commanders a
valid and reliable instrument for assessing veterans’ adjustment following separation from the
military (Romaniuk et al., 2020). Incorporating this tool into reintegration preparation processes
can enhance commanders’ ability to support veterans during this critical transition phase
(Romaniuk et al., 2020).
The study conducted by Elnitsky, Blevins, Fisher, and Magruder (2017) critically
reviewed the challenges and facilitators in the reintegration of military service members and
veterans (MSMVs) following deployment. The objective was to identify gaps in the literature
regarding the reintegration of MSMVs from the current war era. The researchers examined 186
articles published between 2001 and 2015, highlighting a lack of a clear definition or
comprehensive theory on MSMV reintegration.
To address these gaps, the study linked findings from the literature to establish a unified
definition of reintegration and adapted the social ecological systems theory to guide research and
practice in MSMV reintegration. The researchers identified challenges at the individual,
interpersonal, community, and societal levels related to reintegration. While numerous studies
detailed challenges and interventions for MSMV reintegration, the majority focused on
descriptive studies and pilot intervention trials. There was limited evidence evaluating
intervention effectiveness and integrated delivery system.
The study recommends adopting an ecological model of MSMV reintegration to enhance
research, assessment, and intervention outcomes at multiple levels (individual, interpersonal,
organizational, and societal). This approach aims to systematically address the reintegration of
MSMVs and promote theoretically based interventions and programs to facilitate successful
reintegration. The study by Elnitsky et al. (2017) equips military commanders with a deeper
understanding of the challenges and complexities of MSMV reintegration. It provides a
framework, identifies potential intervention strategies, and underscores the need for evidencebased approaches. Armed with this knowledge, military commanders can enhance their role in
facilitating the successful reintegration of service members and veterans into civilian life. This
instrument offers a valid and reliable means of evaluating veterans’ readiness for civilian life.
Incorporating the M-CARM into reintegration preparation processes enhances commanders’
ability to support veterans effectively during this critical phase.
Proactive Intervention
To address proactive intervention effectively, it’s essential to acknowledge the specific
challenges faced by returning members, particularly women veterans. A study conducted by
Creech et al. (2019) sheds light on the impact of combat exposure on the mental health and
relationship functioning of women veterans who served in the Afghanistan and Iraq wars. Their
research underscores the importance of recognizing the potential mental health challenges that
returning members, including women veterans, may face during the reintegration process. The
study by Creech et al. (2019) illuminates the complex interplay between combat exposure,
mental health outcomes, and relationship dynamics among women veterans, providing military
commanders with valuable insights. These insights emphasize the need for sensitivity to the
mental health and relationship challenges faced by returning members, especially women
veterans. This knowledge can inform the development of supportive policies and programs to aid
in the reintegration of veterans into civilian life.
Burkman et al. (2018) contributes valuable insights into the treatment of moral injury
among combat veterans. It highlights the potential for specialized interventions to facilitate
healing, improve mental health outcomes, and enhance the reintegration of veterans who have
faced moral challenges during their service. Burkman et al. (2018) employed a qualitative
research approach, conducting in-depth interviews with 28 combat veterans who had participated
in the “killing treatment” intervention. The primary objective was to gain a comprehensive
understanding of the veterans’ experiences with this specialized therapeutic approach and to
assess its impact on their mental and emotional well-being. Burkman et al. (2018) offers valuable
insights into a specialized therapeutic intervention known as “killing treatment.” This
intervention is designed to assist combat veterans in coping with the profound psychological
distress associated with moral injury. While the study specifically examines the impact of
“killing treatment” on moral injury, its findings may extend to the broader field of trauma and
mental health treatment. This suggests that addressing moral distress and ethical conflicts in
therapeutic settings can be beneficial for individuals who have encountered morally challenging
situations.
In the study conducted by Carlson et al. (2021), a comprehensive analysis is undertaken
regarding the challenges encountered by returning veterans and the imperative need for support
during their reintegration phase. This scholarly investigation elucidates the coping mechanisms
employed by veterans and underscores the significance of establishing meaningful connections
with individuals beyond their immediate family, including military leadership, to raise awareness
about their adversities. Employing expressive writing as a methodological approach, this study
sheds light on the inner thoughts and coping strategies employed by individuals during the
reintegration process.
In a complementary study authored by Gulliver et al. (2016), a more in-depth
examination is carried out on the coping mechanisms and overall quality of life experienced by
returning veterans following deployment, with a particular focus on 130 veterans who served in
Middle Eastern conflicts. This inquiry involves a meticulous evaluation of coping skills through
neuropsychological testing, which ultimately reveals notable deficits in cognitive functions
related to information recall and detail retention. As a result, this investigation posits the need for
a more comprehensive understanding of brain function both prior to deployment and upon return,
thereby offering valuable recommendations for policy and practice.
The insights derived from both the study by Carlson et al. (2021) and the research
conducted by Gulliver et al. (2016) can be instrumental in shaping proactive interventions for
military post-deployment reintegration. The cumulative findings from these studies shed light on
various facets of the challenges faced by returning veterans, their coping mechanisms, and the
impact on their quality of life. By synthesizing these insights, a more comprehensive approach to
proactive intervention can be developed.
Firstly, the study by Carlson et al. (2021) underscores the importance of establishing
meaningful connections beyond immediate family, including with military leadership. Proactive
intervention programs could incorporate strategies to facilitate these connections and encourage
veterans to seek support from their peers and superiors. This might involve mentorship
programs, support groups, or structured communication channels within the military community.
In Gulliver et al. (2016), research highlights the cognitive deficits observed in returning veterans,
particularly in information recall and detail retention. Proactive interventions can address these
issues by implementing cognitive training programs and assessments both before deployment
and upon return. This could involve neuropsychological testing to identify potential cognitive
challenges early on and provide targeted interventions to mitigate these issues.
Additionally, the findings from both studies underscore the need for increased awareness
and understanding of the unique challenges faced by veterans during reintegration. Proactive
interventions can include educational initiatives aimed at military personnel, families, and the
broader community to foster empathy, reduce stigma, and create a more supportive environment
for returning veterans. These studies provide valuable insights into the challenges and coping
mechanisms of veterans during post-deployment reintegration. Proactive interventions can draw
from these insights to create comprehensive support systems that emphasize social connections,
address cognitive deficits, and promote awareness, ultimately improving the overall reintegration
experience for military veterans.
The study by Hourani et al. (2016), which focuses on the development and testing of a
pre-deployment stress inoculation training program, is highly relevant to the concept of proactive
intervention for reintegration of military personnel. This research delves into the critical phase of
preparing military members for deployment by equipping them with stress-coping skills and
strategies before they face the rigors of combat. Here’s how it relates to proactive intervention for
reintegration.

Preparation for Stressful Situations: The pre-deployment stress training program
discussed in the article is designed to prepare military personnel mentally and
emotionally for the stressors they are likely to encounter during deployment. This
proactive approach aims to build resilience and coping mechanisms in advance,
which can significantly impact their ability to handle stress during deployment.

Minimizing Post-Traumatic Stress Disorder (PTSD) Risk: One of the primary
goals of the program is to reduce the risk of post-traumatic stress disorder (PTSD)
among deployed service members. By providing them with tools and skills to manage
stress proactively, the program aims to prevent or mitigate the development of PTSD,
a condition that often requires intensive intervention during reintegration.

Ease of Reintegration: The study’s findings indicate that participants who received
pre-deployment stress training had an easier time reacclimating into society upon
their return. This suggests that proactive intervention before deployment can
positively influence the reintegration process by helping military members maintain
better mental health and reduce the challenges they face upon return.

Shift from Resilience Training to Proactive Training: The research acknowledges
a shift from traditional resilience training to a more proactive approach. Instead of
relying solely on resiliency training as a post-deployment intervention, the study
advocates for preparing military personnel ahead of time to reduce the need for
extensive resilience training after deployment.

Potential for Broader Application: While this study was a pilot program with a
limited sample size, its positive outcomes suggest the potential for broader
application. Proactive intervention programs, like the one discussed, could be
implemented on a larger scale to benefit a wider population of U.S. military members,
ultimately enhancing their reintegration experiences.
This study by Hourani et al. (2016) underscores the importance of proactive training
before deployment to bolster the mental resilience of military personnel. By doing so, it aligns
with the broader goal of improving the reintegration process by reducing the incidence of PTSD
and facilitating a smoother transition to civilian life for returning service members. Further
research can help refine and expand the application of such proactive interventions.
Identity Adjustment.
I now turn to the article “Creative and Critical Thinking in an Age of Complexity” by
Alexa Andreas (2021). Andreas emphasizes the imperative for military commanders to adapt to
the increasing complexity of contemporary challenges by fostering creative and critical thinking
skills. This shift from linear thinking to creative and critical thinking is essential as military
operations often take place within complex and uncertain environments (Alexa, 2021). Andreas
highlights that creative thinking involves generating innovative solutions by deviating from
traditional paths, while critical thinking enables conscious questioning and analysis (Alexa,
2021). Both thinking skills are vital for military commanders operating in complex situations
(Alexa, 2021).
In a study by Meca et al. (2020), the researchers aimed to investigate the influence of
various aspects of United States (US) identity on the mental health and substance use of military
Veterans. Given the substantial number of US service members deployed in the past two decades
and the challenges associated with reintegrating into civilian life, understanding these factors
was considered crucial. The study included 195 US military Veterans, primarily comprising
women (53.3%), with a majority being of White ethnicity (73.3%). The participants’ average age
was 35.12 years. The researchers examined four aspects of US identity: US identity exploration,
US identity commitment, US identity affirmation, and US identity centrality. They analyzed the
correlations between these aspects and substance use, symptoms of depression, and symptoms of
anxiety The findings indicated that US identity affirmation was negatively linked to substance
use, symptoms of depression, and symptoms of anxiety. Conversely, US identity centrality
showed a positive correlation with alcohol use. Using a structural equation model, the
researchers demonstrated that US identity affirmation was negatively associated with alcohol
use, substance use, and symptoms of depression and anxiety, whereas US identity centrality
exhibited positive associations with these outcomes. Additionally, US identity exploration was
positively associated with symptoms of anxiety, which partially supported the study’s
hypotheses, while US identity commitment did not exhibit significant associations with any of
the outcomes. These results highlight the importance of considering different dimensions of US
identity in understanding the mental health and substance use issues faced by Veterans during
their transition to civilian life. (Meca et al., 2020).
Adams et al. (2019) explored the role of veteran identity in the well-being of military
veterans, drawing upon social psychological theory that suggests an individual’s identity and
self-definitions within a particular social role can influence their sense of purpose in life and
impact their behavior in specific social contexts. This identity, they hypothesized, could serve as
a protective factor against the development of psychological disorders.
The study examined data collected from 1,730 military veterans who were recruited to
investigate the health effects of warzone deployments. The sample predominantly consisted of
male participants who were older and identified as White. The researchers used a Likert scale to
measure the prominence of each respondent’s veteran identity, indicating how significant it was
to them. They also assessed several outcome variables, including post-traumatic stress disorder
(PTSD), suicidal ideation, depression, alcohol misuse, and the utilization of Veterans Affairs
(VA) services.
The initial bivariate analysis revealed that veterans with a prominent veteran identity
tended to be older, without college degrees, had lower incomes, and had experienced their first
deployment in Vietnam. However, in the multivariate analyses, participants with a strong veteran
identity were less likely to exhibit suicidal ideation, indicating a potential protective aspect of
this identity against such thoughts. On the other hand, those with a prominent veteran identity
were more likely to misuse alcohol and utilize VA services.
Interestingly, there were no significant differences observed in the prevalence of PTSD,
self-rated health, or depression based on the strength of the veteran identity. The study by Adams
et al. (2019) highlighted the complex relationship between veteran identity and the mental wellbeing of military veterans. While a prominent veteran identity appeared to offer protection
against suicidal ideation, it was also associated with an increased risk of alcohol misuse and a
higher likelihood of using VA services. These findings underscore the importance of considering
the multifaceted nature of identity and its implications for intervention strategies to support the
well-being of veterans.
In the context of military commanders assisting their members with identity adjustment
during reintegration, it’s crucial to recognize the complex interplay between identity, mental
well-being, and the challenges faced by veterans. As highlighted in the study by Meca et al.
(2020), the transition from military service to civilian life can have profound effects on veterans’
mental health and substance use. This transition involves a multifaceted process of redefining
one’s identity, including their roles as civilians and veterans. Understanding the role of identity in
this adjustment is pivotal.
Meca et al. (2020) emphasized the importance of considering different dimensions of US
identity when assessing veterans’ mental health. Their findings indicated that while US identity
affirmation was associated with better mental health outcomes, US identity centrality was linked
to increased alcohol use. This complexity underscores the need for military commanders to
provide tailored reintegration support that acknowledges the diverse aspects of identity among
their members. Furthermore, the study by Adams et al. (2019) highlighted the protective and
potentially risk-enhancing aspects of veteran identity. A strong veteran identity appeared to offer
protection against suicidal ideation but was associated with an increased risk of alcohol misuse.
This suggests that identity adjustment is a nuanced process, and military commanders should be
equipped to address the unique identity challenges their members may face during reintegration.
In this context, the insights provided by Alexa (2021) on fostering creative and critical
thinking skills among military commanders become relevant. Military operations often occur in
complex and uncertain environments, requiring commanders to adapt to new challenges.
Developing creative and critical thinking skills can empower commanders to better understand
and support their members’ identity adjustment processes. Creative thinking encourages
innovative solutions and approaches to addressing identity-related issues, while critical thinking
enables commanders to critically analyze the challenges faced by veterans and the effectiveness
of reintegration strategies.
To facilitate successful reintegration and address identity-related challenges, military
commanders should adopt a holistic approach. This involves recognizing the multifaceted nature
of identity, providing tailored support, and equipping themselves with creative and critical
thinking skills to adapt to the evolving needs of their members during the transition from military
to civilian life.
Summary
The successful reintegration of military personnel into civilian life is a complex
endeavor, with military commanders playing a pivotal role in facilitating this transition. This
literature review explores the experiences of military commanders in the context of reintegration,
highlighting the challenges they face and the strategies they employ to support their members
during this critical phase. The review draws from a range of studies, including those addressing
proactive intervention, identity adjustment, and the development of creative and critical thinking
skills. These insights provide a foundation for understanding the multifaceted nature of
reintegration and the importance of tailored support for veterans as they navigate this significant
life transition. To comprehensively address the challenges and complexities of military
reintegration and to better understand the role of military commanders in this process, this
dissertation employs a rigorous research strategy. The following chapter outlines the
methodology used to investigate the experiences of military commanders and their impact on the
reintegration of service members. Building on the insights garnered from the literature review,
the research methodology is designed to provide a deeper understanding of the strategies
employed by military commanders and their effectiveness in supporting their members during
the reintegration process. This research strategy includes data collection, analysis techniques, and
theoretical frameworks that will contribute to advancing our knowledge in this critical area of
study.
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