Identifies the student’s specific literature review topic, explicitly articulating a unifying, overarching theme that will guide the project Literature Review: Summarizes the general state of the lit

OUTLINE 5

Outline

Introduction

Due to specific military laws, service members' privacy is not as protected in a counseling relationship. Therefore, service members are reluctant to seek mental health help out of fear of losing their careers.

The topic is crucial because any supervisor may inquire about a counseling session under the pretense of the need to know title. Unfortunately, with the service members' mental state often being put after the mission, many issues may arise, such as depression, PTSD, or even suicide.

The subject should be researched because service members are entrusted with such important tasks. Having underlying mental issues means that they may be unable to perform given tasks to the highest level of their ability. Culture, depression, and stigma will be used through the study as a means to help grasp the subject.

Culture: Any group of people who classify or relate with one another based on some common purpose, need, or similarity of background.

Depression: is a disturbance in emotions, behaviors, cognition, and body function.

Stigma is the negative status associated with a particular subject.

The issue of protecting the service member's privacy has been an ongoing one for quite some time. According to Kennedy, C., and Johnson, W. (2009), Mixed-agency ethical impasses happen when there are conflicts between loyalties or obligations to patients and the Department of Defense.

The study is relevant because veterans are coming to the VA with issues that could and should have been taken care of while serving. It also contributes to psychology in many ways. It provides insight into understanding the service member better.

As a veteran and a clinical psychologist, one hopes to help members while serving. Assisting in creating a better environment for counseling relationships will help the members feel understood and have a certain level of trust in the treatment.

The purpose of the literature review is to provide awareness of mental health and military members. It also highlights their fears concerning their privacy in a counseling relationship and the difficulties met by them therapists who are unable to protect their clients.

Literature Review.

To complete the literature review, multiple articles have been chosen. Articles describing the culture of the military, ethical issues faced by therapists assist in introducing the subject. In order to have a thorough view of the subject, researchers showing data about the rate of suicide and depression among service members are used. Last but not least, articles highlighting how the service members and their families could benefit from counseling are also included.

The first point of the review is about the refers to the culture and the ethical issues faced by therapists. According to Cole, R. (2014), the military culture is unique from the language used to the hierarchy, the sense of rules, expectations, and self-sacrifice. Cole, R. also mentioned that as part of the military's culture, a sense of strength Is often embedded in the service member, which consequently forces a sense of fear to appear weak, especially concerning mental health. Therefore, it creates a stigma around mental health. The culture frequently prioritizes the mission. Such priority often creates ethical dilemmas for therapists, therefore further feeding the fear of the service members to seek counseling and hindering counseling relationships. As per Kennedy, C., & Johnson, W. (2009), Military psychology can significantly deviate from traditional practice. A dilemma often arises when the provider must choose between his client or his loyalty to the Department of Defense. The combination of culture and such ethical issues often creates a lack of trust between service members and providers, which leads to unreported mental issues bringing one to explore stigma depression and suicide in the military.

A second point in the review of the consequences of stigma will be discussed, the rates of depression and suicide are studied. In an article was written by Dr. Kaplan, D. (2019), stigma is firmly established in the military culture and is connected to a desire to self-handle issues. Moreover, when said issues go untreated, they may result in depression or even suicide. According to the Department of Defense (DoD) Suicide Event Report (DoDSER) Annual Reports, in 2017, 50.8 percent of reported suicide had no mental health diagnoses in their medical records. Tucker, J. (2020) reported that military suicide rates significantly increased from 2011 to 2018. Depression amongst military members, according to Hepner, K. (2016), has been on the rise, and the quality of treatment is adequate; however, the follow-ups rate is not as high as it should be. This topic brings one to discuss the care that both members and family receive when it comes to mental health.

Treatment comprises the third point. Although many service members do not seek mental health treatments, there are many options available to help them. According to Luxton, D. (2016), home-based tele-behavioral is an option offered to service members that have been proved to be as efficient as face to face counseling. Behavioral marital therapy is also available to couples.

Discussion

The literature review will discuss the subject of service members' privacy in a therapy session. Other studies have highlighted the importance of the military's culture and its effect on the members and their families. Stigmas that plague the military and their effect on mental health are also visited.

As for new knowledge, therapists are always advocating with hope to change specific reporting criteria and how much influence they have over sending a member back to on deployment. With this information, one can see the bigger picture and how much emphasis is placed on the mission.

Bringing awareness to both service members and higher-ranking officers would be the recommendations for future researches. Once an education has been established, and there is a certain level of understanding and acceptance, the therapist could survey and see how stigma is affected.

As a summary, one will review the mental health of military members. Their culture, the effects of deployments, the stigma attached to mental health will all be addressed. The code of ethics of military therapists will also be a point of focus. PTSD, depression, and suicide will be discussed as results of untreated mental issues that may be present. Treatment will also be a subject examined with hopes that military therapists will reach an agreement where the need to know status is not given to every supervisor, and the member's privacy is protected.

References

Cole, R. F. (2014). Understanding military culture: A guide for professional school counselors. The Professional Counselor, 4(5), 497-504. doi:http://dx.doi.org.ezproxy2.apus.edu/10.15241/rfc.4.5.497

Kaplan, D. A. (2019, July 8). Reducing Military Mental Health Stigma to Improve Treatment Engagement: Guidance for Clinicians. Psychological Health Center of Excellent. https://www.pdhealth.mil/news/blog/reducing-military-mental-health-stigma-improve-treatment-engagement-guidance-clinicians

Kennedy, C., & Johnson, W. (2009). Mixed Agency in Military Psychology: Applying the American Psychological Association Ethics Code. Psychological Services, 6(1), 22–31. https://doi.org/10.1037/a0014602

Luxton, D. D., Pruitt, L. D., Wagner, A., Smolenski, D. J., Jenkins-Guarnieri, M., & Gahm, G. (2016). Home-based telebehavioral health for U.S. military personnel and veterans with depression: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 84(11), 923-934. doi:http://dx.doi.org.ezproxy1.apus.edu/10.1037/ccp0000135

Tucker, J., Dr. (2020, April 27). 2018 DoD Suicide Event Report Released. Psychological Health Center of Excellence. https://www.pdhealth.mil/news/blog/2018-dod-suicide-event-report-released