2010 Graduating Class Capstone Project
2011 Capstone Project: Critical Multi-systems Analysis
Columbia University School of Social Work
The 2011 CAPSTONE PROJECT: Critical Multi-systems Analysis
The case of Eli Painted Crow - The Lonely Soldier by Helen Benedict (2009)
The story of Eli Painted Crow provides the basis of this year’s capstone project, though all of the narratives in the book provide important context and additional aspects to advance the understanding of the experience of women in the military before, during and after active duty in the current war zones of Iraq and Afghanistan.
You are asked to bring your specific and integrated skills to bear as you consider Ms. PaintedCrow from the macro, mezzo, and micro perspectives to answer the questions that follow. Remember that the three systems levels (macro, mezzo and micro) are constant, interactional, and fluid.
You have read The Lonely Soldier (Benedict, 2009) and are asked to focus particularly, though not exclusively, on the case of Eli Painted Crow. As you approach the challenges from all system levels please consider both the general state of services for members of the military and veterans, the VA administration, and relevant policies, current debates, etc, and the personal experience of Eli Painted Crow. Apply your considerations to each of the three system levels below to demonstrate your method-specific and cross-systems analytical skills.
Before you start, please use the following as the framework guide your analysis for all of the
three systems:
Consider Eli Painted Crow as an individual – a woman, a native of the Yaqui Nation, a daughter, a partner, a mother and grandmother, a soldier, a leader, a professional, etc.. Understand the power and authority structure within the military (as part of the culture) and the impact this structure can have on the lives of military service members and their families. Policy-making and implementation can be heavily impacted by the intersectionality of various diversity factors (e.g., in-rank structure [hierarchy]; military occupational specialty statuses; racial status; class; gender; service cultures and practices; “family” composition and definition; sexual orientation; age; disability; life stage; culture and ethnicity; spirituality; and citizenship status).
Expectations:
1. Students should research and become aware of major pieces of legislation, policies and recent cases addressing sexual assault and discrimination in the military.
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2. Students should address issues of the potential macro, mezzo, and micro level barriers to the effectiveness of the current formal and informal systems in dealing with issues facing female soldiers.
3. Bottom-Line: students should get to know the history and current structures of social policies and services, the role of policy in service delivery, and the role of practice in policy development, including relevant congressional, governmental, and oversight committees and groups (e.g., Office of Management and Budget and Government Accountability Office); Uniform Code of Military Justice.
4. Students should be paying attention to:
a) Military culture
b) Individual, family and community impact, support and services.
c) Preparedness and prevention: How do evidence based practices inform your approach?
d) Issues such as developmental stage, gender, race, class, abilities, culture, among others.
e) Training to the health and mental health professionals regarding treatment of PTSD and issues specific for women
f) Services for military personnel and veterans who experience sexual harassment and/or assault
g) Training for armed service members regarding sexual harassment and related areas
h) Reporting procedures for sexual harassment and assault and resulting process and outcomes
i) Services for abusers
j) Consequences for soldiers involved in crimes
k) Consequences for commanders
l) Support services and networks for women
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System 1: Macro Analysis
Learning Objectives: Students should demonstrate through their posters, discussion points
during the poster session, the executive summary and the final group paper, their ability to do the following:
Identify current and proposed legislation and policies (including policy debates) that affect women in the military and their families. Which policies support military women and their families? How would these apply to Eli Painted Crow and her family? What policy and/or legislative changes would better support Ms. Painted Crow (as well as the other military women in the book)? Please examine and discuss the feasibility of such policy changes taking into account the level of government, political context, ethical issues and values underlying the policies.
Please use the following three questions to tackle the macro and policy environment and issues.
While you do so, please also explore and relate these issues in regards to the universal declaration of human rights, as well as include the intersectionality of power in all of Eli Painted Crow’s primary areas of identity (e.g. gender, race, age, nationality).
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1. What are the formal structural issues that frame Eli Painted Crow’s experiences during and after her military experience?
2. What broad policies within and outside of the military provide the context to inform Eli Painted Crow’s narrative?
3. Examine and discuss how military culture perceives and treats women (e.g., physical strength, capacity, attitudes toward women)
Then, please use the following questions to guide your analysis, having identified the formal structural and policy contexts that are relevant to Eli Painted Crow’s experience,
1. What structure and policy issues can be addressed and how? Please identify and discuss at least three policies that you deem the most important to address Eli Painted Crow’s experience.
2. How do all of these structural issues support or challenge the core values of the Social Work Profession?
3. Using Eli Painted Crow as your example, please discuss how the policies you selected institutionalize support and/or challenges for members of the military given their multiple social identities.
4. What policy-level interventions (these could be current or proposed) may address some of the challenges Eli Painted Crow experiences especially during and after her military service? Please discuss the feasibility of these policy-level interventions.
System 2: Mezzo Analysis
Learning Objectives: Students should demonstrate through their posters, discussion points during the poster session, the executive summary and the final group paper, their ability to do the following:
Consider the impact of the organizational structure on the military community. Describe and evaluate current services for military personnel and their families over the span of their military career (recruitment, active duty, discharge and post-discharge). Conduct an organizational analysis identifying procedures and processes (VA and others) that support and/or create barriers to military personnel and their communities. Identify and understand how the organization’s formal and informal systems impact women’s position and experience in military services. Direct your discussion specifically to the experience of Eli Painted Crow?
1. What role does Veteran Affairs (VA) play in military personnel’s experiences, particularly for women? Which Veteran Affairs (VA) services might be helpful and which might need some reconstruction? (e.g. entitlements and benefits, health services, reporting methods). For those that need reconstruction, describe how you would reconstruct and discuss the feasibility of your proposed changes.
2. Describe and discuss human resources staffing and procedures and their alignment with employment law as it applies to the military.
3. Based on the narratives of the women in the Lonely Soldier and on current events, discuss sexual assault and rape within the military. Focus on the organizational policies and responses that apply.
4. Discuss community and organizational level supports available to military personnel as they re-enter their communities using Eli Painted Crow’s experience as your guide. Are these supports sufficient or do you identify additional unmet needs. Briefly discuss how you identified both supports and needs. Describe several methods to meet these needs that are grounded in existing supports. Include the roles of military and civilian organizations in your discussion
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System 3: Micro Analysis
Learning Objectives: Students should demonstrate through their posters, discussion points during the poster session, the executive summary and the final group paper, their ability to do the following:
Prepare a social work clinical case formulation that integrates many characteristics of Eli Painted Crow, her development, culture, strengths, challenges and coping capacities and skills.
Students must integrate the multiple contextual variables as they affect her life, and discuss how Eli’s narrative emerges.
1. Use multiple assessment tools to deepen your knowledge and understanding of Ms. Painted Crow, her family and community(ies) to conduct an assets and risk assessment.
2. Identify three theoretical frameworks used to guide your understanding of Ms.Painted Crow, her family and community(ies).
3. Address relational aspects of engagement, potential challenging and facilitating process elements that one anticipates could affect the development of a helping relationship. How might these relational aspects affect the assessment, intervention, monitoring and termination phases of clinical work with Ms. Painted Crow? Emphasize attention to your professional use of self in the therapeutic relationship.
4. What are the biological, psychological, social and spiritual manifestations of Ms. Painted Crow’s exposure to violence, war, personal assault and rape, and other traumatic events?
5. Discuss treatment recommendations, rationale, and direction of interventions. Identify evidence based assessment tools and interventions that one considered in evidence based search to direct and inform the recommendations.
Please consider the following as a starting point from which your teams will build to further understand the context and develop your analyses.
I. General Statistics
Women are prohibited to the assignment of any unit below brigade level whose primary mission is to engage in direct ground combat. Women are excluded from direct ground combat yet they are still exposed to combat action such as defending themselves and their units from attack.
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Combat exclusion is the major barrier to career advancement (DoD, 2009; Reinke & Miller, 2010).
Department of Defense Statistics:
92% of specialties are open to women
198,000 women are in the military as of the most current assessment conducted in 2007, comprising 14.25% of the 1.38 million total US military personnel.
Women have served in the US military since the Revolutionary War (Reinke & Miller, 2010).
Over 200,000 women, making up 13.5%, are on active duty and over 260,000 women are in the National Guard and Reserves, comprising 17% (Reinke & Miller, 2010).
Women in the military face many challenges, however, they often manifest in one or more of the following three ways: professional opportunity, sexual harassment and assault, and family issues (Reinke & Miller, 2010).
Despite women being prohibited from direct combat, 634 women have been wounded and 121 have been killed while deployed in Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom (Street, Vogt, & Dutra, 2009).
II. Homelessness
Approximately 2.3 to 3.5 million people are homeless in a given year and 26% of the homeless population are veterans. Women veterans are three to four times more likely to become homeless compared to their non-veteran counterparts, and this ratio has been steadily increasing since the US invaded Iraq and Afghanistan (Gamache, Rosenheck, & Tessler, 2003; Street, Vogt, & Dutra, 2009). However, homeless veteran women face the same issues as nonveteran women regarding concerns around privacy, gender-related care, treatment for physical and sexual trauma, housing support, and care for children (Washington et al., 2010).
The findings from one study conducted with homeless veteran women in Los Angeles County show that of those who had been homeless after serving in the military, they had an average of four entries and exits into and out of homelessness, and each period of homelessness was about 2.1 years, with 1 year between periods. Many of the women in the study had children under age 18. Homeless veteran women are more likely to be either low-income or unemployed, disabled, and to have diagnosed medical and psychological conditions including PTSD (Washington et al., 2010). Homeless veteran women are less likely to be college graduates, employed, married, have health insurance, and are less likely to utilize mental health services and VA healthcare. It is important to note that all of these risk factors were greater for veteran women of color (Washington et al., 2010).
III. Health Related Issues and Healthcare
Only 5-7% of veteran women – of the total veteran population – use VA healthcare services (Meehan, 2006; Yano, Goldzweig, Canelo, & Washington, 2006). However, rates of PTSD and military sexual trauma have increased among veteran women since the beginning of the US invasion of Iraq (Yano, Goldzweig, Canelo, & Washington, 2006). Female veterans are twice as likely as male veterans to be diagnosed with PTSD (Street, Vogt, & Dutra, 2009).
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Women in the military report lower levels of social support and a lack of positive interpersonal relationships compared to their male counterparts. Socially supportive relationships among military personnel have been identified as a major resilience factor for stressors, in general and combat exposure, in particular (Street, Vogt, & Dutra, 2009). Given that women service members are systematically ostracized, targeted for harassment, and discriminated against, they have very little to no support from their peers, especially since women may often be the only one of their gender in a particular unit (Street, Vogt, & Dutra, 2009). The authors suggest that for women, a lack of support from their comrades may exacerbate war zone stressors
Some estimates indicate that between 9.5% to 33% of women report experiencing attempted or completed rape while serving in the military (DoD, 2009) Of all veteran women seeking help with PTSD, since and including the war in Vietnam, 71% reported that they were sexually assaulted or raped while serving (Benedict, 2009)
Regarding sexual harassment, 22%-84% of women report being sexually harassed during military service (Turchik & Wilson, 2010; Kelty, Kleykamp, & Segal, 2010)
Within one year, 9% of military women reported experiencing some form of sexual coercion, 31% reported experiencing some form of unwanted sexual attention, and 52% reported offensive sexual behaviors from men (Street, Vogt, & Dutra, 2009). The same authors emphasize that sexual trauma experienced in the context of a combat operation or a war zone, are more likely to have an elevated effect of threat and harm, resulting in increased risk for negative mental health functioning. Female military personnel also experience gender harassment, which are gender-based degradations, and women in the military are subjected to this type of harassment more than any other type (Street, Vogt, & Dutra, 2009).
Department of Defense (DoD) studies are not disaggregated by service, war, or other characteristics. Most of the studies concentrate on women as victims/survivors and men as perpetrators; and very few studies have examined men as victims. However, recent studies highlight that the total number of female and male survivors of military sexual assault is equal (Turchik & Wilson, 2010).
A DoD study found that rates of sexual harassment against women were highest in the Marine Corps and lowest in the Air Force, and reported incidence of sexual assault were highest in the Army in 2007, compared to the Marines, Air Force, and Navy (Turchik & Wilson, 2010).
DoD published data are typically underestimates, compared to what is reported by survivors, and what actually occurs. Such gaps in reporting, both on behalf of victims/survivors and also on behalf of those publishing the statistics, are not exclusive to the military, rather, these gaps exist within all sectors of society regarding sexual assault and rape (Turchik & Wilson, 2010).
Veteran women who experienced sexual assault while serving in the military are more likely to have increased rates of depression, alcohol use, and are nine times more likely to have PTSD (Turchik & Wilson, 2010). These women are less likely to be employed, they feel negatively
about their military service, have a harder time adjusting to civilian life, and have increased rates of psychological and substance abuse problems when compared to female veterans who were not sexually assaulted (Turchik & Wilson, 2010).
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The Veterans Health Administration states thatPTSD, and dissociative, anxiety, alcohol, eating, and personality disorders (Kelty, Kleykamp, & Segal, 2010). Moreover, women in the military who survive sexual assault or rape while serving are five times as likely to develop PTSD compared to civilian women who are sexually assaulted and/or raped (Suris et al., 2004). Veterans (both women and men) who were sexually harassed or assaulted while serving attempt suicide or intentionally harm themselves at more than twice the rate of veterans who were not sexually harassed and/or assaulted (Kimerling et al., 2007).
Results from a large study (n = 7,714) indicate that Black women in the military reported experiencing less overall sexual and gender harassment, crude behavior, and unwanted sexual attention and coercion compared to white women (Buchanan, Settles, & Woods, 2008).
This data was true across the ranks of officer and enlisted service member, however officers, both Black and white, reported fewer incidences of the above, overall. Researchers predict that the high prevalence of sexual assault and rape in the military has to do with the hyper-masculine (associated with control, power, competition, tolerance of pain, mandatory heterosexuality), violent, and aggression-based environment of military; and sociodemographic factors. For example, the US military is composed of fewer women, younger individuals – often directly out of high school, fewer college graduates, and more individuals from lower socioeconomic backgrounds.
Some researchers argue that these factors combined, create an increased risk for individuals to be subjected to, and perpetuate sexual assault, as is evidenced by a large stratified national sample, illustrating that individuals between the ages of 18 and 24 represent 35% of sexual assault victims yet they are only 12% of the national population (Elliot, Mok, & Briere, 2004). Further, 83% to 87% of victims and 40% to 68% of perpetrators in the military are between the ages of 17 to 24 (DoD, 2004).
V. Marriage and Divorce
Hogan and Seifert (2010) found that individuals with a history of military service were three times more likely to be married compared to non-military civilians from the same age cohort, but also that among those who had married, they were much more likely to be divorced when compared to individuals who had never served on active duty. They found that military women are more likely to get divorced than non-military women. Further, veterans had higher divorce rates and were more likely to become divorced, compared to non-veterans (Hogan and Seifert,2010).
The authors used a sample of 25,329 individual veterans, out of which 1,778 (7%) were divorced. The authors predict that the military’s compensation and benefits system is an incentive for personnel to marry early yet may result in a higher percentage of failed or unsuccessful marriages (Hogan and Seifert, 2010).
Kelty, Kleykamp, and Segal (2010) found that divorce rates were significantly higher for enlisted women. They did not specify whether both spouses were enlisted, however they concluded that “starting and maintaining a marriage appears to be most challenging for military women” (p. 191). The authors attribute the dissolution of unions to early marriages, financial stress, spouse unemployment, inaccessibility to services, separation from social support networks, frequent relocations, and risk of death and injury.
Because the majority of couples in the military marry earlier, on average, than civilians, they also tend to have their first child earlier. This is true especially for women in the military. However, when both spouses are service members, they are less likely to have children compared to couples in which only one spouse is a service member (Kelty, Kleykamp, & Segal,
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2010). Among all active-duty women and men, 44% have dependent children, and they are disaggregated in the following manner: 53% and 52% of Black men and women have children, respectively; 44% and 33% of white men and women have children, respectively; and 42% and 34% of Hispanic men and women have children, respectively (Kelty, Kleykamp, & Segal, 2010).
The authors claim that friendly family policies within the military do not end with promoting marriage, rather, the military has many institutional systems in place that facilitate a conducive environment for young children, such as free medical care, housing policies based on family size, good schools, organized youth and sports programs, affordable childcare, and support for single-parents. These marriage- and child-friendly practices could be part of a long-term recruitment plan, as it has been shown that children with at least one parent in the military are more likely to join as well (Kleykamp, 2006). Military spouses, who work in other domains, have lower employment rates and wages compared to non-military spouses (Kleykamp, 2006).
VI. Pregnancy and Abortion
Unintended pregnancies are a concern for the military, because major losses are incurred when new recruits become pregnant and therefore non-deployable (Ponder & Nothnagle, 2010).
Approximately 10% of active duty service members become pregnant every year. The authors (Ponder & Nothnagle, 2010), attribute age as being the factor most likely to contribute to unintended pregnancies in the military, as the majority of women are between ages 18 to 24.
Contraceptive use dropped sharply among deployed women compared to non-deployed women. While healthcare is provided to service members, women may not have comprehensive reproductive health services and contraceptive options, especially during deployment (Ponder & Nothnagle, 2010). Physicians in military hospitals are legally prohibited from performing abortions and women in the military must therefore go off-base to seek an abortion, unless a woman becomes pregnant via rape or incest or if her life is at risk if she carries the fetus to term. One study among active service women found that 60% of the pregnancies were unplanned and contraceptive failure accounted for 35% of all pregnancies (Biggs et al., 2009).
References
Benedict, H. (2009). The lonely soldier: The private war of women serving in Iraq. Boston: Beacon Press.
Biggs, R.L., Douglas, B.H., Boyle, A.L., & Rieg, T.S. (2009). The impact of pregnancy on the individual and military organization: A postpartum active duty survey. Military Medicine,
(1), 61-75.
Buchanan, N.T., Settles, I.H., & Woods, K.C. (2008). Comparing sexual harassment subtypes among black and white women by military rank: Double jeopardy, the jezebel, and the cult of true womanhood. Psychology of Women Quarterly, 32(4), 347-361.
Department of Defense (DoD). (2004). Task force report on care for victims of sexual assault. Washington, DC: Author.
Department of Defense (DoD). (2009). Report on the White House Council on women and girls. Washington, DC: Author.
Elliot, D.M., Mok, D.S., & Briere, J. (2004). Adult sexual assault: Prevalence, symptomatology, and sex differences in the general population. Journal of Traumatic Stress, 17, 203-211.
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Gamache, G., Rosenheck, R., & Tessler, R. (2003). Overrepresentation of women Veterans among homeless women. American Journal of Public Health, 93(7), 1132-1136.
Hogan, P.F., & Seifert, R.F. (2010). Those who serve marry earlier and divorce earlier. Armed (3), 420-438.
Kelty, R., Kleykamp, M., & Segal, D.R. (2010). The military and the transition to adulthood. The (1), 181-207.
Kimerling, R., Gima, K., Smith, M.W., Street, A., & Frayne, S. (2007). The Veterans Health Administration and military sexual trauma. American Journal of Public Health, 97(12),2160-2166.
Kleykamp, M. (2006). College, jobs, or the military? Enlistment during a time of war. Social (2), 272-290.
Meehan, S.M. (2006). Improving health care for women veterans. Journal of General Internal , S1-S2.
Ponder, K.L., & Nothnagle, M. (2010). Damage control: Unintended pregnancy in the United States military. The Journal of Law, Medicine & Ethics, 38(2), 386-395.
Reinke, S.J., & Miller, R.D. (2010). Women in the US military. In M.J. D’Agostino & H. Levine (Eds.), Women in public administration, Theory and practice (pp. 211-333). Sudbury, MA: Jones & Bartlett Learning.
Street, A.E., Vogt, D., & Dutra, L. (2009). A new generation of women veterans: Stressors faced by women deployed to Iraq and Afghanistan. Clinical Psychology Review, 29(8), 685- 694.
Suris, A., Lind, L., Kashner, M., Borman, P.D., & Petty, F. (2004). Sexual assault in women veterans: An examination of PTSD risk, health care utilization, and cost of car. Psychometric Medicine, 66(5), 749-756.
Turchik, J.A., & Wilson, S.M. (2010). Sexual assault in the U.S. military: A review of the literature and recommendations for the future. Aggression and Violent Behavior, 15(4), 267-277.
Washington, D.L., Yano, E.M., McGuire, J., Hines, V., Lee, M., & Geldberg, L. (2010).
Risk factors for homelessness among women veterans. Journal of Health Care (1), 81-91.
Yano, E.M., Goldzweig, C., Canelo, I., & Washington, D.L. (2006). Diffusion of innovation in women’s health care delivery: The Department of Veterans Affairs’ adoption of women’s health clinics. Women’s Health Issues, 16(5), 226-235.
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Columbia University School of Social Work
The 2011 CAPSTONE PROJECT: Critical Multi-systems Analysis
The Lonely Soldier by Helen Benedict (2009)
The stories of returning military women provide the basis of this year’s Capstone Project. All of the narratives in the book provide important contextual and additional information to advance understanding of the experience of soldiers in the military before, during and after active duty in war zones in Iraq and Afghanistan.
You are asked to bring your specific and integrated knowledge and skills to bear as you consider the lives and experiences of military women from the macro, mezzo, and micro perspectives to answer the questions that follow.
Remember that the three systems levels (macro, mezzo and micro) are constant, interactional, and fluid. : You have read The Lonely Soldier (Benedict, 2009) and are asked to focus on all of the stories of these soldiers and others you have researched. As you approach the challenges from all system levels please consider the general state of services for members of the military and veterans, the Veterans Administration (VA), relevant policies, etc, and the experiences of returning military, Apply your considerations to each of the three system levels below to demonstrate your method-specific and cross-systems analytical skills.
Before you start, please use the following as the framework guiding your analysis for all of the three systems:
Consider a returning soldier as an individual in her or his many roles. Understand the power and authority structure within the military (as part of the culture) and the impact this structure can have on the lives of service members and their families. Policymaking and implementation can be heavily impacted by the intersectionality of various diversity factors (e.g., in-rank structure [hierarchy], military occupational specialty statuses, racial status, class gender, service cultures and practices “family” composition and definition, sexual orientation, age, disability, life stage, culture and ethnicity, spirituality, and citizenship status).
Expectations:
1. Students should research and become aware of major legislation, policies and recent cases addressing sexual assault and discrimination in the military.
2. Students should address issues of the potential macro, mezzo, and micro level barriers to the effectiveness of the current formal and informal systems in dealing with issues facing soldiers.
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3. Bottom-Line: students should get to know the history and current structures of social policies and services, the role of policy in service delivery, and the role of practice in policy development, including relevant congressional, governmental, and oversight committees and groups (e.g., the Office of Management and Budget and the Government Accountability Office); the Uniform Code of Military Justice.
4. Students should be paying attention to:
a) Military culture;
b) Individual, family and community impact, support and services;
c) Preparedness and prevention: How do evidence based practices inform you?;
d) Issues such as developmental stage, gender, race, class, abilities, culture, among others;
e) Training of the health and mental health professionals regarding treatment of PTSD
(post-traumatic stress disorder) and issues specific for women such as MST (military sexual trauma);
f) Services for soldiers and veterans who experience sexual harassment and/or assault;
g) Training for armed service members regarding sexual harassment and related areas;
h) Reporting procedures and resulting process and outcomes;
i) Services for those who abuse;
j) Consequences for soldiers involved in crimes;
k) Consequences for commanders; and
l) Support services and networks for soldiers, women in particular.
System 1: Macro Analysis
Learning Objectives: Students should demonstrate through their posters, discussion points during the poster session, their executive summary and their final group paper, their ability to do the following:
Identify current laws and proposed legislation and policies that affect women in the military and their families. Which policies support military women and their families? What policy and/or legislative changes would better support the women about whom you have read? Please consider and discuss the feasibility of such policy changes, taking into account the level of government, political context, ethical issues and values underlying the policies.
Please use the following three questions to tackle the macro- and policy environment and issues. While you do so, please also explore and relate these issues to the universal declaration of human rights, and include the intersectionality of power in all of returning military person’s primary areas of identity (e.g. gender, race, age, nationality).
1. What are the formal structural issues that frame a female soldier’s experiences during and after her military experience?
2. What broad policies within and outside of the military provide the context to inform a returning military woman’s narrative?
3. Examine and discuss how the military culture shapes perception and treats women (e.g., physical strength, capacity, attitudes toward women).
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Then, please use the following questions to guide your analysis, having identified the formal structural and policy contexts that are relevant to returning female soldiers’ experiences.
1. What structural and policy issues can be addressed and how? Please identify and discuss at least three policies that you deem the most important to address.
2. How do all of these structural issues support or challenge the core values of the social work profession?
3. Please discuss how the policies you selected institutionalize support and/or challenges for members of the military given their multiple social identities.
4. What policy-level interventions (these could be current or proposed) may address some of the challenges you have identified especially during and after one’s military service?
Please discuss the feasibility of these policy-level interventions.
System 2: Mezzo Analysis
Learning Objectives: Students should demonstrate through their posters, discussion points during the poster session, the executive summary and the final group paper, their ability to do the following:
Consider the impact of the organizational structure on the military community. Describe and evaluate current services for military personnel and their families over the span of their military career (recruitment, active duty, discharge and post-discharge). Conduct an organizational analysis identifying procedures and processes (VA and others) that support and/or create barriers to military personnel and their communities. Identify and understand how the organization’s formal and informal systems impact women’s position and experience in military services.
What role does the Veterans Administration play in former military personnel’s experiences, particularly for women? Which Veterans Administration services might be helpful and which might need some reconstruction? (e.g. entitlements and benefits, health services, reporting methods). For those that need reconstruction, describe how you would reconstruct and discuss the feasibility of your proposed changes.
1. Describe and discuss human resources staffing and procedures and their alignment with employment law as it applies to the military.
2. Based on the narratives of the women in The Lonely Soldier, and on current events, discuss sexual assault and rape within the military. Focus on the organizational policies and responses that apply.
3. Discuss community and organizational level supports available to military personnel as they re-enter their communities. Are these supports sufficient or do you identify additional unmet needs? Briefly discuss how you identified both supports and needs. Describe several methods to meet these needs that are grounded in existing supports. Include the roles of military and civilian organizations in your discussion.
System 3: Micro Analysis
Learning Objectives: Students should demonstrate through their posters, discussion points during the poster session, the executive summary and the final group paper, their ability to do the following:
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Discuss how you would approach conducting a clinical formulation of a returning female soldier or veteran taking into account her development, culture, strengths, challenges and coping capacities and skills. You must integrate multiple contextual variables as they affect their lives.
1. Choose several assessment tools you would use to deepen your knowledge and understanding of a returning female soldier or veteran, her family and community(ies) to conduct an assets and risk assessment.
2. Identify three theoretical frameworks you would use to guide your understanding of the returning soldier or veteran, her family and community(ies).
3. Address relational aspects of engagement, potential challenging and facilitating process elements that one anticipates could affect the development of a helping relationship. How might these relational aspects affect the assessment, intervention, monitoring and termination phases of your clinical work? Emphasize attention to your professional use of self in the therapeutic relationship, particularly focusing on issues of cross-cultural work.
4. Describe biological, psychological, social and spiritual manifestations of exposure to violence, war, personal assault and rape, and other traumatic events?
5. Discuss treatment recommendations, rationale, and direction of interventions. Identify evidence based assessment tools and interventions that one considered in an evidence based search to direct and inform the recommendations.
Please consider the following as a starting point from which your teams will build to further understand the context and develop your analyses.
I. General Statistics
Women are prohibited to the assignment of any unit below brigade level whose primary mission is to engage in direct ground combat. Women are excluded from direct ground combat yet they are still exposed to combat action such as defending themselves and their units from attack.
Combat exclusion is the major barrier to career advancement (DoD, 2009; Reinke & Miller, 2010).
Department of Defense Statistics:
92% of specialties are open to women
198,000 women are in the military as of the most current assessment conducted in 2007, comprising 14.25% of the 1.38 million total US military personnel.
Women have served in the US military since the Revolutionary War (Reinke & Miller, 2010).
Over 200,000 women, making up 13.5%, are on active duty and over 260,000 women are in the National Guard and Reserves, comprising 17% (Reinke & Miller, 2010).
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Women in the military face many challenges, however, they often manifest in one or more of the following three ways: professional opportunity, sexual harassment and assault, and family issues (Reinke & Miller, 2010).
Despite women being prohibited from direct combat, 634 women have been wounded and 121 have been killed while deployed in Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom (Street, Vogt, & Dutra, 2009).
II. Homelessness
Approximately 2.3 to 3.5 million people are homeless in a given year and 26% of the homeless population is comprised of veterans. Women veterans are three to four times more likely to become homeless compared to their non-veteran counterparts, and this ratio has been steadily increasing since the US invaded Iraq and Afghanistan (Gamache, Rosenheck, & Tessler, 2003; Street, Vogt, & Dutra, 2009). However, homeless veteran women face the same issues as nonveteran women regarding concerns around privacy, gender-related care, treatment for physical and sexual trauma, housing support, and care for children (Washington et al., 2010).
The findings from one study conducted with homeless veteran women in Los Angeles County show that of those who had been homeless after serving in the military, they had an average of four entries and exits into and out of homelessness, and each period of homelessness was about 2.1 years, with 1 year between periods. Many of the women in the study had children under age 18. Homeless veteran women are more likely to be either low-income or unemployed, disabled, and to have diagnosed medical and psychological conditions including PTSD (Washington et al., 2010).
Homeless veteran women are less likely to be college graduates, employed, married, have health insurance, and are less likely to utilize mental health services and VA healthcare. It is important to note that all of these risk factors were greater for veteran women of color (Washington et al., 2010).
III. Health Related Issues and Healthcare
Only 5-7% of veteran women – of the total veteran population – use VA healthcare services (Meehan, 2006; Yano, Goldzweig, Canelo, & Washington, 2006). However, rates of PTSD and military sexual trauma have increased among veteran women since the beginning of the US invasion of Iraq (Yano, Goldzweig, Canelo, & Washington, 2006). Female veterans are twice as likely as male veterans to be diagnosed with PTSD (Street, Vogt, & Dutra, 2009).
Women in the military report lower levels of social support and a lack of positive interpersonal relationships compared to their male counterparts. Socially supportive relationships among military personnel have been identified as a major resilience factor for stressors, in general and combat exposure, in particular (Street, Vogt, & Dutra, 2009).
Given that women service members are systematically ostracized, targeted for harassment, and discriminated against, they have very little to no support from their peers, especially since women may often be the only one of their gender in a particular unit (Street, Vogt, & Dutra, 2009).
The authors suggest that for women, a lack of support from their comrades may exacerbate war zone stressors. Some estimates indicate that between 9.5% to 33% of women report experiencing attempted or completed rape while serving in the military (DoD, 2009)
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Of all veteran women seeking help with PTSD, since and including the war in Vietnam, 71% reported that they were sexually assaulted or raped while serving (Benedict, 2009)
Regarding sexual harassment, 22%-84% of women report being sexually harassed during military service (Turchik & Wilson, 2010; Kelty, Kleykamp, & Segal, 2010)
Within one year, 9% of military women reported experiencing some form of sexual coercion, 31% reported experiencing some form of unwanted sexual attention, and 52% reported offensive sexual behaviors from men (Street, Vogt, & Dutra, 2009). The same authors emphasize that sexual trauma experienced in the context of a combat operation or a war zone, are more likely to have an elevated effect of threat and harm, resulting in increased risk for negative mental health functioning. Female military personnel also experience gender harassment, which are gender-based degradations, and women in the military are subjected to this type of harassment more than any other type (Street, Vogt, & Dutra, 2009).
Department of Defense (DoD) studies are not disaggregated by service, war, or other characteristics. Most of the studies concentrate on women as victims/survivors and men as perpetrators; and very few studies have examined men as victims. However, recent studies highlight that the total number of female and male survivors of military sexual assault is equal (Turchik & Wilson, 2010).
A DoD study found that rates of sexual harassment against women were highest in the Marine Corps and lowest in the Air Force, and reported incidence of sexual assault were highest in the Army in 2007, compared to the Marines, Air Force, and Navy (Turchik & Wilson, 2010).
DoD published data are typically underestimates, compared to what is reported by survivors, and what actually occurs. Such gaps in reporting, both on behalf of victims/survivors and also on behalf of those publishing the statistics, are not exclusive to the military, rather, these gaps exist within all sectors of society regarding sexual assault and rape (Turchik & Wilson, 2010).
Veteran women who experienced sexual assault while serving in the military are more likely to have increased rates of depression, alcohol use, and are nine times more likely to have PTSD (Turchik & Wilson, 2010).
These women are less likely to be employed, they feel negatively about their military service, have a harder time adjusting to civilian life, and have increased rates of psychological and substance abuse problems when compared to female veterans who were not sexually assaulted (Turchik & Wilson, 2010).
The Veterans Health Administration states that for veteran women who reported experiencing sexual trauma while serving presented with PTSD, and dissociative, anxiety, alcohol, eating, and personality disorders (Kelty, Kleykamp, & Segal, 2010). Moreover, women in the military who survive sexual assault or rape while serving are five times as likely to develop PTSD compared to civilian women who are sexually assaulted and/or raped (Suris et al., 2004). Veterans (both women and men) who were sexually harassed or assaulted while serving attempt suicide or intentionally harm themselves at more than twice the rate of veterans who were not sexually harassed and/or assaulted (Kimerling et al., 2007).
Results from a large study (n = 7,714) indicate that Black women in the military reported experiencing less overall sexual and gender harassment, crude behavior, and unwanted sexual attention and coercion compared to white women (Buchanan, Settles, & Woods, 2008). This data was true across the ranks of officer and enlisted service member, however officers, both Black and white, reported fewer incidences of the above, overall.
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Researchers predict that the high prevalence of sexual assault and rape in the military has to do with the hyper-masculine (associated with control, power, competition, tolerance of pain, mandatory heterosexuality), violent, and aggression-based environment of military; and socio demographic factors. For example, the US military is composed of fewer women, younger individuals – often directly out of high school, fewer college graduates, and more individuals from lower socioeconomic backgrounds.
Some researchers argue that these factors combined, create an increased risk for individuals to be subjected to, and perpetuate sexual assault, as is evidenced by a large stratified national sample, illustrating that individuals between the ages of 18 and 24 represent 35% of sexual assault victims yet they are only 12% of the national population (Elliot, Mok, & Briere, 2004). Further, 83% to 87% of victims and 40% to 68% of perpetrators in the military are between the ages of 17 to 24 (DoD, 2004).
V. Marriage and Divorce
Hogan and Seifert (2010) found that individuals with a history of military service were three times more likely to be married compared to non-military civilians from the same age cohort, but also that among those who had married, they were much more likely to be divorced when compared to individuals who had never served on active duty. They found that military women are more likely to get divorced than non-military women. Further, veterans had higher divorce rates and were more likely to become divorced, compared to non-veterans (Hogan and Seifert,
2010). The authors used a sample of 25,329 individual veterans, out of which 1,778 (7%) were divorced. The authors predict that the military’s compensation and benefits system is an incentive for personnel to marry early yet may result in a higher percentage of failed or unsuccessful marriages (Hogan and Seifert, 2010).
Kelty, Kleykamp, and Segal (2010) found that divorce rates were significantly higher for enlisted women. They did not specify whether both spouses were enlisted, however they concluded that “starting and maintaining a marriage appears to be most challenging for military women” (p. 191). The authors attribute the dissolution of unions to early marriages, financial stress, spouse unemployment, inaccessibility to services, separation from social support networks, frequent relocations, and risk of death and injury.
Because the majority of couples in the military marry earlier, on average, than civilians, they also tend to have their first child earlier. This is true especially for women in the military. However, when both spouses are service members, they are less likely to have children compared to couples in which only one spouse is a service member (Kelty, Kleykamp, & Segal, 2010).
Among all active-duty women and men, 44% have dependent children, and they are disaggregated in the following manner: 53% and 52% of Black men and women have children, respectively; 44% and 33% of white men and women have children, respectively; and 42% and 34% of Hispanic men and women have children, respectively (Kelty, Kleykamp, & Segal, 2010).
The authors claim that friendly family policies within the military do not end with promoting marriage, rather, the military has many institutional systems in place that facilitate a conducive environment for young children, such as free medical care, housing policies based on family size, good schools, organized youth and sports programs, affordable childcare, and support for single-parents. These marriage- and child-friendly practices could be part of a long-term recruitment plan, as it has been shown that children with at least one parent in the military are more likely to join as well (Kleykamp, 2006).
Military spouses, who work in other domains, have lower employment rates and wages compared to non-military spouses (Kleykamp, 2006).
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VI. Pregnancy and Abortion
Unintended pregnancies are a concern for the military, because major losses are incurred when new recruits become pregnant and therefore non-deployable (Ponder & Nothnagle, 2010).
Approximately 10% of active duty service members become pregnant every year. The authors(Ponder & Nothnagle, 2010), attribute age as being the factor most likely to contribute to unintended pregnancies in the military, as the majority of women are between ages 18 to 24. Contraceptive use dropped sharply among deployed women compared to non-deployed women. While healthcare is provided to service members, women may not have comprehensive reproductive health services and contraceptive options, especially during deployment (Ponder & Nothnagle, 2010).
Physicians in military hospitals are legally prohibited from performing abortions and women in the military must therefore go off-base to seek an abortion, unless a woman becomes pregnant via rape or incest or if her life is at risk if she carries the fetus to term. One study among active service women found that 60% of the pregnancies were unplanned and contraceptive failure accounted for 35% of all pregnancies (Biggs et al., 2009).
References
Benedict, H. (2009). The lonely soldier: The private war of women serving in Iraq. Boston: Beacon Press.
Biggs, R.L., Douglas, B.H., Boyle, A.L., & Rieg, T.S. (2009). The impact of pregnancy on the individual and military organization: A postpartum active duty survey. Military Medicine, (1), 61-75.
Buchanan, N.T., Settles, I.H., & Woods, K.C. (2008). Comparing sexual harassment subtypes among black and white women by military rank: Double jeopardy, the jezebel, and the cult of true womanhood. Psychology of Women Quarterly, 32(4), 347-361.
Elliot, D.M., Mok, D.S., & Briere, J. (2004). Adult sexual assault: Prevalence, symptomatology, and sex differences in the general population. Journal of Traumatic Stress, 17, 203-211.
Gamache, G., Rosenheck, R., & Tessler, R. (2003). Overrepresentation of women Veterans among homeless women. American Journal of Public Health, 93(7), 1132-1136.
Hogan, P.F., & Seifert, R.F. (2010). Those who serve marry earlier and divorce earlier. Armed (3), 420-438.
Kelty, R., Kleykamp, M., & Segal, D.R. (2010). The military and the transition to adulthood. The (1), 181-207.
Kimerling, R., Gima, K., Smith, M.W., Street, A., & Frayne, S. (2007). The Veterans Health Administration and military sexual trauma. American Journal of Public Health, 97(12), 2160-2166.
Kleykamp, M. (2006). College, jobs, or the military? Enlistment during a time of war. Social (2), 272-290.
Meehan, S.M. (2006). Improving health care for women veterans. Journal of General Internal , S1-S2.
Ponder, K.L., & Nothnagle, M. (2010). Damage control: Unintended pregnancy in the United States military. The Journal of Law, Medicine & Ethics, 38(2), 386-395.
Reinke, S.J., & Miller, R.D. (2010). Women in the US military. In M.J. D’Agostino & H. Levine (Eds.), Women in public administration, Theory and practice (pp. 211-333). Sudbury, MA: Jones & Bartlett Learning.
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Street, A.E., Vogt, D., & Dutra, L. (2009). A new generation of women veterans: Stressors faced by women deployed to Iraq and Afghanistan. Clinical Psychology Review, 29(8), 685- 694.
Suris, A., Lind, L., Kashner, M., Borman, P.D., & Petty, F. (2004). Sexual assault in women veterans: An examination of PTSD risk, health care utilization, and cost of car. Psychometric Medicine, 66(5), 749-756.
Turchik, J.A., & Wilson, S.M. (2010). Sexual assault in the U.S. military: A review of the literature and recommendations for the future. Aggression and Violent Behavior, 15(4), 267-277.
U.S. Department of Defense (DoD). (2004). Task force report on care for victims of sexual assault. Washington, DC: Author.
U.S. Department of Defense (DoD). (2009). Report on the White House Council on women and girls. Washington, DC: Author.
Washington, D.L., Yano, E.M., McGuire, J., Hines, V., Lee, M., & Geldberg, L. (2010).
Risk factors for homelessness among women veterans. Journal of Health Care (1), 81-91.
Yano, E.M., Goldzweig, C., Canelo, I., & Washington, D.L. (2006). Diffusion of innovation in women’s health care delivery: The Department of Veterans Affairs’ adoption of women’s health clinics. Women’s Health Issues, 16(5), 226-235.
for the Poor and Underserved, 21 Medicine, 21 Science Quarterly, 87 Future of Children, 20 Forces & Society, 36 174
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Background and context of the women in the military:
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The Capstone Project
Three Critical Systems Analyses
for the Poor and Underserved, 21
Medicine, 21
Science Quarterly, 87
Future of Children, 20
Forces & Society, 36
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Additional Materials for Consultation
Background and context of the women in the military:
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The Analysis Framework for the Capstone Project Case
Three Critical Systems Analysis