Current Issues in Practice Veteran Family Reintegration : Strategic Insights to Inform Stakeholders ’ Efforts

In 2015, the Department of Veterans Affairs Office of Policy and Planning convened the first of its kind forum to inform stakeholders about national policy needs to advance the outcomes for veterans and their families as they reintegrate back to civilian life after military service. This article reports of the proceedings of the forum, which brought together more than 30 participants from across the federal government, private sector, nongovernmental organizations, and academic institutions. During the forum, participants discussed the need for a conceptual framework and standard lexicon to support veteran family reintegration policy and strategy. Forum participants highlighted the importance of a collaborative relationship between researchers and policy makers, and identified research gaps and emerging topics that will help inform national reintegration outcomes.

Every year, hundreds of thousands of service members and their families leave the military and begin the process of permanently reintegrating back into their civilian communities.The Department of Defense forecasts that the rate of separations from active duty will result in over 1 million new veterans over the next 5 years (Chairman's Office of Reintegration, 2014).For many veterans and their families, reintegration is a complex, multifaceted process that involves finding a "new normal" in the realm of family relationships, wellness, and economic stability.
The fluctuating nature, frequency, and intensity of military conflicts coupled with an everchanging American society have presented incomparable challenges and complexities for both the veteran family and the community during the reintegration process.This complexity continues for veterans who have served since the attacks of September 11, 2001, many of whom experienced combat in Iraq and Afghanistan.Research conducted by the Department of Veterans Affairs (VA) estimates that about half of all Iraq and Afghanistan veterans perceive some difficulty in their own reintegration (Sayer et al., 2015).Post-9/11 veterans are more likely to experience head or neck trauma (30 percent) than those who served in Vietnam (16 percent) or World War II (21 percent) (Owens et al., 2008).Furthermore, while veteran unemployment is lower than non-veterans, more than half of all post-9/11 veterans will experience a period of unemployment upon separation from the military, often compounding the reintegration process (Bureau of Labor Statistics, 2016;Department of Veterans Affairs, 2015a).
What has not fluctuated, however, is our nation's resolve and determination to support veterans and their families as they reintegrate back into our communities.As the Civil War came to a close in 1865, Abraham Lincoln charged that we would "care for those who shall have borne the battle and for his widow, and his orphan."Nearly 100 years later in the wake of World War II and Korea, General Omar Bradley's Commission of Veterans Pensions affirmed that our main obligation is to ensure the successful reintegration of veterans into civilian life (President's Commission on Veterans ' Pensions, 1956).This commitment continues today.Practitioners and academics have worked to affirm this commitment to veterans and their families by developing programs and research to (a) reduce veteran homelessness; (b) advance education by implementing and evaluating the Post-9/11 GI Bill; (c) partner on veteran hiring initiatives; and (d) identify opportunities to better connect veterans to their local communities (Johnston & Angell, 2013;McDonald, Jin, Camilleri, & Reitano, forthcoming).Despite these efforts, the individual nature of each veteran family's reintegration presents significant challenges for policy makers.We found that ongoing research and analysis is generally confined to specific areas, such as health care, employment, disability, or education.Furthermore, there are currently limited theories in the literature to support a multidisciplinary framework regarding the full cycle of the reintegration process or how these areas interrelate.This can present challenges for policy makers, service providers, and stakeholders to develop, agree on, and ultimately fund complementary strategies that enable holistic outcomes for veterans and families.Moreover, the family unit has often been overlooked in the literature as key parties that both support the veteran and experience the reintegration journey themselves.
VA's Office of Policy and Planning (OPP) recognizes that concentrated efforts are needed to advance the connection between multidisciplinary research and interdisciplinary policy analysis in order to inform policies which support positive reintegration outcomes for veterans and families.To this end, OPP has developed a policy research agenda which identifies veteran family reintegration as a priority research area (Office of Policy and Planning, 2015a).In June 2015, OPP convened a day-long forum in Arlington, VA with the purpose of informing stakeholders of policy needs in order to advance the outcomes for veterans and their families as they reintegrate back to civilian life after military service.Government experts from VA and other federal agencies, such as the Departments of Defense and Labor, were joined by experts from other government and non-government organizations.Participants were asked to leverage their practitioner experiences and academic research knowledge in order to explore key challenges facing veterans and families during reintegration, and to consider desired scenarios that address the key challenges from a broader conceptual perspective.This article summarizes the proceedings of OPP's forum on veteran family reintegration and incorporates information from practitioners and researchers, a review of current literature, and OPP's ongoing veteran policy and research initiatives.More specifically, this article (1) explores the need for a conceptual framework and standardization in understanding of the reintegration process; (2) discusses the importance of stakeholder awareness through an understanding of programs, services, and partnerships involved in veteran family reintegration; and (3) identifies data gaps and understudied areas critical to further understanding veteran family reintegration.

Participants
OPP hosted the forum and invited the Department of Defense's Office of Military Community and Family Policy as an honorary co-host.Forum participants included individuals with a range of backgrounds, experiences, and knowledge.They were either involved in current veteran family reintegration efforts, and/or were experts who could address related policy and research areas.Attendees represented the organizations are identified in table 1.

Framework for Veteran Family Reintegration
Castro and Kintzle (2014) postulate that military transition, or the progression through which service members transition out of the military, occurs in three overlapping phases: (1) approaching the military transition, (2) managing the transition, and (3) assessing the transition.Forum participants did not come to a consensus on the definition of veteran family reintegration.Participants tended to define the process in a way that was most applicable to their organizations' specific programs and initiatives, and while certain aspects such as wellbeing, employment, and education were commonly cited as important to the reintegration process, the importance of these aspects were weighed differently based on the area of expertise of each practitioner or expert.Nevertheless, forum participants agreed that veteran family reintegration, in its broadest sense, is a process by which a service member and his or her family leave the military for civilian life.As the forum progressed, participants also agreed that the reintegration process to civilian life for veterans and families begins well before the service member leaves the military and continues until well after the service member becomes a veteran.
While forum participants did not attempt to define a framework for veteran family reintegration or identify parameters of such a framework, many participants agreed that a conceptual framework is an important first step for researchers and policy makers to analyze and develop an understanding of what key events have major implications on reintegration outcomes and when they occur.Some participants also stated that that the potential aspects which could be incorporated into such a framework for veteran family reintegration are multifaceted and unique to each veteran family.This sentiment is echoed by other gatherings of experts who have concluded that there is no "gold standard" of elements of life which could be incorporated into the assessment of reintegration that is applicable to all persons (Resnik et al., 2012).Furthermore, many participants stated that a framework would need to be applicable to the needs of both the veteran and the veteran's family.
The forum also highlighted the difficulties presented by inconsistent language and conflicting understanding of key terms in establishing broad strategies to support successful veteran family reintegration.When describing the concept of leaving the military for civilian life, participants oftentimes used "reintegration" or "transition" interchangeably.Participants confirmed that the terms are often confused or used interchangeably in program implementation.When looking at certain government and nongovernment reintegration programs, the context of reintegration can refer to either post-deployment reintegration or permanently leaving the military.For example, Currie, Day, and Kelloway (2011) define reintegration as a post-deployment transition.
The Defense Centers of Excellence ( 2015) defines periods of transition as being many things, such as a change in status, relocation, or the permanent return to civilian life.These different processes may present service members, veterans, and their families with different challenges.
Post-deployment reintegration may present challenges towards reintegrating the service member back into the family unit, whereas permanent reintegration into the civilian community may present different challenges to the family unit, such as changes to the family's financial status (Doyle & Peterson, 2005;Sayers, 2011;Government Accountability Office, 2014).Furthermore, a review of the United States Code and Code of Federal Regulations finds no common legislative language that defines "veteran reintegration" or which governs all federal veteran reintegration support programs and strategies across multiple agencies.
Because the forum focused on veteran family reintegration, some participants also highlighted the changing understanding of what defines the veteran family.Participants stated that the veteran family is no longer limited to the veteran with an opposite-sex spouse and dependent children.Participants generally agreed that the definition should be broad and allow for any definition of family, as defined by the veteran and those closest to him or her.For example, participants stated that the veteran family can include caregivers, children, parents, partners, and siblings, because each plays an important role in the veteran family and can also be affected by reintegration themselves.The VA is already taking some efforts to recognize this changing definition of the veteran family.For example, the Secretary of Veterans Affairs has started socializing the subtle change in the language of VA's mission, which is based on Abraham Lincoln's "to care for him who shall have borne the battle, and his widow, and his orphan."VA (2014b), in Secretary Robert McDonald's core values message, states that VA's mission is "to care for those who shall have borne the battle and their dependents, and their survivors."Furthermore, in response to recent Supreme Court decisions regarding Fourteenth Amendment protections for same-sex marriage recognition, VA now recognizes all same-sex marriages without regard to a veteran's state of residence (Department of Veterans Affairs, 2015b).
With more than 218,000 service members projected to leave active duty military service in fiscal year 2015 alone, forum participants agreed that there is an urgent need for practitioners and researchers to have an understanding of a framework for reintegration, which should include a standardized lexicon surrounding veteran family reintegration (Office of the Assistant Secretary of Defense for Readiness and Force Management, 2014).Furthermore, an increased dialogue between researchers, practitioners, and policy makers within the context of a conceptual framework and standard lexicon was said to be required in order to ensure that stakeholders are able to broadly align their efforts in order to best understand and improve veteran family reintegration outcomes for each individual case.

Inventory of Programs, Services, and Partnerships
Forum participants represented the broad array of reintegration programs available for veterans and their families in government and non-government sectors.OPP ensured that a wide representation of VA offices dedicated to veteran family reintegration participated in the forum.For example, staff and leadership from VA's Veterans Health Administration, Veterans Benefits Administration, National Cemeteries Administration, and Voluntary Service Office attended the event.Further, government and non-government stakeholders with unique perspectives on women veterans, military and veteran families, and other veterans' needs were also invited to ensure a diverse representation of thought.Many participants had pre-existing relationships and were already working to develop or sustain partnerships around specific veterans' issues.For example, VA cooperates with the Departments of Defense and Labor, as well as the military services and Small Business Administration, to implement transition assistance programs (Veterans Benefits Administration, 2013).Despite the prominence and experiences of attendees, however, participants were not positioned to be aware of every possible program or service already supporting veterans and their families.In fact, many times throughout the day, a participant would highlight the need to develop a certain program only to be informed by another participant that such a program already existed.
Participants noted that this lack of complete awareness may be the result of the sheer number and scope of military and veteran-focused organizations, programs, and services.Some participants stated that this makes it a challenge to be fully aware of the entire spectrum of programs, services, and partnerships available for veterans and their families.Other participants stated that this is representative of a strong community of concern.However, still others noted that this uncharted and overwhelming community of concern can lead to reintegration programs and initiatives being disjointed or compartmentalized.According to the National Center for Charitable Statistics (2015), there were more than 41,000 registered nonprofit organizations alone serving the military and veterans.Furthermore, federal, state, and local governments, as well as academic institutions, local communities, and private citizens also provide a wide array of programs and services to veterans and their families (Mendieta & McDonald, 2013).As a result, even the most seasoned advocates participating in the forum did not know about all of the available reintegration programs and services for veterans and their families.This may present difficulties for veterans and their families as well (Carter & Kidder, 2013).

Data Gaps on the Veteran Family
Throughout the forum, many participants cited available data sets on military families, such as those found in the Department of Defense's Military Family Life Project's Active Duty Spouse Study and annual Support to Military Family Readiness Plans report.However, they noted the lack of available similar data on veterans' families.A few participants stated that this is primarily due to a lack of longitudinal data on veteran families.A forum held by the Department of Defense's Transition to Veterans Program Office (2015) reported similar concerns about longitudinal data gaps.While the Department of Defense and VA have collaborated on some research, such as on post-combat family reintegration, and many universities have established centers that dedicate research towards both the military and veteran family, the literature does not offer many examples of veterans and their families being the subject of research during both pre-and post-separation (Doyle & Peterson, 2005).
As a solution to gaps in longitudinal data, some participants recommended extrapolating information from the available research on military families.Other participants, however, cautioned against this activity to avoid making erroneous conclusions, as the needs and situations of military and veteran families may not be the same.They also highlighted the challenges with obtaining and sharing data across organizations, both government and nongovernment alike.Research being conducted outside of the United States, such as the Life After Service Survey conducted by Veterans Affairs Canada, may provide an example of how researchers can follow service members and their families as they become veteran families (Thompson et al., 2014).As part of the Life After Survey Study series, Veterans Affairs Canada will be conducting a study specifically on the outcomes of families as they transition from military to civilian life.
Through the forum and other veteran policy research and analysis initiatives, VA has found that the veteran family has not yet been the subject of a comparative amount of study and research attention that the military family community has received.For example, a simple internet search using variations of the phrase "veteran family research" results in information sources on military family research.In order to help make the veteran demographic more accessible to researchers and encourage interest in veteran topics, VA has identified some preliminary resources to help guide first-time veteran researchers (Office of Policy and Planning, forthcoming).Furthermore, VA has improved its efforts to make public data easily accessible and usable through the Open Data Initiative (Department of Veterans Affairs, 2014a).However, there is a continued need by government and non-government organizations to collect and share the information needed to support strategic policy, especially on non-healthcare topics such as veteran and families' choices, contemporary challenges, and their concerns.

Emerging Areas of Research
Throughout the day, forum participants cited that while there are data gaps relating to veteran family research, several understudied areas related to veteran families and reintegration are emerging but require additional research for further policy exploration.
Participants commented that service members are provided financial education and protections from predatory lending to mitigate financial instability for the military family, while veterans are not provided the same protections.For example, the Military Lending Act of 2006 provided specific protections for active-duty service members and their families in consumer credit transactions.In 2015, after new legislation and a 3-year study by the Departments of Defense and Treasury, the Federal Trade Commission, and financial regulators, service members and their families are further protected from committing to loans with excessive fees and charges (Cronk, 2015).1However, such legislation does not apply once the service member leaves the military and becomes a veteran.The potential for loss of income and non-transferability of protective measures may result in financial instability for certain veterans and their families, especially during the period of reintegration, where as many as 1 out of every 2 Iraq and Afghanistan veterans face a period of unemployment (Department of Veterans Affairs, 2015a; Government Accountability Office, 2014).
Participants also noted that geographic dispersion and other differences between the active duty and reserve and national guard (R/NG) component creates added challenges, including greater isolation and reduced access to the military community supportive network.This is particularly important as R/NG service members have had an increase in combat deployments over recent decades (Vogt et al., 2008).Given the frequency of mobilization, the experiences of the R/NG service member and their families in dealing with separation, relocation, and reintegration are distinct from their active duty counterparts.A review of literature has found that limited research has been done to look at how these differences post-deployment affect the reintegration outcomes of R/NG service members, especially when confronted with similar combat experiences as their active duty counterparts.
When active duty service members return from combat, they will return to their military bases, which oftentimes have support services available within their own communities.Many reintegration resources are available to R/NG service members when they return home (Defense Centers of Excellence, 2016).However, some participants stated that support to R/NG may not be as readily available and may require additional initiative or effort on the part of the R/NG service member or family, because they may live in communities that are a great distance from the nearest military base.Additional research on R/NG outcomes are required to understand the challenges faced and to evaluate the effectiveness of programs and support offered to R/NG families.

Conclusion
Government and non-government organizations provide resources, support, and services through programs and benefits in order to facilitate successful veteran family reintegration.However, the forum highlighted the need for further research and collaboration to ensure that there is a common understanding of veteran family reintegration.Based on these findings, practitioners and academics can take immediate action by exploring the development of a collective framework for reintegration with input from the community of veteran stakeholders.Such a framework should include a common understanding of the lexicon of definitions, outline broad strategies, and identify potential roles and responsibilities for the federal government and community stakeholders.Furthermore, the veteran family reintegration framework can help serve to identify which of the tens of thousands of military and veteran support programs in the United States today are stakeholders specific to the veteran family reintegration process.
Even with such a framework in place, researchers and policy makers need to take steps to address gaps in data, in particular, surrounding the veteran family.As a first step, VA is implementing veterans policy research and analysis as a process for analyzing issues related to the benefits and services needed for the overall health and wellbeing of veterans, service members, and their families (Office of Policy and Planning, 2015b).Innovative collaboration between researchers and policy makers, such as the veterans research and analysis process, is one example of how this can be achieved.Such collaboration, as exemplified by this forum, has already highlighted the need to focus on data gaps relating to the veteran family and to continue efforts on emerging research topics such as family financial literacy and R/NG reintegration outcomes.In the long-term, practitioners and academics must continue to work collaboratively to drive a more robust, veteran-focused dialogue around the myriad of policy issues affecting the lives of veterans and their families.

Table 1 .
Organizations Participating in the Forum on Veteran Family Reintegration