Reintegration and Transition Following Active Duty: Identifying the Challenges for Veterans Returning From Deployment in Afghanistan and Iraq

PURPOSE: The purpose of this study was to identify challenges of reintegration that affect veteran transition into civilian life after deployment in order to inform and educate the occupational therapy field on current veteran care.

BACKGROUND: Since 2001, approximately 2.6 million military service members have been deployed overseas to serve in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq (Radomski & Brininger, 2014). According to Sayer et al. (2015), about half of veterans returning from Iraq and Afghanistan experience some difficulty with reintegration. Research indicates these reintegration problems are transitory for some veterans but may not resolve without intervention (Sayer et al., 2015). Many veterans returning from deployment in Afghanistan and Iraq encounter challenges and obstacles that can limit their ability to successfully reintegrate into civilian life, ultimately hindering their performance in occupations. Occupational therapists can work with veterans who demonstrate deficits in activities of daily living, motor performance deficiencies as a result of injury, and occupational and role performance deficits due to impairments in mental health (Doukas & Howard, 2006).

DESIGN AND METHOD: A thematic synthesis was used to draw conclusions based on common themes across heterogeneous studies on reintegration and transition following active duty. The peer-reviewed articles were found on multiple databases, including EBSCOhost, Google Scholar, and JSTOR. Search terms and phrases used on the previously listed databases included the following: military, transition, reintegration, veteran, soldier, challenges, civilian life, PTSD, mental health, adjustment, and occupational therapy. The articles were reviewed and cross-checked by the members of the research team in order to ensure validity of the themes and provide investigator triangulation.

RESULTS: Four themes emerged to explain the 21 codes derived from the literature. The four themes are as follows: diagnosis and trauma (21 articles), dysfunction (14 articles), effects on occupation (17 articles), and support systems (13 articles).

CONCLUSION: Efforts to further identify and investigate barriers to veteran reintegration after deployment need to continue as more veterans return with increasingly complex challenges that hinder their efforts toward successful transition into civilian life. Overall, veterans are in need of more assistance with transitioning than they are currently receiving. Given the results found in this study, occupational therapy evaluation and intervention can have considerable impact on the transition from military to civilian life for veterans.

IMPACT STATEMENT: Occupational therapists must be thoroughly educated on the dynamic veteran population and their unique needs and associated challenges as they transition into civilian life in order to best support reengagement in meaningful occupations.

References

Doukas, W. C., & Howard, W. J., 3rd. (2006). Process of care for battle casualties at Walter Reed Army Medical Center: Part IV. Occupational therapy service. Military Medicine, 171, 209–210. https://doi.org/10.7205/MILMED.171.3.209

Radomski, M. V., & Brininger, T. L. (2014). Occupational therapy for servicemember and veteran recovery, resilience, and reintegration: Opportunities for societal contribution and professional transformation. American Journal of Occupational Therapy, 68, 379–380. https://doi.org/10.5014/ajot.2014.013060

Sayer, N., Orazem, R., Noorbaloochi, S., Gravely, A., Frazier, P., Carlson, K., . . . Oleson, H. (2015). Iraq and Afghanistan war veterans with reintegration problems: Differences by Veterans Affairs healthcare user status. Administration and Policy in Mental Health and Mental Health Services Research, 42, 493–503. https://doi.org/10.1007/s10488-014-0564-2