1. Military Culture for Non-military Therapists Dr. Kate McGraw Psychological Health Clinical Standards of Care Deputy Director Angela Halvorson Healthcare Solutions Division of Advocates for Human Potential Senior Program Associate July 17, 2012

2. 2 “Anything may happen when womanhood has ceased to be a protected occupation.” Virginia Woolf, A Room of One's Own

3. 3  Overview  Context: Women in military history  Military culture  Impact of culture on military female  Scenarios  Discussion/Questions Overview

4. 4 History:  1948: Women’s Armed Services Integration Act  1951: Defense Advisory Committee on Women in the Services  1967: Two percent cap females in service, one line Colonel per Service limits removed by Public Law 90-130  1972: Reserve Officer Training Corps admits females  1973: Flight training open to females in the Navy and Army, and in 1976, the Air Force  1974: Defense Department (DoD) rescinded separation of pregnant females  1976: Military academies admitted females Women in Military History

5. 5  1977: First Air Force Titan missile female crew members  1978: Army Women’s Air Corps abolished, Public Law 95-485  1978: First Navy females reported for sea duty  1980: First DoD sexual harassment policy issued  1985: First female ICBM Minuteman/Peacekeeper missile crews assigned  1988: First male/female ICBM missile crews authorized  1989: Females served in Operation Just Cause  1990: 90,000 females participate in Operation Desert Storm/ Desert Shield; two POWs and five died in action  1992: Combat aircraft and ships open to females Women in Military History

6. 6  2008: First DoD four star General: Dunwoody  2011: Females permitted to serve on submarines  2012: Since 2001, about 280,000 women have deployed to Iraq and Afghanistan; 144 have been killed, and 865 have been wounded  2012: First Air Force female four star general nominated: Janet Wolfenbarger  2012:DoD lifts restrictions on over 14,000 front line positions to females Women in Military History

7. 7 Mental Health Task Force (2007)  The needs of women service members and veterans should remain a focus of high-level planning groups in DoD (with all military services represented) and the Department of Veterans Affairs. The DoD Psychological Health Strategic Plan should include specific attention to the psychological health needs of women. The annual report on the “Status of Female Members of the Armed Forces” should include information about the adequacy of support for psychological health of women.  DoD should develop treatment programs specifically geared toward the psychological health needs of female service members. Collaborative Strategies

8. 8 2010 VA/DoD Integrated Mental Health Strategies Strategic Action #28: Gender; Military Sexual Trauma  Use information from research and the evaluation of clinical and administrative data to explore gender differences in the delivery and effectiveness of mental health services. Use findings to improve the accessibility and quality of care, develop strategies for overcoming health care disparities and barriers to care, and to identify the need for further research.  To support mental health services and research for female service members and veterans, and for those who have experienced military sexual trauma (both men and women) to ensure ongoing surveillance, program evaluation and research, and to identify disparities, specific needs and opportunities for improving both treatment and preventive services. Collaborative Strategies

9. 9  Reality of military family life  Rule bound culture: Uniformed Code Military Justice (UCMJ)  Family impacts career  Living on installation  Frequent moves  Frequent, prolonged deployments/TDY Military Culture

10. 10  Unusual work hours/schedules  Fish bowl effect  Strong social support  Travel and exposure to diversity  Steady employment  Honor and patriotism  Role and responsibility of commander Military Culture

11. 11 Hochschild (1983) Emotions system theory:  Emotion management/work, suppression, and evocation  Feeling rules and affective culture: often at odds with individual experience Schein (1987) Organizational culture:  Basic assumptions: unseen, commonly held beliefs  Values: conscious or espoused beliefs commonly held  Artifacts/creations: Visible manifestations of belief system (ie uniforms, etc.) Impact of Culture on Military Female

12. 12  Duty, honor, country: combat and the masculine warrior image  Comprised mostly of men, shaped by men  Celebration of masculine at the expense of feminine  Affective neutrality: gender perception differs Impact of Culture on Military Female

13. 13 Bean-Mayberry et al. (2010)  Military females are more likely to experience mental health issues compared to their military male counterparts Military females are more likely to experience sexual assault or sexual trauma than military males  True prevalence unknown due to research and survey construct differences  Estimated between 3 and 50% of all military females have reported being victims, however, this number varies based on defined construct  Number of male victims underestimated because of stigma, reported events range from 1.5 to 38% Impact of Culture on Military Female

14. 14 Pryor (1993)  Perception of a commanding officer’s (CO) attitude toward sexual harassment was related to the prevalence of reported sexual harassment among military females  Prevalence higher in the group of females who reported a CO who encouraged sexual harassment than in the group of females who reported a CO who was neutral/indifferent to sexual harassment  Prevalence of sexual harassment higher in the group of females with CO who was neutral/indifferent to sexual harassment, than the group with CO who discouraged sexual harassment Impact of Culture on Military Female

15. 15 Rosen & Martin (1998)  Relationship between negative attitudes toward females and tolerance of sexual harassment Ilies (2003)  Meta-analysis of empirical literature on sexual harassment and workplace  Government, private sector, academic and military  Meta-analysis  Military environment: high power differential across organizational levels  Environment with a putatively higher power differential (military environment): highest rates of sexual harassment  No connection higher power differential and hyper-masculinity Impact of Culture on Military Females

16. 16  One of you is the Secretary of Defense. The rest of you are the subject matter experts advising the Secretary on this matter:  What would you change about the military culture to improve it for females?  What would you keep the same?  How would you implement these changes?  What do you see as your biggest obstacle to success in implementing these changes? Scenario One

17. 17  You are the CEO or president of the current organization that you work for. You’d like to make a change in your culture to empower all minorities, including women, to be successful in your culture.  What are the biggest cultural barriers in you organization?  What changes do you need to make?  How would you being the transformation? Scenario Two

18. 18 "Don't compromise yourself. You are all you've got." Janis Joplin

19. 19  Overview  Context: Women in military history  Military culture  Impact of culture on military female  Scenarios  Discussion/Questions Summary

20. 20 Discussion and Questions

21. Military Culture for Non-military Therapists Dr. Kate McGraw Psychological Health Clinical Standards of Care Deputy Director Angela Halvorson Healthcare Solutions Division of Advocates for Human Potential Senior Program Associate July 17, 2012