Exploring the Role of Social Connection in Interventions With Military Veterans Diagnosed With Post-traumatic Stress Disorder: Systematic Narrative Review

Abstract

BackgroundIt has been identified that military veterans have distinct experiences of loneliness and social isolation and, when comparing this community to other client groups with a PTSD diagnosis, veterans respond less favorably to treatment. However, the link between PTSD and loneliness for veterans remains insufficiently researched and it is unclear if there are effective interventions tackling this distinct experience of loneliness.AimsThis systematic narrative review aimed to synthesize existing evidence incorporating elements of social connection, social isolation, and loneliness within interventions for military veterans with a diagnosis of PTSD, consequently aiming to examine the impact of such interventions upon this community.MethodsSix databases were searched, utilizing relevant search criteria, with no date restrictions. Articles were included if they involved intervention or treatment for military veterans with PTSD and considered elements of social connection, social isolation, and/or loneliness. The initial search returned 202 papers. After exclusions, removal of duplications, and a reference/citation search, 28 papers remained and were included in this review.ResultsFrom the 28 studies, 11 directly addressed social isolation and two studies directly addressed loneliness. Six themes were generated: (i) rethinking the diagnosis of PTSD, (ii) holistic interventions, (iii) peer support, (iv) social reintegration, (v) empowerment through purpose and community, and (vi) building trust.ConclusionsA direct focus upon social reintegration and engagement, psychosocial functioning, building trust, peer support, group cohesiveness and empowerment through a sense of purpose and learning new skills may mitigate experiential loneliness and social isolation for veterans with PTSD. Future research and practice should further explore the needs of the PTSD-diagnosed veteran community, seek to explore and identify potential common routes toward the development of PTSD within this community and consider bespoke interventions for tackling loneliness.

Meaning(s) of transition(s) from military to civilian life at the intersection with mental health: implications for clinical settings

“…This has also been recognized as playing an important part of clinical interventions, including both the encouragement to engage in services and also adherence to psycho-social interventions (Chinman et al, 2006 ; Hundt et al, 2015 ). Moreover, in light of emerging evidence (reviewed in Gettings et al, 2022 ) to indicate the need for an integrated system of interventions that encompasses peer support, it is crucial that service provision and development involves input from “experts by experience”.…”

“…However, as one interviewee stated peer interactions should not act to prevent or delay interaction with the community, rather it should act to enable the journey. There is a growing body of research regarding peer led service provision in both the veteran and civilian population (Cheney et al, 2016 ; Shaw et al, 2021 ; Anderson et al, 2022 ; Gettings et al, 2022 ). Although such peer interventions hold great value there is a lack of research into their effectiveness (Ahern et al, 2015 ; Derefinko et al, 2018 ).…”

Operational Stress Injury

“…During this period of transition, veterans often need to wrestle with losing a sense of their identity which they fused to their military membership during service [83]. Social engagement, learning new skills, and finding a sense of purpose can help offset these feelings [84]. Peer support can also help in introducing veterans to treatment programs, encourage their ongoing engagement, and enable the use of the skills acquired through therapy [66].…”

Hygienic assessment of the occurrence and development of emotional burnout syndrome among medical students and its prevention

“…EMDR involves a patient suffering from post-traumatic stress disorder focusing on a traumatic image, thought, emotion, and bodily sensation while receiving bilateral stimulation, most often in the form of eye movements. 47,48 Cognitive behavioral therapy, which was developed by Aaron Beck in the 1960s, is also widely used today, but its effectiveness has been scientifically proven only recently. It is a structured, didactic, and focused form of therapy.…”