title: How do male military veterans cope with psychological difficulties?
Creators: name: Ferguson, Heather
Publisher: name: University of Liverpool Repository
Year: 2016

description: This thesis consists of three sections: a systematic review, an empirical paper and the appendices, which are intended to support the empirical paper. The two papers are intended for publication in different journals and are written in the style required by those journals. Thesis Overview In the UK, a military veteran is defined by the government as anyone who has served in the armed forces for at least one day; they will simply be referred to as veterans from here on. The mental health of veterans is very much in the public awareness, especially due to the recent conflicts in Iraq and Afghanistan. Research dedicated to this area has mostly used quantitative methodologies, focused on Post-traumatic stress disorder and has been conducted in the United States. The research, and the media, has a tendency to give a more negative overview of veteran’s mental health, and their health outcomes, by emphasising such difficulties as substance misuse and offending behaviour. Therefore the aim of this thesis was to start to fill in the gaps. This was achieved by reviewing and adopting qualitative methodologies and involving British veterans. The research aimed to explore the possibility of positive change after military service, and veterans own views on how they experience and cope with psychological difficulties. By knowing more about veterans’ experiences, from veterans’ themselves, we will be more able to inform services and tailor the support to improve their outcomes and enhance their well-being. The term Post-traumatic growth (PTG) is relatively new, but the concept of growth out of adversity dates back to at least the 1960s. PTG was introduced by Tedeschi and Calhoun to describe positive psychological change resulting from experiencing traumatic events. It is conceptualised as a long-term coping strategy for ongoing stress following adversity (Tedeschi &amp; Calhoun, 2004). Positive growth has been indicated in the experiences of people after a range of traumatic events but the types and levels of trauma experienced by military personnel are unique. This is because they may endure multiple and chronic trauma, they have voluntarily put themselves in harm’s way and they could experience combat exposure both as victim and perpetrator (Linley &amp; Joseph, 2004; Larner &amp; Blow, 2011; Larner, 2013). Research suggesting that veterans can experience PTG has tended to focus on quantitative aspects of prevalence and influential factors, with no qualitative review of how veterans actually experience PTG. Chapter one of this thesis is a systematic review of the qualitative literature exploring veterans’ subjective experiences of PTG after military service. It aims to highlight those areas more prone to growth and to help inform interventions that may facilitate this process. To enable us to inform interventions to promote positive change, it is important to know how veterans are coping with psychological difficulties from their own perspective. Chapter two of this thesis is an empirical study that explored the way veterans from the North West of England, who had accessed a veterans’ psychology service, are coping with psychological difficulties. Q Methodology (Stephenson, 1935) was used to provide a systematic and non-threatening way to collect a large range of subjective viewpoints. The paper discusses the clinical implications of the findings and recommendations for future research within the context of the strengths and limitations of the study. It is hoped the findings will increase the awareness of this complex area, highlight the need for more research and aid the development of more targeted interventions focused on those more adaptive and growth promoting coping processes.