Veterans Treating Veterans: Positive Perceptions of Potential Therapeutic Alliances

Abstract

Veteran suicide is the leading cause of veteran deaths in the United States, as reported by the Department of Veteran Affairs in 2017 and 2019. The continued increase of veteran suicides is most often attributed to the stigmatization for seeking mental health care and the subsequent perceived barriers to care. The creation of Vet Centers was a direct result of the stigma Vietnam Era veterans experienced, and the centers emphasize the concept of veteran-to-veteran care. Vet Centers continue to thrive in the post-Vietnam era, and recently are becoming more well known to active service members and veterans, but the model has not been able to stem the veteran suicide epidemic. As hypothesized in this study, the increase of the perception of a strong therapeutic alliance led to increased credibility and expectancy for treatment and decreased barriers to care and perceived stigma. This study did not support the hypothesis that a veteran therapist would directly lead to an increased therapeutic alliance and thus improve treatment. One hundred sixty- one veterans (51% female, 49% male) from the Persian Gulf & War on Terror service eras were surveyed regarding an assigned vignette of a therapist, their perceptions of a potential alliance with the therapist, and if they perceived an increase in the credibility of the therapist, and a decrease in perceived stigma and barriers. There were no distinguishable differences between the therapist profiles and how veterans perceived them as measured by this study. Future research should focus on in-session and post-session measures of therapeutic alliance with a variety of therapist models to better refine the necessary treatment considerations to successfully reduce veteran suicide.