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Since 2001, less than half of one percent of the American public have volunteered to serve in the United States Armed Forces. With high-tempo repeated deployments and unconventional warfare, the Post 9/11 military has been exposed to unique trauma and stressors during an unprecedented two-decade long conflict. In voluntarily taking on this role, members are immersed in the total institution of military culture and required to make countless personal sacrifices, often experiencing trauma or other stressors that most in a civilian population will never face. Prevalence rates of mental health problems in active duty as well as veteran populations suggest that approximately 15-30% have acquired mental health conditions (including PTSD, TBI, depression). Substance use and suicidality are often comorbid and may complicate the clinical profile considerably. Current treatment approaches include those well validated and common in general clinical populations (i.e., CBT, PE, CPT) although many have been modified for use with veterans. Nonetheless, despite billions of dollars in public support, many military members continue to not receive the mental health services they need. Challenges include system and access barriers, a lack of military cultural competency in providers, as well as societal and institutional stigma leading to veteran reluctance to seek mental health treatment. Best practice recommendations are offered to clinicians who seek to better serve clients who are military members (both active duty and veterans).


This is a pre-peer reviewed draft of a chapter that has been accepted for publication by Oxford University Press in the forthcoming book Bringing psychotherapy to the underserved: Challenges and strategies, edited by J. Zimmerman, J. Barnett, and L. Campbell, due for publication in 2020. All rights reserved by Oxford University Press.

The final version of this article will be published as:

Kalmbach, K.C., & Moore, B.A. (2020). Bringing mental health services to military members. In J. Zimmerman, J. Barnett, and L. Campbell (Eds.), Bringing psychotherapy to the underserved: Challenges and strategies. New York: Oxford University Press.

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