Among the counseling supports the U.S. Department of Defense (DoD) offers to service members and their families is short-term, solution-focused counseling for common personal and family issues, called non-medical counseling within the DoD. This report evaluates whether non-medical counseling provided by the DoD is effective in improving outcomes and whether effectiveness varies by problem type and/or population.

Cover: An Evaluation of U.S. Military Non-Medical Counseling Programs
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An Evaluation of U.S. Military Non-Medical Counseling Programs

by Thomas E. Trail, Laurie T. Martin, Lane F. Burgette, Linnea Warren May, Ammarah Mahmud, Nupur Nanda, Anita Chandra

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Research Question

  1. Is non-medical counseling provided through the Military and Family Life Counseling and Military OneSource programs effective in improving outcomes for U.S. service members and their families, and does effectiveness vary by problem type and/or population?

This report evaluates two programs offered by the U.S. Department of Defense (DoD) that provide short-term, solution-focused counseling for common personal and family issues to members of the U.S. military and their families. These counseling services are collectively called non-medical counseling within the DoD and are offered through the Military and Family Life Counseling (MFLC) and Military OneSource programs. RAND's National Defense Research Institute was asked to evaluate these programs to determine whether they are effective in improving outcomes and whether effectiveness varies by problem type and/or population. Two online surveys were provided to program participants — the first two to three weeks after their initial session and the second three months later. Surveys were designed to gain information on 1) problem severity and overall problem resolution, 2) resolution of stress and anxiety, 3) problem interference with work and daily life, 4) connection to other services and referrals, 5) experiences with MFLC and Military OneSource programs, and 6) perceptions of non-medical counselors. The majority of participants experienced a decrease in problem severity and a reduction in reported frequency of feeling stressed or anxious as a result of their problem following counseling. These improvements were sustained or continued to improve in the three months after initiation of counseling. Non-medical counseling was not universally successful, however, and a small minority expressed dissatisfaction with the program or their counselor. Collectively these findings suggest a number of policy implications and programmatic improvements of interest to program leadership in the Office of the Secretary of Defense.

Key Findings

  • In general, most people who used non-medical counseling experienced a reduction in problem severity and its impact on their lives over the short and long term.
  • There was a statistically significant decrease in the frequency with which a participant's problem interfered with work or daily routines following non-medical counseling, and a decrease in stated difficulty coping with day-to-day demands.
  • Most non-medical counseling participants were connected with support and services outside of the program — although not necessarily to support they would not have found on their own.
  • Across most measures, over 90 percent of participants reported positive experiences with non-medical counseling provided through the Military and Family Life Counseling and Military OneSource programs.
  • Over 90 percent of participants expressed favorable perceptions of the professionalism and knowledge of non-medical counselors, thought that their counselor listened to them and spent enough time with them, and agreed that their counselor provided the services they needed to address their problem.
  • Despite positive perceptions from the majority of participants, between 1 percent and 7 percent of participants reported being dissatisfied or very dissatisfied with non-medical counseling, and about 15 percent continued to rate their problem as severe or very severe, suggesting that there is room for improvement.

Recommendations

  • Take steps to increase awareness of the program. Open-ended survey responses by participants noted the awareness of non-medical counseling in the broader military community may be limited, suggesting that more work could be done to disseminate information about the availability of this service.
  • Provide opportunities for ongoing support, guidance, and training for counselors. A small minority of participants' dissatisfaction with their counselor suggests that counselors might benefit from more opportunities to receive support and guidance from other non-medical counselors or from supervisors with more experience in the military community. These activities may provide consistent counselor support and supervision and standardize high-quality non-medical counseling approaches and experiences across counselors.
  • Strengthen non-medical counseling for parents with child-related concerns. Participants who sought non-medical counseling for child-related problems reported lower levels of problem resolution and lower satisfaction with the continuity of care. Services for this population could potentially be strengthened through warm handoffs to counselors who hold specialized training with children.
  • Identify ways to systematically collect counselor-level feedback and incorporate findings into performance review. Both programs may benefit from systematically collecting counselor-level feedback to establish whether identified concerns are more prevalent for a given counselor or location.
  • Strengthen continuity of care. Satisfaction with continuity of care varied significantly across respondents. While most participants were satisfied, open-ended comments suggest a need for greater continuity of care.
  • Strengthen screening and connections to other services. Survey results and open-ended comments from participants suggest that non-medical counseling could benefit from strengthening connections to other services.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Evaluation Design, Methodology, and Analytic Approach

  • Chapter Three

    Severity and Overall Problem Resolution

  • Chapter Four

    Resolution of Stress and Anxiety

  • Chapter Five

    Interference with Work and Daily Life

  • Chapter Six

    Connection to Services and Referrals

  • Chapter Seven

    Experiences with MFLC and Military OneSource Programs

  • Chapter Eight

    Perceptions of Non-Medical Counselors

  • Chapter Nine

    Summary and Conclusions

  • Appendix A

    Data Collection, Weighting, and Analytic Approach

  • Appendix B

    Survey Instruments

  • Appendix C

    Tables of Significant Subgroup Differences

Research conducted by

This research was sponsored by the Office of Deputy Assistant Secretary of Defense for Military Community and Family Policy (ODASD [MC&FP]) and conducted within the Forces and Resources Policy Center of RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

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