How to Improve Military Transition Outcomes through Values-Based Activities

Imagine that within the next 12 months, you will need to find a new job, potentially in a field in which you lack experience. You may also need to relocate, find new housing, address family needs, migrate your healthcare, manage new financial obligations, and build new relationships—all in a society with limited understanding of the many talents you possess.

Approximately 200,000 U.S. military service members undertake this adjustment each year during the transition from military to civilian life. For many service members and veterans, this transition also involves a loss of identity and purpose as they separate from the mission and camaraderie central to military life.

Current Military Transition Assistance Programs and Outcomes

Existing military transition initiatives provide transitioning service members and veterans numerous resources. For example, the Department of Defense manages the congressionally mandated Transition Assistance Program, which helps transitioning service members meet prespecified career readiness standards. Through the Solid Start outreach program, the Department of Veterans Affairs connects new veterans to benefits and services during their first year after service. 

For many new veterans, these policies, programs, and community supports enable them to transition smoothly and lead fulfilling post-military lives. A subset of new veterans, however, experience adverse military transition outcomes such as mental health disorders and suicide. National death certificate data show that the first year out of the military is a critical period during which new veterans are at higher risk for suicide compared to sex- and age-matched civilians, and veterans who have been out of the military for longer than one year.

A Theoretical Model of Suicide Risk during the Military Transition

To inform suicide prevention and intervention efforts, clinical psychologists have developed theoretical models for understanding which factors increase or decrease the likelihood someone will develop suicidal ideation and attempt suicide when undertaking a transition to civilian life. 

One popular model emphasizes the importance of perceived burdensomeness and belonging in the onset of suicidal ideation. Applied to the military transition, a new veteran struggling to secure post-military employment, housing, or financial stability or who feels limited by medical or mental health conditions may perceive that they are a burden to loved ones or society. Similarly, a new veteran having difficulty reconnecting with friends and family, maintaining military friendships, building new civilian relationships, or nurturing their spirituality may perceive that they do not belong in post-military life.

New veterans hopeless about their perceived burdensomeness and belonging who acquire the capability and means to engage in lethal self-harm may go on to attempt suicide. Research shows that triggering stressors often precede a military suicide attempt, highlighting the additional importance of developing effective problem-solving skills during the military transition.

Optimizing Military Transition Outcomes through Upstream Intervention

Mental health treatments are available for veterans navigating the military transition, but these interventions are typically delivered after the onset of suicidal ideation. Transition supports may be more effective long-term if delivered “upstream” of perceived burdensomeness and lack of belonging altogether.

The idea to proactively deliver interventions to avert future health problems is not new. In 2009, the National Research Council and Institute of Medicine expanded their definition of the mental health intervention spectrum to include mental health promotion alongside prevention and treatment. This update emphasized that focusing on positive factors, rather than disorders, not only decreases the likelihood of developing those disorders but also enhances people’s “self-esteem, mastery, wellbeing, social inclusion… and ability to cope with adversity.” 

Health promotion emphases are also consistent with military culture. For example, the Department of Defense explicitly frames wellness promotion as a method for optimizing Force readiness and performance. The Department of Veterans Affairs, by adopting its Whole Health approach, similarly shifted from a disease focus towards a wellbeing focus, “moving from ‘what’s the matter with you?’ to ‘what matters to you?’.”

Leveraging Behavioral Activation to Promote Mental Health During the Military Transition

Behavioral Activation is a psychological treatment effective for improving well-being and reducing depression and anxiety symptoms. It aims to improve a person’s mental health by increasing their daily engagement in pleasant and meaningful activities.  

How Behavioral Activation Helps Prioritize Personal Values

Because not all individuals find the same activities equally pleasant and meaningful, Behavioral Activation emphasizes centering activities around someone’s personal values within key areas of their life. That is because people are more likely to engage in activities that are naturally rewarding rather than arbitrarily selected.

There is no single correct way to organize life areas, but common groupings are:

• Relationships with people like romantic partners, family, friends, and co-workers
• Community membership, or involvement in larger groups with which someone identifies
• Hobbies and recreation, or how someone spends their free time
• Spirituality, which can refer to organized religion as well as broader beliefs and practices like mindfulness or connectedness to nature
• Work and education, which can include a current job, finding a new job, formal education, informal training, and self-guided learning
• Physical and mental health, also referred to as physical fitness, medical wellness, and emotional well-being

Individuals then self-identify their personal values, or ‘what matters most’, related to each life area. For example, someone could value being a loyal friend (relationships), giving back to those less fortunate (community membership), trying new foods (hobbies and recreation), having a close relationship with God (spirituality), being a lifelong learner (work and education), and being physically active (physical and mental health).

Using Behavioral Activation to Identify and Incorporate Meaningful Daily Activities

Next, Behavioral Activation guides individuals to brainstorm activities that will help them live daily life according to their personal values. To increase chances of success, people are encouraged to identify activities that are SMART: specific, measurable, attainable, relevant to values, and time-bound. To illustrate, consider someone with a health life area value of eating nutritious food. Rather than the vague activity of “eating healthier,” a SMART activity might be to “eat 1 cup of green vegetables with dinner.” Importantly, while some activities may only target a single value, other activities can address multiple life areas and values at once. For example, someone who values supporting live music (hobbies and recreation) and being a present parent (relationships) could simultaneously move toward both values by taking their child to a concert.

After people brainstorm values-based activities, Behavioral Activation shifts to helping individuals systematically plan for when to complete those activities to ensure that values-based activities are intentionally woven into a person’s daily routine. By proactively deciding what value(s) someone will focus on each day, when, and how, they are more likely to accomplish the activity, even if barriers arise. 

Behavioral Activation and Problem-Solving

A final skill taught in many variants of Behavioral Activation is problem-solving. Problem-solving entails a systematic approach to defining a problem and desired end state and subsequently generating, implementing, and evaluating the outcome of possible solutions. Problem-solving is at the core of military mission analysis and planning, but military members may not have practiced applying military decision-making processes to their personal lives. Behavioral Activation could therefore provide new veterans with a simplified framework for translating this existing skillset to the military transition context.

By helping new veterans identify their post-military mission, Behavioral Activation could be leveraged to buffer against proximal risk factors for suicidal ideation and other mental health conditions that sometimes develop during the military transition period.

Acknowledgements

As previously announced, RTI was selected by the Department of Defense to develop and pilot a program to promote mental health and thereby reduce suicide risk for new veterans. In this study, new veterans will receive a Behavioral Activation-based program, called Transition Health and Resilience through Valued Experiences (THRiVE), delivered virtually to small cohorts by a trained veteran peer facilitator. The objective of adapting Behavioral Activation for the military transition is to empower and equip new veterans with psychosocial transition skills before they need to use them.

This project is one of many RTI-led endeavors to reduce harmful behaviors in military populations, incorporate peers into preventative behavioral health interventions, and address unique needs of communities at elevated risk for suicide. Results from the THRiVE study are expected to be announced in Spring 2027.

The U.S. Army Medical Research Acquisition Activity, 808 Schreider Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office of the THRiVE program pilot study. This work is supported by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, in the amount of $848,248, through the Traumatic Brain Injury and Psychological Health Research Program under Award No. HT9425-24-1-0947. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense.