May 16, 2023
Domestic abuse is among many harmful behaviors of concern to the U.S. Department of Defense (DoD) because of its consequences for military personnel, their families, and military readiness. RAND's National Defense Research Institute is conducting a multiyear research effort, requested by Congress in Section 546C of the Fiscal Year 2021 National Defense Authorization Act, to study domestic abuse from a variety of perspectives.
In the first phase of this study, the RAND team focused its work on identifying strategies that can help prevent domestic abuse among service members and their spouses or partners before it occurs and strategies for outreach and communication to high-risk groups that could be effective in the military environment. The aim was to identify strategies that may improve the programs and resources already offered by DoD and the services.
The select prevention and outreach strategies highlighted in this brief were synthesized from recommendations made by 80 experts—domestic abuse survivor experts and advocates, military program or service providers and practitioners, military leaders, and domestic abuse scholars—in a series of virtual panels and a review of relevant literature published in the past two decades. The strategies are grouped in categories drawn from the Centers for Disease Control and Prevention (CDC) framework for domestic abuse prevention.
Healthy relationship skills are skills such as empowerment, communication, and conflict resolution that can prevent the occurrence of domestic abuse. Programs to build healthy relationship skills may teach listening skills, effective communication, and strategies for setting personal boundaries. Targeted programs for families can focus on building effective parenting skills, for example, which can reduce the potential for family stresses that can contribute to abuse. Teaching healthy relationship skills is among the most well-studied prevention strategies in the academic literature, with studies showing effective outcomes such as improvements in relationship satisfaction and lower instances of domestic abuse.
Experts believe that offering healthy relationship programs would benefit military couples and DoD. Indeed, some healthy relationship education efforts have already been tailored to a military population by including content that is related to trauma or to circumstances that are unique to the military that stress relationships, such as deployments. Even commonly studied healthy relationship programs that are available to the general public have content targeted to the needs of military and veteran couples.
A cohesive series of military-specific education and training modules that teach about safe and healthy relationships could be part of a comprehensive prevention approach. Such a program should focus on teaching what having a healthy relationship means and building the skills necessary to have a healthy relationship. The curriculum should also include information about add-on services, such as resources for stress and anger management, relationship counseling, and family support for new parents.
Experts believe that offering healthy relationship programs would benefit military couples and DoD.Share on Twitter
Creating such resources within a military context is highly feasible given DoD's experience implementing similar programs. To ensure success, the development, implementation, and dissemination of these programs should be supported by highly qualified subject-matter experts. The curriculum should be engaging, interactive, delivered using different modes (not centered exclusively around a slide presentation), relevant to spouses and partners, and accessible.
Although such programs are promising, implementing them could be difficult given the high number of existing training requirements. To reach families and to help bolster attendance, voluntary training needs to be widely advertised and scheduled at times that are convenient for families and at locations where child care can be arranged or provided. To mitigate the expense of developing such programs, it might be possible to adopt effective programs already in use in civilian settings.
Many prevention strategies center on engaging influential community members to help develop prevention materials, promote preventive values in the community (such as positive relationship expectations and beliefs), and guide people to needed resources. Influential community members might include military leaders, faith leaders, and peers. Although few studies have evaluated whether these strategies reduce domestic abuse, there is some evidence that they can increase knowledge about domestic abuse among influential community members, improve attitudes about intervention, increase resource-sharing, and strengthen intentions to intervene in abuse when identified, which are all valuable outcomes.
In the military, influential community members can come from both leadership and peer groups. Experts generally agreed that leadership buy-in is a necessary ingredient for successful prevention, but buy-in alone is not sufficient. Preparing military leaders to take an active role in prevention activities should be an important component of successful domestic abuse prevention.
To help advance domestic abuse prevention efforts, military leaders—junior and senior—need education, incentives, guidance, and support. Leadership training should be designed to help military leaders maintain knowledge about domestic abuse, identify risk factors, and understand and direct service members to domestic abuse support and resources. Mandatory training in the Air Force for military leaders on identifying partner and child abuse has improved knowledge of domestic abuse topics, beliefs and attitudes about domestic abuse, and confidence in the ability to detect and intervene in cases of suspected child or partner abuse.
Leadership training cannot simply be a knowledge dump of policies and procedures. Military leaders need high-quality education that incorporates time to examine their own experiences, perspectives, and biases that may interfere with or support their capacity to implement policies around domestic abuse. Leader involvement needs to be genuine, and training should help develop soft skills, such as active listening, so that leaders become more effective and actively engaged.
In addition to leaders, influential community members also include respected peers. Service members who are similar in pay grade to the people who will participate in a program should be involved in developing and tailoring credible prevention activities, outreach, and communication. Greater involvement of peers can be very effective in developing culturally sensitive messaging tailored to communities within the military. Many experts believe that peer involvement is essential to producing high-quality prevention programming and that influential peers, domestic abuse survivors, and individuals with diverse perspectives and lived experiences should be consulted. Peers should be viewed as credible messengers, and their participation should be voluntary.
Organizations can create protective environments through programs, policies, and procedures that target the broader social, cultural, or physical environment. Experts explained that this was an important strategy because it equips spouses with information and resources that could help them be more self-sufficient, regardless of whether they have experienced domestic abuse. When spouses have the tools to be self-sufficient and independent, they are in a better position to handle relationship difficulties when they arise.
Promoting a variety of different opportunities for partners and families to engage in the military community and to build social networks can reduce the social isolation and dependency that can be associated with domestic abuse. Increased engagement helps them build support networks that can also support self-sufficiency.
The formal and informal resources available on base and through the wider military community can be helpful, but they may be particularly important for spouses when their partner is on an extended deployment or if the couple is experiencing conflict over financial, legal, or interpersonal issues. Financial resources include financial literacy courses, advice from financial planners, existing programs to support spouse employment, and help applying for financial aid or assistance. Legal support might include assistance with separation, divorce, child custody, and immigration issues. Informal social supports from a community of friends, colleagues, and acquaintances can help to buffer spouses and families from stress.
However, many isolated and abused spouses are cut off from informal supports and unaware of the resources available to them, often because most of the information flows through the service member. If the person inflicting abuse is also the information gatekeeper, relevant information may never reach the victim. Although making victims of abuse aware of military and community services is helpful, a comprehensive strategy to address domestic abuse needs to pay more attention to how victims can safely and confidentially find and access services when doing so could put them at greater risk.
Although active-component service members are fully employed and have benefits, such as health care and housing support, they are not immune to financial challenges. Military families can experience limited access to adequate healthy food and income instability, and the military lifestyle can also disrupt spouse employment and earnings. Recognizing these challenges, experts emphasized the importance of addressing economic needs as part of comprehensive domestic abuse prevention.
Studies of programs providing economic and job support strategies that target financial stress, instability, control, or dependence in relationships have found a reduction in domestic abuse from these types of programs. Welfare dependence increases the risk of domestic abuse because people tend to stay in unhealthy relationships when they do not have the resources to live independently. Participation in programs that help victims or high-risk partners find employment has been associated with reductions in domestic abuse.
Many experts believe that reducing economic stress among families can help prevent domestic abuse. Although the financial stress does not cause domestic abuse, it can contribute to increased arguments or exacerbate volatile circumstances for people with poor communication skills or who have trouble regulating their emotions. Providers who work in financial support services and domestic abuse prevention should be aware of the link between the two areas and ensure that their clients receive support from the other service when needed. Furthermore, financial services should be readily available to the entire community as a strategy to reduce the financial stress that is a risk factor for domestic abuse and to prevent domestic abuse from emerging in the first place.
DoD and the services are well positioned to implement this strategy because of the variety of financial supports that the services already provide to service members and their families. But central to effective implementation is finding ways to make these resources available to more families, particularly isolated and unmarried partners. Such individuals often live far from military bases, which limits familiarity with and access to service programs. The limited interaction that isolated families have with the military community calls for innovative solutions to reach them.
It is also important that awareness-raising and dissemination efforts avoid using language and statements that stigmatize individuals with fewer resources or suggest that they are more prone to violence. At the same time, domestic abuse should not be justified because of financial strains. Insensitivity and shame about financial insecurity are more likely to turn people away from the resources that could help them.
The key is to provide people with more opportunities—military and civilian—to access support in whatever way works for them.Share on Twitter
The CDC model of domestic abuse prevention includes a component to support survivors of domestic abuse. Here, the focus is on ensuring the safety of these survivors and lessening the harms they may be experiencing in their relationships. The goal is to identify abuse as early as possible in a relationship so that steps can be taken to prevent abuse from occurring again, which is often referred to as secondary prevention. Secondary prevention strategies include improving safety services, screening for domestic abuse and risk factors for domestic abuse, crafting outreach messages to reduce stigma, and partnering with organizations that can increase the reach of outreach efforts.
The most elemental support for survivors of domestic abuse is to ensure their safety. Depending on individual circumstances, options to consider are protective orders, no-contact orders, shelter-at-home approaches that keep families in place, or partnerships with local safe houses to remove families from dangerous situations.
However, making such services available may not be enough. Perpetrators of domestic abuse often isolate their partners from support and services. Therefore, providers need to reach out to victims in the few places where they can, such as through the primary care offered by the military health care system or TRICARE. In these settings, incoming service members and their partners can be screened for domestic abuse and risk factors during routine appointments. When indicated, victims can be offered options for confidential assistance. It is especially important that the staff administering screenings are highly trained in the dynamics of domestic abuse, because screening without proper safety supports could increase patient risk.
Efforts to reach victims of domestic abuse will need to be multifaceted and extend beyond the military community to include relevant local civilian community organizations. Some victims may be more comfortable seeking help outside the military for various reasons, including career concerns, confidentiality, or geographic proximity. The key is to provide people with more opportunities—military and civilian—to access support in whatever way works for them. In addition, messages that encourage victims to seek help need to include language that normalizes the experiences of stress and relationship struggles, to focus on behaviors rather than criminal labels, and to promote relationship support and enhancement.
Domestic abuse prevention may also be strengthened through holistically addressing interrelated risk factors and building capacity in the prevention system. DoD Instruction 6400.09, DoD Policy on Integrated Primary Prevention of Self-Directed Harm and Prohibited Abuse or Harm, calls for the integration of domestic abuse prevention activities with other violence prevention and risk reduction efforts. This approach aligns with recommendations from CDC to take a comprehensive prevention approach to integrating various sectors, including public health, education, social services, health services, and government, across multiple types of strategies.
Responsibilities for prevention and response to domestic abuse and other harmful behaviors have been distributed across DoD and the services, with a heavy focus on response. The findings from an assessment of installation-level prevention activities published in DoD's 2021 On-Site Installation Evaluation Report identified significant gaps in prevention programs, a lack of real understanding of what such programming entails, and few integrated prevention services. The experts who participated in developing the strategies discussed here also emphasized the need for integrated activities, because such activities could achieve a greater impact through mutual support compared with fragmented and siloed efforts. But the experts went further to talk about the need to advance strategies for how such activities might be structured. If organizations coordinate and collaborate, more members of the military community can be reached.
If DoD wants to make prevention and outreach a priority, providers must have the capacity to conduct these activities. Otherwise, their priority will always be on responding to the immediate needs of domestic abuse victims. Prevention is more than just making a poster or giving an annual training. People involved in prevention activities must have the time to keep current on the science and the local community, tailor activities and delivery modes and channels, use adult learning principles, coordinate internally and externally with other organizations, create a variety of activities that speak to many subgroups or situations, get activities out into the units, make the additional effort to try to reach spouses or partners who live off the installation, have time to solicit feedback on activities, assess what is working and what is not, and make improvements.
Not surprisingly, achieving a truly integrated and effective prevention approach will require time, resources, robust training, and consistent effort. What this means in practice is expanding capacity for Family Advocacy Program staffs and increasing the number of medical, mental health, and substance abuse providers to ensure that those in need are identified and able to access services in a timely manner. Building workforce capacity in prevention will help address immediate staff shortages and burnout, which hinder effective domestic abuse prevention. DoD has already begun to recruit and train prevention personnel, and these efforts will need to be sustained.
In addition to expanding capacity, staff roles need to be reviewed to ensure that clinical staff are being used to provide direct services and that prevention experts fill outreach and programming roles. Expanding the number of personnel who are knowledgeable about prevention and increasing coordination across organizations would provide a forum for sharing ideas, strategies, trends, and concerns that will contribute to and improve a cohesive and comprehensive approach tailored to the local military population.
A recurring theme that runs through these strategies is the need for adequate resources to support expanded programs. Staff shortages and heavy workloads understandably force providers to focus on supporting families who are already in crisis and in need of immediate services. The current system does not support the aim of conducting more primary and secondary prevention work. Thus, the final two strategies—strengthening the prevention system by developing a skilled prevention workforce and improving integration efforts—are essential elements of a functional prevention system that should be prioritized. Such a system needs to be in place before many of the remaining strategies can be tackled.