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Background Research has demonstrated that partners living alongside veterans with mental health difficulties are at high risk of developing mental health difficulties themselves and secondary trauma. A variety of interventions have been developed to support partners. Research to date has relied on quantitative methodologies to evaluate the efficacy of such interventions with less emphasis on learning about the experiences of individuals on the courses. Objective The aim of this qualitative paper was to understand the experiences of partners who engaged in a five-week structured support intervention, ‘The Together Programme’ (TTP) which had been piloted across UK cities. This programme involved tailored psycho educational materials adapted to the needs of veteran’s partners living alongside PTSD. Further the potential mechanisms of change for participants engaged with the programme were explored as well as the impact of treatment on their relationships. Methods Eight female partners were recruited from an original sample of 57 partners who were intimate relationships with treatment seeking veterans with mental health difficulties. These participants had completed TTP. Qualitative data was collected using a semi structured interview and explored using Interpretative Phenomenological Analysis. Results Three key themes emerged from the data, these were self-growth, changing role in relationships and connecting with others. The themes included several sub themes. Self-growth sub-themes were mastering the ‘inner judge’, ‘confidence in ability to cope’ and ‘taking care of my needs’. Changing role in relationship sub-themes were ‘acceptance and understanding’ and ‘improved communication in relationship’. Connecting with others was described by the sub-themes of ‘knowing I am not alone’, ‘peer support’ and ‘hope’. Conclusions This study suggests there were three key areas where the structured evidence-based support programme had an impact on participants experiences. These were factors that helped participants to normalise their experiences and increase participants understanding and interpersonal skills that promote changes in relationship functioning with the veteran. DOI: 10.14302/issn.2640-690X.jfm-19-2726 Freely Available Online www.openaccesspub.org JFM CC-license DOI : 10.14302/issn.2640-690X.jfm-19-2726 Vol-1 Issue-2 Pg. no.– 20 Introduction Mental Health of Military Partners It has long been recognised the challenges military veterans face in terms of physical and mental health difficulties upon their return from conflict. A recent study of veterans who have served in conflict zones suggests the number of veterans in need of support is growing. Less attention has been given to the impact of veterans’ partners. However, there is a growing body of literature which suggests veteran’s mental health difficulties to have an enduring impact on partners mental health, caregiving burden and secondary. This implies military stress is experienced both individually and systemically. In greater appreciation for the needs of partners and supporting the veteran’s family as a whole, there has been a wide range of psychological support-based interventions developed which incorporate a variety of formats including; individual, group, psycho education couple-based and family-based support interventions. They appear to have promise and have been found to improve partners mental health and relationship satisfaction, veterans’ rates of engagement in therapy and their treatment outcomes. Support Interventions for Military Partners The US has taken a leading role in providing group-based support interventions for veterans and their families. Examples of three interventions which have been trialled include SAFE (Support and Family Education), REACH (Reaching Out to Educate and Assist Caring, Healthy Families) and SAH (Strength at Home). REACH and SAH share similarities in that they both contain couple-based formats and do not include children whereas the SAFE programme is widely available to all family members living or caring for veterans. The SAFE programme is non-diagnostic specific and is available for any carer of family member living alongside a veteran with mental illness. Although REACH and SAH were not explicitly developed to tackle PTSD, they are sensitive to mental health and relationship difficulties that are likely to have been incurred as a result of the veteran serving in military. All three programmes vary in length and format from nine to 18 sessions on a weekly or monthly basis. The common components of these interventions are that they strongly feature psychoeducation and include didactic and group exercises, in addition to home activities for the family to complete. All programmes covered the following topics; Communication skills, Problem solving and anger management. However, the SAH programme covers more material on relationship management and the impact of PTSD on the relationship. Self-care is reinforced in the SAFE programme and is achieved through practical skills training. Findings from evaluations of these programmes are promising with improvements in areas of caregiver burden, knowledge of mental illness/PTSD and ability to self-care, relationship satisfaction and conflict management. Similar findings have been reported for residential based programmes designed to target veterans and their partners and highlight the benefits of incorporating wellbeing activities. For instance, in an intervention whereby meditation was delivered in addition to core aspects like psychoeducation and individual or couple therapy, significant improvements in partners mental health outcomes like depression, anxiety, anger and stress were observed. Another study which measured clinical levels of PTSD in partners Corresponding author: Lucy Spencer-Harper, Combat Stress, Tyrwhitt House, Oaklawn Road, Leatherhead, Surrey, UK, Email: lucy.spencer-harper@combatstress.org.uk

journal of family medicine

Exploring the Experiences of Partners of Veterans with Mental health Difficulties Attending a Group Psychoeducation Support Intervention: A Qualitative Study.