Factors That Predict Behavioral Health Clinicians’ Progression from Military Cultural Competency Training through Advanced Training In Evidence Based Practices

Introduction: The passage of the COMPACT (2020), Brandon (2021), and PACT (2022) Acts created new pathways for the military and Veteran community to access behavioral health services, likely increasing the demand for culturally competent providers with skills in evidence-based interventions. Although social work serves as a critical access point for Service Members, Veterans, and their families seeking mental health care (e.g., Matthieu, 2022), most schools of social work do not offer specialized tracks to train pre-professionals in unique military cultural competence and service-connected behavioral health needs. This training gap is often met by continuing education providers. Yet, no study has assessed the relationship between provider characteristics and persistence from introductory to advanced training in military behavioral health. Understanding such factors can help training program administrators tailor educational opportunities aimed at clinicians most likely to complete training in evidence-based psychological practices that reduce or prevent harmful behaviors in military populations. This study aims to address this gap, which is particularly timely given current global conflicts and the need for effective support for service members and their families.

Materials and Methods: Star Behavioral Health Providers offers clinicians training in military cultural competency (Tier 1/T1), military service-related behavioral health challenges (Tier 2/T2), and evidence based psychological assessments and interventions (Tier 3/T3). Data about personal demographics (sex, education level, experience), professional discipline (social worker, psychologist/psychiatrist, nurse, marriage/family therapist, mental health or addiction counselor), and military exposure (personal military service, lived with a Service Member or Veteran, high volume of military-connected clients) were collected via questionnaire from 20,250 trainees between 2011 and 2025. Progression of eligible clinicians from T1 to T2 (n=6,614) and T2 to T3 (n=2,916) was assessed using administrative data. Logistic regression analyses were conducted using SPSS 29.0.0.0.

Results. Binary logistic regression analyses revealed that sex (p<.001), education (p<.001), social work specialty (p<.001), marriage/family therapy specialty (p<.001), and military exposure (p<.001), significantly and positively predicted persistence from T1 toT2 and T2 to T3. Years of experience (p<.026), nursing (p<.003), and psychology/psychiatry (p<.006) were associated only with persistence from T1 to T2. Mental health counseling specialty (p<.001) was associated only with persistence from T2 to T3.

Conclusions. This study indicated that clinicians, particularly social workers, with certain demographic characteristics and with military exposure persisted from introductory to advanced military-focused training in evidence-based practices. For the social work field, these findings may help program administrators to adapt their design and delivery strategies to reach similarly situated clinicians, thus equipping motivated practitioners with the skills for reducing or preventing harmful behaviors in military populations. In the broader context of Social Work Research at the Service of Democracy: Advancing Rigorous Inquiry for the Common Good, this work underscores how empirically grounded training can strengthen the profession’s capacity to deliver high-quality, evidence-based care to military and Veteran communities. By informing workforce development strategies, this research contributes to a more prepared, equitable, and responsive behavioral health system, which is aligned with social work’s commitment to democratic ideals and the well-being of those who defend it.