Learning in and from the Military


In 2009, the Chairman of the Joint Chiefs of Staff commissioned a study to look at how to develop a whole systems approach to prevention, wellness, recovery and resilience.

At that time, the military was seeing increases in obesity, diabetes, lowering of psychological resilience, chronic pain, PTSD and suicide. It became clear that a fit force could not depend upon a health care system to improve health, as health care focused primarily on disease treatment and little on prevention. What was needed was a whole-systems approach that came from the units, the families and the communities in which service members were living.Total Force Fitness

The result was a framework called Total Force Fitness. It showed that creating a fit and flourishing fighting force required optimizing all the areas of a person’s life—a mind-body psychosocial approach.

Integration and Evaluation

Many programs are available to enhance health and human functioning in each of the areas of a service member’s life. However integrating and evaluating these programs is essential to their success.

When Samueli Institute mapped all of the fitness programs and health-promoting, resilience-promoting programs on a major military base, researchers confirmed the importance of integration and evaluation. Researchers found more than 50 independently funded and operated programs for service members, with very little coordination and practically no evaluation opportunities to measure what worked and what didn’t.

This lack of coordination and evaluation meant that money was possibly being wasted, and the value of many of the effective programs was not being captured nor were best practices shared to improve other programs. Samueli Institute is currently working with many health care systems outside of the military that are also facing these same challenges of integration and evaluation in our learning collaboratives.

A Focus on Self-Care

During my time as an Army physician and for the last decade at the Institute, I have been investigating self-care and alternative approaches for their potential application to enhance and optimize human performance. These so-called “alternative practices” form the foundation of military health care, as they allow independent optimization of function, and they do not dependent upon medical interventions and technologies.

My team and I have been scientifically investigating these self-care approaches, with an eye on their application to the military fighting force. They’ve worked with many military organizations across the country to examine ways of re-integrating service members optimally, as they come back from the wars. Learn about this work.

As the wars in Afghanistan and Iraq wind down, it’s time to collect these self-care and alternative approaches, and explore again their application within the military community.

In 2015 the Institute started a process to assist in implementing many of these self-healing practices in health care settings for the application of chronic pain. This learning collaborative on chronic pain, has begun to do the detailed operational testing of new self-care and drugless pain approaches, to assist in these areas.

These whole-person healing approaches seem to have application well beyond individual medical problems. Post-traumatic stress, optimal functioning even with a traumatic brain injury, and self-healing of chronic pain, are only the tip of the iceberg.

Health systems that are interested in learning about and implementing non-drug approaches to pain are welcome to join the community of learning. Learn more.