Abstract
Military veterans can face unique challenges to their mental health, which may be related to
stressful working environments, long periods of time away from loved ones, and the
difficulty transitioning to civilian life. Awareness and understanding of military veterans’
mental health is increasing in the United Kingdom, and specialist mental health services for
veterans in the National Health Service and third sector organisations have been developed.
This thesis aimed to review the effectiveness of a psychological intervention for military
veterans, and to explore veterans’ experiences of therapy with civilian therapists. Part A of
this portfolio presents a systematic review and meta-analysis of the effectiveness of imagery
rescripting interventions for military veterans with nightmares and sleep disturbances. The
findings suggest that imagery rescripting interventions can be effective in improving
nightmare frequency, sleep quality and PTSD symptoms. However, the review also
highlighted the need for further research using larger samples of veterans from a broader
range of sources. Part B presents an empirical paper that investigated veterans’ experiences
and perceptions of trust in the therapeutic relationship with civilian therapists. Interpretative
Phenomenological analysis found that veterans identified as uniquely different to civilians
which impacted their views on the therapist’s ability to understand and help them. The
importance of working with veterans as individuals rather than protocols was highlighted,
and the influence of the therapeutic relationship on veterans’ ability to be vulnerable and open
up was discussed. Part C presents a summary of clinical practice and assessments undertaken
during training.