Is Using Advocacy Coalition Framework Effective? (Dissertation Sample)

Using an Advocacy Coalition Framework in examining Family-Centered Care for Veterans Returning from the Theater of War: Is it Effective?
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Chapter 2 Literature review
2.1 Introduction
Military veterans subjected to intense operational stress tend to undergo increased rates of post-traumatic stress disorders among other key depression problems. Literature has it that the implications of military service are not only limited to service veterans but equally their families (children, spouses and other members of the larger family). It is imperative that post-treatment and care programs should incorporate family-centered approaches in order to minimize risk through stimulating positive family adaptation to enduring stressors. This section of the study offers a review of related literature on the use of an Advocacy Coalition Framework (ACF) in examining family-centered care for veterans returning from the theater of war, with the intent of determining its efficacy. The literature will start-off with definition and discussion of the advocacy coalition framework and phenomenological research method as considered in the current study.
2.2 Existing studies on phenomenological method
In accordance with Gallagher (2012), phenomenological approaches seek to describe, comprehend and decipher the significance of human life experiences. It highlights research questions like ‘how does it feel to endure a given situation?’ Besides, Gallagher criticize qualitative research approaches purported to be founded upon philosophical phenomenology by arguing that: “Thinkers in other fields saw promise in phenomenology as a basis for qualitative research; however, it has often been the case that practitioners with only a passing knowledge of phenomenology were able to talk about “getting to” the lived experience of their clients and patients, but in some important sense they were unable to deliver. Much of their work depended on interviewing subjects about the particularities of their ongoing experiences. If questions were not framed well, however, investigators would frequently get an opinion or an explanation of why subjects were feeling a certain way rather than a description of the subjects' lived experiences. Another difficulty appeared at the point of interpretation by the investigators.
Various methods for organizing the data or for developing categories that generalize the individuals' reports were brought over from psychology or the social sciences but were not necessarily phenomenological or well integrated with phenomenology. The result was that the same phenomenological data could be construed in a number of ways and could end up far removed from the lived experiences of the subjects.” (p. 306). In his historical introduction to phenomenology in psychiatry and psychology, Spiegelberg (1976) argued that “a luxuriant field like ours had better not be cluttered by too many varieties and subdivisions which may even interfere with our growth” (p.36). Nonetheless, and albeit considering the warning by Spiegelberg, it is imperative to hold with high admiration the approaches that are deeply rooted in their philosophical grounds and that can function shoulder to shoulder in a harmonizing and parallel fashion. Going beyond the shallow methodological differences apparent outwardly, other forms of reductions may be clearly found within Husserl’s works that could function for definite scientific purposes. Therefore, the best approach to create a qualitative, human scientific method is by remaining close to the philosophical foundations.
2.3 Advocacy Coalition Framework (ACF)
The ACF framework is said to hold a design that is significant in illuminating how actors act on contentious issues affecting the general public (Weible and Jenkins, 2016, p.34). Although there are numerous other frameworks capable of being effectively utilized, the ACF is unique as it is considered the “very close to an overall theory of policy making” thereby facilitating an all-inclusive framework for achieving key intervention factors like psychological education, goal setting, problem solving abilities and goal setting, family communication skills, emotional regulation abilities and traumatic stress reminder management approaches (Cairney and Sabatier, 2015). In the current study, the researcher will highly focus on psychological education, family communication skills, emotional regulation abilities and traumatic stress reminder management approaches as these are highly associated with a family-centered care for war veterans and their families. The key theoretical settings defining ACF include policy subsystems, advocacy coalitions and policy change. The ACF argues that the best-fitted techniques in addressing empirical research include policy subsystems and advocacy coalitions. The former constitutes to the major analysis unit in the ACF. The feature that has attained significant attention in prevailing uses is the impact of external events on policy change, with key refinement areas comprising of policy-oriented learning, involvements across subsystems, the theoretical basis to realization of belief systems, and the manner in which relations between interests and beliefs influence coalition behavior (Cairney and Sabatier, 2015).
2.4 Family-centered treatment approaches
Lester et al. (2011) examined a family-centered prevention strategy for prevailing over stress among military families. According to the scholars, the impact of manifold and protracted deployment on families remain highly evident in recent years since military families have witnessed an increment in anxiety cases among children, marital conflicts and parental psychological distress. The scholars examined a FOCUS (families overcoming under stress) approach, which is a family-centered framework founded on resiliency and evidence established at the University of Los Angeles, University of California and Harvard Medical School, and targeting military facilities via the Navy Bureau of Medicine and Surgery. FOCUS’ research foundation comprised of evidence-founded preventive programs tailored to meet certain requirements of military families embattled with PTSD due to extreme events during wartime deployments.
Recent researches by MacDermid et al. (2013) and Saltzman et al. (2011) have verified that recurrent deployment of a parent inflicts a toll on military families while the value and functionality of familial associations is interrelated with readiness and force preservation. Due to this, family-centered care gradually remains a primacy across the military health system. Both studies (MacDermid et al., 2013; Saltzman et al., 2011) used FOCUS approach in implementing a family-centered care among military families. MacDermid et al. (2013) highlighted an empirical and theoretical rationale and foundation for FOCUS, entrenched in a broad conception of family resilience. The scholars further focus on family resilience literature, indicating that a key phase in establishing a clinically significant theory of family resilience is via going past creation of broad “shopping lists” of risk indicators by recommending definite techniques of risk and resilience. The scholars proposed five key risk approaches for military families and mutual negative “chain reaction” methods where they destabilize the resilience of families coping with battlefield deployments and parental injury. Besides, the authors suggest the need for definite mechanisms that activate and increase resilience among military families and encompass the FOCUS program’s central features. The scholars define these resilience-promoting mechanisms comprehensively, with the support of the program’s data evaluation.
The concerns of military officers regarding detachment from family members remains a key noncombat factor defining the mental health status of service members within the MHAT (Mental Health Advisory Team) studies. Empirical literature indicates how healthy family associations act as protective factors for military officials in search of mental health services (Saltzman et al., 2011). The authors further indicate a high correlation between families with deployed parents and increased domestic violence and conflict, while combat-associated deployment enhances the likelihood of parental negligence of children or maltreatment. Combat stress has been associated with “secondary traumatization” of their family members in addition to interference with competent parenting (Layne, Saltzman, Poppleton, et al., 2018). Recurrent placement of members has subjected servicemen and women to intricacies in relinking with family members in addition to being worried about the safety of their family members (Layne et al., 2018). Children whose one or both parents have been redeployed in battle field tend to go through behavioral or emotional complications, as well as emotional distress (Beardslee, Wright, Gladstone, and Forbes, 2007). Child distress’ risk factors associated with parental deployments comprise of continuing parental psychological disorder and collective combat deployment months in the lifetime of a child. The United States military is highly made up of servicemen and women with young families residing in every state and DC. A significant number of these military families live within or close proximity to military facilities, while the rest reside on Reserve, National Guard, while veteran families reside in civilian communities but benefit from military health privileges. While all military families tend to be susceptible with reference to their experience with placement-associated activities, those impacted by comba...