Background: Suicide rates among military personnel have steadily increased in the most recent decades. The role of clinicians’ personal beliefs about suicide and their impact on clinical judgment, treatment planning, and adherence to military protocols is not well understood. Further, the impacts of these policies and perspectives on building a therapeutic alliance are understudied. This study aims to explore how these beliefs influence clinical decision-making and suicide intervention practices within military healthcare settings. Methods: This study used phenomenological methods to understand the core experiences of providing therapeutic care to service members exhibiting suicidal behavior in the unique military context. Qualitative interviews were conducted with clinical social workers and psychologists with at least one year of experience working with active-duty service members. Participants were recruited from various branches of the military. The interviews focused on their philosophies and approaches regarding suicide risk assessment, the influence of military doctrine, and the challenges they face when navigating patient care within the constraints of military policies. Verbatim transcripts were coded and analyzed for core elements of the phenomenon in question. This included attention to participant reports and researcher experiences with military protocol regarding the care of service members exhibiting suicidal behaviors for a rich and detailed picture of the phenomenon. Finally, this researcher evaluated participant-reported challenges in establishing therapeutic relationships using the tenets of Relational Cultural Theory. Results: Analysis of the interviews revealed three distinct clinician typologies regarding personal beliefs, which influenced clinical judgment and at times conflicted with military protocol: autonomy advocates, pro-life determinists, and nuanced navigators. Autonomy advocates struggled with the complexity of self-determination within the military institution. Pro-life determinists aligned their actions with life preservation, often guided by religious or spiritual ethos. Nuanced navigators emphasized situational context while adhering strictly to military doctrine. These varying belief systems shaped clinicians’ decision-making processes regarding suicide intervention, revealing challenges in balancing ethical complexities with military requirements. Participants shared that within the hierarchies, policies, and procedures of the military complex, connection and power imbalances challenged clinicians to create the space for authentic relationships. They worked to balance the requirements of their role with the ethics of their profession.
Conclusions: Clinicians’ personal beliefs intersected with their clinical judgment and approaches to suicide intervention within military settings. Understanding these perspectives—autonomy advocacy, pro-life determinism, and nuanced navigation—offers insights into the complexity of providing mental health care in a structured military environment. The findings contribute to a broader understanding of how personal beliefs intersect with clinical practice and provide recommendations for enhancing clinician training and support to improve care quality for military personnel facing suicidal challenges. Approaches to care that utilize relational cultural theory methods that explicitly address the challenges of therapeutic care in the military context may facilitate building robust therapeutic relationships that address power differences and chronic disconnection while engaging authenticity towards connection.