A lifeline in the dark: Breaking through the stigma of veteran mental health and treating America's combat veterans

Botero, Gabriel; Rivera, Nilsa I.; Calloway, Shakeya C.; Ortiz, Pedro L.; Edwards, Emily; Chae, John W.; Geraci, Joseph C.

doi:10.1002/jclp.22918

Cited by 14 publications

(10 citation statements)

References 12 publications

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“…To aid in addressing some of these limitations of VAMCs, VA Vet Centers are community-based clinics providing outreach, counseling, and referral services for Veterans. To make Vet Centers more accessible and less stigmatizing, these clinics are located in the Veteran’s community, employ a high number of Veterans, and utilize a unique record-keeping system that maintains confidentiality separate from other VA and DoD medical records (Botero et al, 2020). Unlike VAMCs and CBOCs, Vet Centers will also work with Veterans with less than honorable discharge types provided the Veteran is engaged in applying for a discharge upgrade.…”

Section: Resultsmentioning

confidence: 99%

Supporting the nation’s transitioning veterans: Narrative review of practices and recommendations for psychotherapy and counseling of veterans separating from military service.

Edwards¹,

Goldsmith²,

Tran³

et al. 2023

Psychological Services

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Each year, approximately 200,000 service members transition out of military service and return to civilian life. For many, the stresses of this military-to-civilian transition are vast and include instabilities in mental health, relationships, employment, education, and housing. Given their unique training, mental health professionals often find themselves on the front lines of efforts to support this population. However, to date, literature to guide work with this population has been scant and disorganized. This narrative review provides practitioners both within and outside the Veterans Health Administration with an overview of relevant literature in this area and offers concrete, practical recommendations for how to best support transitioning Veterans through psychotherapy and counseling. Three major themes are reviewed: (a) Engagement strategies, including clinical style, mitigation of privacy concerns, and consideration of broader psychosocial issues; (b) contextual considerations, including challenges of the "Thank You for Your Service" phenomenon, identity considerations, and circumstances of discharge; and (c) information about available services. Impact StatementMental health professionals are uniquely trained to provide psychosocial supports to service members and veterans struggling to navigate the transition from military service to civilian life. However, the empirical literature to guide provision of such support has been scant and disorganized. Through a narrative review, this article offers recommendations around engagement strategies, contextual considerations, and available services to consider in service of this population.

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Section: Resultsmentioning

confidence: 99%

Supporting the nation’s transitioning veterans: Narrative review of practices and recommendations for psychotherapy and counseling of veterans separating from military service.

Edwards¹,

Goldsmith²,

Tran³

et al. 2023

Psychological Services

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“…Military veterans are faced with constant stigma regarding their mental fitness and a marid of other life struggles (Botero et al., 2022). However, Black veterans have deeper concerns than their counterparts because they are returning to a culture and identity that has been the subject of discrimination, disparities, and anti‐Black ideation.…”

Section: Discussionmentioning

confidence: 99%

The relationship between Black racial identity, military identity, and postdeployment reintegration of Black male veterans

Winters

Hutchins

Nelson

2023

J Multicult Couns & Deve

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Given the increasing rate of military service members who experience mental health issues during reintegration into civilian culture, the need for counselors who specialize in postdeployment reintegration practices for Black men persists. Moreover, a nuanced approach to understanding how best to provide culturally competent support in therapeutic contexts for Black male veterans, a psychologically vulnerable population due to historical experiences of oppression and discrimination, is worthy of additional consideration. This study explored the impact of Black U.S. men's (N = 94) racial and military identities on postdeployment reintegration. Results indicated a significant predictive relationship between Black racial identity, military identity, and postdeployment reintegration. Practical implications and directions for future research are discussed.

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“…Some veterans with mental health conditions may be willing to share de-identified data with researchers [ 58 ]. However, others remain concerned about the stigma of mental health diagnoses (depression, PTSD) and military sexual trauma and may be reluctant to engage in treatment [ 59 , 60 ]. In this trial, veterans often mentioned their specific condition during their interviews.…”

Section: Discussionmentioning

confidence: 99%

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care

Salsbury

Twist

Wallace

et al. 2022

Pilot Feasibility Stud

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Background Low back pain (LBP) is common among military veterans seeking treatment in Department of Veterans Affairs (VA) healthcare facilities. As chiropractic services within VA expand, well-designed pragmatic trials and implementation studies are needed to assess clinical effectiveness and program uptake. This study evaluated veteran stakeholder perceptions of the feasibility and acceptability of care delivery and research processes in a pilot trial of multimodal chiropractic care for chronic LBP. Methods The qualitative study was completed within a mixed-method, single-arm, pragmatic, pilot clinical trial of chiropractic care for LBP conducted in VA chiropractic clinics. Study coordinators completed semi-structured, in person or telephone interviews with veterans near the end of the 10-week trial. Interviews were audiorecorded and transcribed verbatim. Qualitative content analysis using a directed approach explored salient themes related to trial implementation and delivery of chiropractic services. Results Of 40 participants, 24 completed interviews (60% response; 67% male gender; mean age 51.7 years). Overall, participants considered the trial protocol and procedures feasible and reported that the chiropractic care and recruitment methods were acceptable. Findings were organized into 4 domains, 10 themes, and 21 subthemes. Chiropractic service delivery domain encompassed 3 themes/8 subthemes: scheduling process (limited clinic hours, scheduling future appointments, attendance barriers); treatment frequency (treatment sufficient for LBP complaint, more/less frequent treatments); and chiropractic clinic considerations (hire more chiropractors, including female chiropractors; chiropractic clinic environment; patient-centered treatment visits). Outcome measures domain comprised 3 themes/4 subthemes: questionnaire burden (low burden vs. time-consuming or repetitive); relevance (items relevant for LBP study); and timing and individualization of measures (questionnaire timing relative to symptoms, personalized approach to outcomes measures). The online data collection domain included 2 themes/4 subthemes: user concerns (little difficulty vs. form challenges, required computer skills); and technology issues (computer/internet access, junk mail). Clinical trial planning domain included 2 themes/5 subthemes: participant recruitment (altruistic service by veterans, awareness of chiropractic availability, financial compensation); and communication methods (preferences, potential barriers). Conclusions This qualitative study highlighted veteran stakeholders’ perceptions of VA-based chiropractic services and offered important suggestions for conducting a full-scale, veteran-focused, randomized trial of multimodal chiropractic care for chronic LBP in this clinical setting. Trial registration ClinicalTrials.govNCT03254719

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A lifeline in the dark: Breaking through the stigma of veteran mental health and treating America's combat veterans

Cited by 14 publications

References 12 publications

Supporting the nation’s transitioning veterans: Narrative review of practices and recommendations for psychotherapy and counseling of veterans separating from military service.

Supporting the nation’s transitioning veterans: Narrative review of practices and recommendations for psychotherapy and counseling of veterans separating from military service.

The relationship between Black racial identity, military identity, and postdeployment reintegration of Black male veterans

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care

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