Katinka C Hooyer | Medical College of Wisconsin (original) (raw)
Videos by Katinka C Hooyer
Dear Veteran is a public art project that gives civilians an opportunity to acknowledge Veterans ... more Dear Veteran is a public art project that gives civilians an opportunity to acknowledge Veterans in their lives and communities. Inspired by the Shinto shrines of Japan where devotees write their wishes and prayers on small wooden plaques, and the prayer trees of Tibet, Dear Veteran cards are placed on trees in public places as gestures of tribute and hope.
Dearveteran.com
https://www.facebook.com/Dearveteran/
3 views
Papers by Katinka C Hooyer
Companion of the 2020 ACM International Conference on Supporting Group Work, 2020
Text classification using machine learning can be applied in various contexts such as in classify... more Text classification using machine learning can be applied in various contexts such as in classifying research papers, identifying relevant news stories, and detecting fake reviews. Training an algorithm to perform such tasks generally requires a dataset with predefined labels. Valid labels for texts in a given domain can be predefined by domain experts. However, when it comes to free-form text from messaging applications and social networking sites it is difficult to predict what labels may be extracted from the text. Grounded theory provides a method by which concepts that emerge from data can be expressed as categories and properties. These categories and properties can then be arranged in a hierarchical class label structure that can be used to build a dataset for training models. This study focuses on text related to veterans with post traumatic stress disorder and identifies a hierarchical class label structure, with the future goal of applying this to prevent crisis situations.
Journal of Traumatic Stress, 2024
The two widely available evidence-based psychotherapies (EBPs) for posttrau- matic stress disorde... more The two widely available evidence-based psychotherapies (EBPs) for posttrau- matic stress disorder (PTSD) are cognitive processing therapy and prolonged exposure. Although the U.S. Department of Veterans Affairs (VA) has invested in intensive clinical training to provide these first-line treatments, most mili- tary veterans do not receive these therapies. Prior research indicates that patient interest and motivation depend on how patients are educated, and differences in how information is presented shape their decision-making. To our knowledge, no studies have addressed how clinicians “pitch” EBPs for PTSD and examined whether certain approaches are more effective than others. We recorded and thematically analyzed 25 treatment planning sessions across 10 VA sites in the United States to better understand how providers talk to patients about treatment options. Five themes were identified: using rich description, integrating various forms of questioning to engage the patient, sharing prior patient success stories, using inviting and direct language, and tailoring therapy talk to fit patient needs. Providers learning to offer EBPs can use these strategies to serve as a “menu” of options that will allow them to present EBPs in a way that appeals to a particular patient.
Journal of Traumatic Stress, 2024
Peer mentorship shows promise as a strategy to support veteran mental health. A community-academi... more Peer mentorship shows promise as a strategy to support veteran mental health. A community-academic partnership involving a veteran-led nonprofit organization and institutions of higher education evaluated a collaboratively developed peer mentor intervention. We assessed posttraumatic stress disorder (PTSD), postdeployment experiences, social functioning, and psychological strengths at
Journal of Humanistic Psychology, 2023
Veteran community engagement is an evolving discipline informed by traditional community-based pa... more Veteran community engagement is an evolving discipline informed by traditional community-based participatory research, veteran studies, and veterans themselves. This Special Issue suggests that research collaborations including military veterans, soldiers, and their families as co-researchers is a critical next step toward a design thinking perspective in social and healthcare systems for this population. This Special Issue was conceptualized through a veteran community-academic partnership formed over a decade ago. This partnership hosted several Warrior Summit conferences from 2013 to present, with the last of this series calling for academic contributions. The resulting papers drawn from the conference and other authors form this issue, and include a wide range of topics: veteran microdosing and psychedelic self-medication; a historical view of the impact of education exchange between U.S. and South Korean military nurses; strategies for engaging veterans in research of a theaterbased intervention for PTSD; interprofessional approaches to addressing veteran identity considerations through collaborations between chaplain service and psychologists in the VA Healthcare System; an international perspective
Journal of Humanistic Psychology, 2023
The Medical College of Wisconsin (MCW) serves the Milwaukee metro area, one of the most diverse a... more The Medical College of Wisconsin (MCW) serves the Milwaukee metro area, one of the most diverse and segregated urban areas in the United States. In the acute crisis phase of the COVID-19 pandemic, MCW's Civic and Community Engagement (C/CE) efforts were leveraged to address community concerns around four key initiatives: (a) availability of personal protective equipment in community; (b) food and housing issues for homeless individuals; (c) the
PLoS ONE, 2022
Posttraumatic Stress Disorder continues to be a highly stigmatized disease for the veteran popula... more Posttraumatic Stress Disorder continues to be a highly stigmatized disease for the veteran population and stigma, experienced as a mark of discredit or shame, continues to be identified as the main deterrent in treatment seeking. Little attention has been paid to how the process of obtaining service-connected disability status can amplify veterans' perceptions of being stigmatized. The following ethnographic study identified how combat veterans experienced stigma in processing through Veterans Affairs care and the effects of linking a Posttraumatic Stress Disorder diagnosis with disability compensation. Stigma was identified in two interrelated areas: 1) the structural level in the Veterans Affairs disability claims process and 2) the individual level in interactions with Veterans Affairs service providers. Findings based on veterans' narratives suggest that the disability claims process, requiring multiple repetitions of personal trauma, coupled with perceptions of institutional stigmas of malingering, created bureaugenic effects: a worsening of symptoms caused by bureaucratic protocols intended to help veterans. This process influenced first time treatment users of the Veterans Affairs by deterring treatment-seeking behavior but was not found to affect veterans who had already initiated treatment. Despite the experience of stigma and commodification of their suffering through disability and diagnostic screening, veterans still sought disability compensation. Veterans viewed this compensation as acknowledgment of their loss and validation of their sacrifice.
For veterans with moral conflicts brought on by war work, evidence-based approaches designed for ... more For veterans with moral conflicts brought on by war work, evidence-based approaches designed for posttraumatic stress disorder tend not to attend to resulting spiritual and ethical forms of suffering. These "treatment-resistant" veterans are at high risk for self-harm. While new medical treatments are being developed, it is also clear that veterans themselves are experimenting in collective, ritualistic, and community-based ceremonial uses of psychedelic medicine. This article introduces the concept of altered states of combat (ASCombat) to refer to the specific mind-set soldiers experience in combat. As a preliminary analytical framework, we associate ASCombat to the widely studied altered states of consciousness as a way to advance understanding on the use and effectiveness of psychedelics and collective healing in the veteran population. The notion of ASCombat and typology is grounded in 4 years of veteran-engaged research in community-based healing approaches. The self-report of one case, by the veteran author of this article, provides suggestive materials for analysis, discussion, and future research.
Journal of Veterans Studies, 2021
The media stereotypes military veterans as damaged beings or indestructible heroes, often forming... more The media stereotypes military veterans as damaged beings or indestructible heroes, often forming implicit and explicit biases that impact medical and health providers' capability to connect emotionally with veterans. This educational tool uses interactive theater to challenge veteran stigma, enhance empathy, and increase learners' ability to talk to veterans about their service. This 90-minute session includes an interactive theater performance where learners recite verbatim veteran interview excerpts. This article contains all the materials necessary to replicate this activity in the appendices. The performance is prefaced with an introduction of the script, how it was developed and directions for engaging in the session. The session is facilitated by faculty knowledgeable in veteran culture and care who led post-performance discussion. Electronic survey data provides quantitative and qualitative assessment of learners' attitudes, beliefs, and quality of the session. Learner satisfaction revealed satisfaction among all questions asked, which including the following dimensions: instructional format, session content, impact of content. Qualitative results illustrated a newfound awareness of the diversity of military experience, personal bias, and the impact of social stigma on veteran health. Addressing stigma in the vulnerable veteran population is challenging. This one-time intervention called for learners to confront their biases and showed a short-term impact that may improve clinical care of veterans. Future research should address long-term impact on patient care and clinical outcomes.
Health Expectations, 2021
Background: Patient engagement in research agenda setting is increasingly being seen as a strateg... more Background: Patient engagement in research agenda setting is increasingly being seen as a strategy to improve the responsiveness of healthcare to patient priorities. Implementation of low-dose computed tomography (LDCT) screening for lung cancer is suboptimal, suggesting that research is needed. Objectives: This study aimed to describe an approach by which a Veteran patient group worked with other stakeholders to develop a research agenda for LDCT screening and to describe the research questions that they prioritized.
Practicing Anthropology, 2018
Finding Words for the Indescribable in writing up field notes is an often challenging role for th... more Finding Words for the Indescribable in writing up field notes is an often challenging role for the researcher. The following paper introduces our method of veteran-engaged collaborative writing and offers an example of a creative product. Psychedelic Healing: The Spiritual Polishing of a Battle Fatigued Paratrooper, was a culmination of collaborative writing experiments designed to uncover noetic experiences. We define the noetic as deeply insightful moments of knowing that are life-altering but difficult to describe. The writing experiments, intended to elicit these moments, evolved into a method to collect sensitive data around military war trauma and the ritual use of psycho-active substances to heal from those traumas.
Military veterans are stereotyped in the media as either broken human beings or invincible heroes... more Military veterans are stereotyped in the media as either broken human beings or invincible heroes, often creating implicit bias and affecting medical providers' ability to establish trusting relationships. Interactive learning methods can challenge stigma and create empathic connections with veterans in a manner that conveys sensitivity. Community-engaged theater has been successfully used in health education to transfer knowledge on both emotional and cognitive levels. This article reports on a research-based theater intervention, Tracings of Trauma, codesigned by veterans and aimed at orienting medical/allied health students to the unique experiences of combat veterans. Early stage assessment demonstrated statistically significant improvement in students' self-perceived awareness of stigma and their ability to talk to veterans and empathize with veterans' experiences. Results suggest that interactive, performance-driven dissemination can provide deeper learning experiences regarding stigmatized groups who experience trauma. Evaluating long-term impact on practice will be critical in linking this intervention to clinical outcomes.
2019 IEEE 43rd Annual Computer Software and Applications Conference (COMPSAC), 2019
This research focuses on establishing a psychological treatment system especially for Milwaukee b... more This research focuses on establishing a psychological treatment system especially for Milwaukee based veterans outside the traditional clinical environment of Veterans Affairs (VA). As part of this process, a 12- week intervention had been made. Data had been collected related to different health aspects and psychological measurements. With the help of expert veterans and psychologist, we had defined early warning signs, acute crisis and long-term crisis from this dataset. We had used different algorithms to predict long term crisis using acute crisis and early warning signs. At the end, we had established a clinical decision-making rule to assist peer mentor veterans to help their fellow mentee veterans especially those suffering from PTSD.
Towards Clinical Decision Support for Veteran Mental Health Crisis Events using Tree Algorithm, 2020
Text classification using machine learning can be applied in various contexts such as in classify... more Text classification using machine learning can be applied in various contexts such as in classifying research papers, identifying relevant news stories, and detecting fake reviews. Training an algorithm to perform such tasks generally requires a dataset with predefined labels. Valid labels for texts in a given domain can be predefined by domain experts. However, when it comes to free-form text from messaging applications and social networking sites it is difficult to predict what labels may be extracted from the text. Grounded theory provides a method by which concepts that emerge from data can be expressed as categories and properties. These categories and properties can then be arranged in a hierarchical class label structure that can be used to build a dataset for training models. This study focuses on text related to veterans with post traumatic stress disorder and identifies a hierarchical class label structure, with the future goal of applying this to prevent crisis situations.
Veteran community engagement is an evolving discipline informed by traditional community-based pa... more Veteran community engagement is an evolving discipline informed by traditional community-based participatory research, veteran studies, and veterans themselves. This Special Issue suggests that research collaborations including military veterans, soldiers, and their families as co-researchers is a critical next step toward a designing thinking perspective in social and healthcare systems for this population. This Special Issue was conceptualized through a veteran community-academic partnership formed over a decade ago. We briefly describe the activities of this partnership from 2008 to present in order to frame the praxis considerations within this issue. The partnership hosted several Warrior Summit conferences from 2013 to present, with the last of this series calling for academic contributions. The resulting papers drawn from the conference and other authors form this issue, and include a wide range of topics: Arts-and theater-based interventions for PTSD; engaging veteran college students in higher education; combining strengths
Several attempts have been made at creating mobile solutions for patients with mental disorders. ... more Several attempts have been made at creating mobile solutions for patients with mental disorders. A preemptive approach would definitely outdo a reactive one. This project seeks to ensure better crisis detection, by assigning patients (veterans) to caregivers (mentors). This is called the mentor-mentee approach. Enhanced with the use of mobile technology, veterans can stay connected in their daily lives to mentors, who have gone through the same traumatic experiences and have overcome them. A mobile application for communication between veterans and their mentors has been developed, which helps mentors get constant feedback from their mentees about their state of well-being. However, being able to make good deductions from the data given as feedback is of great importance. Under-representing or over-representing the data could be dangerously misleading. This paper WiPe Paper – Community Engagement & Healthcare Systems Proceedings of the 16th ISCRAM Conference – València, Spain May 20...
PUBLIC: Arts, Humanities, Design , 2017
This " practice biography " of a participatory performance and anti-stigma classroom educational ... more This " practice biography " of a participatory performance and anti-stigma classroom educational tool, Tracings of Trauma, illuminates the important role of emotion in intellectual work. It is rooted in interview data from Iraq and Afghanistan combat veterans and illustrates how artistic translations of research provide social scientists ways to contemplate their work subjectively. Beyond benefits to the researcher, these translations can flow into the emotional landscape of audiences in ways that encourage reflection. This practice of transforming emotion and judgment into artistic products connects us more deeply to the people we work with and can be applied in ways that are relevant and accessible to those who help to produce the findings. The public practice of these interventions in our broader communities produces social change in ways that often escape traditional academic forms of dissemination.
The cross-fertilization between art and science gives birth to interesting forms of disseminating data that connect us to new audiences, but also allow for rapid change in the communities in which we work. This "practice biography" looks at the evolution of one of these forms and the role of emotion in scholarship. It traces my experience as an anthropologist doing research with Iraq and Afghanistan veterans and my growing responsibility to the participants I work with to share the burden of war with the public through non-academic mediums. I will argue that arts-based scholarship offers many opportunities for anthropologists and other social science scholars to develop a public practice that moves us. It moves us to connect on deeper levels with our participants and forges better relationships with them. Most importantly, it generates a knowledge production that is meaningful to the people we work with. These products can teach about social and cultural difference in a manner that nurtures empathy and compassion—the very social experiences that connect us as humans.
Journal of Humanistic Psychology - Call for Papers
This special issue is motivated by experiences of the COVID-19 pandemic, and a desire to explore ... more This special issue is motivated by experiences of the COVID-19 pandemic, and a desire to explore an increasingly transdisciplinary view of public health, integrating ideas as decolonial praxis from psychology, ethnography, anthropology, economics, cultural, arts, and communications studies. Our intent is to build on conversations about inclusive and equitable disaster recovery that place individual and lived experiences of communities - within the context of the broader disaster event - at the forefront of the discussion.
Humanistic psychology presents a unique and open framework for exploring how human potential, actualization, and strengths can be leveraged in challenging situations. The COVID-19 pandemic exposed how profound inequities in social determinants of health lead to increased disease incidence, morbidity and mortality in Black, Indigenous, Hispanic, Asian and other communities, reflecting generations of colonization and epistemicide. Bridging humanistic psychology, public health, and communities can provide important insights about attuning person- and neighborhood-centered public health strategies for major crisis events to particular cultures, languages, and value systems.
This special issue will emphasize completed projects that demonstrate real-world application of the ideas drawn from these disciplines in applied pandemic response and/or recovery. We are looking for specific response examples that show significant and sustained attention to equity, community health concerns, and culturally attuned public health messaging during the pandemic. Projects that explicitly navigate issues around individual, community, and institutional power are encouraged.
The psychiatric costs of war have contributed to an ‘epidemic of suicide’ linked to PTSD among Un... more The psychiatric costs of war have contributed to an ‘epidemic of suicide’ linked to PTSD among United States military service personnel. Current research identifies ‘self-stigma as the barrier to care’ and dominant thinking surrounding interventions focuses on overcoming self- stigma to obtain mental health services. The research and programming is grounded in leading social- cognitive and behavioral models that focus on individual interactions. This descriptive analysis of high-profile AWOL cases provides a counter-narrative to this predominant biomedical discourse. In these cases, soldiers chance increased stigmatization through risking dishonorable discharge in their pursuit of care. The question emerges, is lack of help-seeking taking place due to self-stigmatizing or due to broader structural elements that restrict choices? And more critically, are dominant theories of health behavior that focus on individual choice relevant in contexts where there is limited autonomy? Preliminary ethnographic research with veterans and active duty soldiers in addition to content analysis of online military blogs and investigative news reports explore these questions. Anthropological models are introduced to provide a more fixed consideration of structural influences on individuals’ actions and to offer an alternative approach to intervention.
Community Engagement & Healthcare Systems Proceedings of the 16th ISCRAM Conference, 2019
Several attempts have been made at creating mobile solutions for patients with mental disorders. ... more Several attempts have been made at creating mobile solutions for patients with mental disorders. A preemptive approach would definitely outdo a reactive one. This project seeks to ensure better crisis detection, by assigning patients (veterans) to caregivers (mentors). This is called the mentor-mentee approach. Enhanced with the use of mobile technology, veterans can stay connected in their daily lives to mentors, who have gone through the same traumatic experiences and have overcome them. A mobile application for communication between veterans and their mentors has been developed, which helps mentors get constant feedback from their mentees about their state of well-being. However, being able to make good deductions from the data given as feedback is of great importance. Under-representing or over-representing the data could be dangerously misleading. This paper
Dear Veteran is a public art project that gives civilians an opportunity to acknowledge Veterans ... more Dear Veteran is a public art project that gives civilians an opportunity to acknowledge Veterans in their lives and communities. Inspired by the Shinto shrines of Japan where devotees write their wishes and prayers on small wooden plaques, and the prayer trees of Tibet, Dear Veteran cards are placed on trees in public places as gestures of tribute and hope.
Dearveteran.com
https://www.facebook.com/Dearveteran/
3 views
Companion of the 2020 ACM International Conference on Supporting Group Work, 2020
Text classification using machine learning can be applied in various contexts such as in classify... more Text classification using machine learning can be applied in various contexts such as in classifying research papers, identifying relevant news stories, and detecting fake reviews. Training an algorithm to perform such tasks generally requires a dataset with predefined labels. Valid labels for texts in a given domain can be predefined by domain experts. However, when it comes to free-form text from messaging applications and social networking sites it is difficult to predict what labels may be extracted from the text. Grounded theory provides a method by which concepts that emerge from data can be expressed as categories and properties. These categories and properties can then be arranged in a hierarchical class label structure that can be used to build a dataset for training models. This study focuses on text related to veterans with post traumatic stress disorder and identifies a hierarchical class label structure, with the future goal of applying this to prevent crisis situations.
Journal of Traumatic Stress, 2024
The two widely available evidence-based psychotherapies (EBPs) for posttrau- matic stress disorde... more The two widely available evidence-based psychotherapies (EBPs) for posttrau- matic stress disorder (PTSD) are cognitive processing therapy and prolonged exposure. Although the U.S. Department of Veterans Affairs (VA) has invested in intensive clinical training to provide these first-line treatments, most mili- tary veterans do not receive these therapies. Prior research indicates that patient interest and motivation depend on how patients are educated, and differences in how information is presented shape their decision-making. To our knowledge, no studies have addressed how clinicians “pitch” EBPs for PTSD and examined whether certain approaches are more effective than others. We recorded and thematically analyzed 25 treatment planning sessions across 10 VA sites in the United States to better understand how providers talk to patients about treatment options. Five themes were identified: using rich description, integrating various forms of questioning to engage the patient, sharing prior patient success stories, using inviting and direct language, and tailoring therapy talk to fit patient needs. Providers learning to offer EBPs can use these strategies to serve as a “menu” of options that will allow them to present EBPs in a way that appeals to a particular patient.
Journal of Traumatic Stress, 2024
Peer mentorship shows promise as a strategy to support veteran mental health. A community-academi... more Peer mentorship shows promise as a strategy to support veteran mental health. A community-academic partnership involving a veteran-led nonprofit organization and institutions of higher education evaluated a collaboratively developed peer mentor intervention. We assessed posttraumatic stress disorder (PTSD), postdeployment experiences, social functioning, and psychological strengths at
Journal of Humanistic Psychology, 2023
Veteran community engagement is an evolving discipline informed by traditional community-based pa... more Veteran community engagement is an evolving discipline informed by traditional community-based participatory research, veteran studies, and veterans themselves. This Special Issue suggests that research collaborations including military veterans, soldiers, and their families as co-researchers is a critical next step toward a design thinking perspective in social and healthcare systems for this population. This Special Issue was conceptualized through a veteran community-academic partnership formed over a decade ago. This partnership hosted several Warrior Summit conferences from 2013 to present, with the last of this series calling for academic contributions. The resulting papers drawn from the conference and other authors form this issue, and include a wide range of topics: veteran microdosing and psychedelic self-medication; a historical view of the impact of education exchange between U.S. and South Korean military nurses; strategies for engaging veterans in research of a theaterbased intervention for PTSD; interprofessional approaches to addressing veteran identity considerations through collaborations between chaplain service and psychologists in the VA Healthcare System; an international perspective
Journal of Humanistic Psychology, 2023
The Medical College of Wisconsin (MCW) serves the Milwaukee metro area, one of the most diverse a... more The Medical College of Wisconsin (MCW) serves the Milwaukee metro area, one of the most diverse and segregated urban areas in the United States. In the acute crisis phase of the COVID-19 pandemic, MCW's Civic and Community Engagement (C/CE) efforts were leveraged to address community concerns around four key initiatives: (a) availability of personal protective equipment in community; (b) food and housing issues for homeless individuals; (c) the
PLoS ONE, 2022
Posttraumatic Stress Disorder continues to be a highly stigmatized disease for the veteran popula... more Posttraumatic Stress Disorder continues to be a highly stigmatized disease for the veteran population and stigma, experienced as a mark of discredit or shame, continues to be identified as the main deterrent in treatment seeking. Little attention has been paid to how the process of obtaining service-connected disability status can amplify veterans' perceptions of being stigmatized. The following ethnographic study identified how combat veterans experienced stigma in processing through Veterans Affairs care and the effects of linking a Posttraumatic Stress Disorder diagnosis with disability compensation. Stigma was identified in two interrelated areas: 1) the structural level in the Veterans Affairs disability claims process and 2) the individual level in interactions with Veterans Affairs service providers. Findings based on veterans' narratives suggest that the disability claims process, requiring multiple repetitions of personal trauma, coupled with perceptions of institutional stigmas of malingering, created bureaugenic effects: a worsening of symptoms caused by bureaucratic protocols intended to help veterans. This process influenced first time treatment users of the Veterans Affairs by deterring treatment-seeking behavior but was not found to affect veterans who had already initiated treatment. Despite the experience of stigma and commodification of their suffering through disability and diagnostic screening, veterans still sought disability compensation. Veterans viewed this compensation as acknowledgment of their loss and validation of their sacrifice.
For veterans with moral conflicts brought on by war work, evidence-based approaches designed for ... more For veterans with moral conflicts brought on by war work, evidence-based approaches designed for posttraumatic stress disorder tend not to attend to resulting spiritual and ethical forms of suffering. These "treatment-resistant" veterans are at high risk for self-harm. While new medical treatments are being developed, it is also clear that veterans themselves are experimenting in collective, ritualistic, and community-based ceremonial uses of psychedelic medicine. This article introduces the concept of altered states of combat (ASCombat) to refer to the specific mind-set soldiers experience in combat. As a preliminary analytical framework, we associate ASCombat to the widely studied altered states of consciousness as a way to advance understanding on the use and effectiveness of psychedelics and collective healing in the veteran population. The notion of ASCombat and typology is grounded in 4 years of veteran-engaged research in community-based healing approaches. The self-report of one case, by the veteran author of this article, provides suggestive materials for analysis, discussion, and future research.
Journal of Veterans Studies, 2021
The media stereotypes military veterans as damaged beings or indestructible heroes, often forming... more The media stereotypes military veterans as damaged beings or indestructible heroes, often forming implicit and explicit biases that impact medical and health providers' capability to connect emotionally with veterans. This educational tool uses interactive theater to challenge veteran stigma, enhance empathy, and increase learners' ability to talk to veterans about their service. This 90-minute session includes an interactive theater performance where learners recite verbatim veteran interview excerpts. This article contains all the materials necessary to replicate this activity in the appendices. The performance is prefaced with an introduction of the script, how it was developed and directions for engaging in the session. The session is facilitated by faculty knowledgeable in veteran culture and care who led post-performance discussion. Electronic survey data provides quantitative and qualitative assessment of learners' attitudes, beliefs, and quality of the session. Learner satisfaction revealed satisfaction among all questions asked, which including the following dimensions: instructional format, session content, impact of content. Qualitative results illustrated a newfound awareness of the diversity of military experience, personal bias, and the impact of social stigma on veteran health. Addressing stigma in the vulnerable veteran population is challenging. This one-time intervention called for learners to confront their biases and showed a short-term impact that may improve clinical care of veterans. Future research should address long-term impact on patient care and clinical outcomes.
Health Expectations, 2021
Background: Patient engagement in research agenda setting is increasingly being seen as a strateg... more Background: Patient engagement in research agenda setting is increasingly being seen as a strategy to improve the responsiveness of healthcare to patient priorities. Implementation of low-dose computed tomography (LDCT) screening for lung cancer is suboptimal, suggesting that research is needed. Objectives: This study aimed to describe an approach by which a Veteran patient group worked with other stakeholders to develop a research agenda for LDCT screening and to describe the research questions that they prioritized.
Practicing Anthropology, 2018
Finding Words for the Indescribable in writing up field notes is an often challenging role for th... more Finding Words for the Indescribable in writing up field notes is an often challenging role for the researcher. The following paper introduces our method of veteran-engaged collaborative writing and offers an example of a creative product. Psychedelic Healing: The Spiritual Polishing of a Battle Fatigued Paratrooper, was a culmination of collaborative writing experiments designed to uncover noetic experiences. We define the noetic as deeply insightful moments of knowing that are life-altering but difficult to describe. The writing experiments, intended to elicit these moments, evolved into a method to collect sensitive data around military war trauma and the ritual use of psycho-active substances to heal from those traumas.
Military veterans are stereotyped in the media as either broken human beings or invincible heroes... more Military veterans are stereotyped in the media as either broken human beings or invincible heroes, often creating implicit bias and affecting medical providers' ability to establish trusting relationships. Interactive learning methods can challenge stigma and create empathic connections with veterans in a manner that conveys sensitivity. Community-engaged theater has been successfully used in health education to transfer knowledge on both emotional and cognitive levels. This article reports on a research-based theater intervention, Tracings of Trauma, codesigned by veterans and aimed at orienting medical/allied health students to the unique experiences of combat veterans. Early stage assessment demonstrated statistically significant improvement in students' self-perceived awareness of stigma and their ability to talk to veterans and empathize with veterans' experiences. Results suggest that interactive, performance-driven dissemination can provide deeper learning experiences regarding stigmatized groups who experience trauma. Evaluating long-term impact on practice will be critical in linking this intervention to clinical outcomes.
2019 IEEE 43rd Annual Computer Software and Applications Conference (COMPSAC), 2019
This research focuses on establishing a psychological treatment system especially for Milwaukee b... more This research focuses on establishing a psychological treatment system especially for Milwaukee based veterans outside the traditional clinical environment of Veterans Affairs (VA). As part of this process, a 12- week intervention had been made. Data had been collected related to different health aspects and psychological measurements. With the help of expert veterans and psychologist, we had defined early warning signs, acute crisis and long-term crisis from this dataset. We had used different algorithms to predict long term crisis using acute crisis and early warning signs. At the end, we had established a clinical decision-making rule to assist peer mentor veterans to help their fellow mentee veterans especially those suffering from PTSD.
Towards Clinical Decision Support for Veteran Mental Health Crisis Events using Tree Algorithm, 2020
Text classification using machine learning can be applied in various contexts such as in classify... more Text classification using machine learning can be applied in various contexts such as in classifying research papers, identifying relevant news stories, and detecting fake reviews. Training an algorithm to perform such tasks generally requires a dataset with predefined labels. Valid labels for texts in a given domain can be predefined by domain experts. However, when it comes to free-form text from messaging applications and social networking sites it is difficult to predict what labels may be extracted from the text. Grounded theory provides a method by which concepts that emerge from data can be expressed as categories and properties. These categories and properties can then be arranged in a hierarchical class label structure that can be used to build a dataset for training models. This study focuses on text related to veterans with post traumatic stress disorder and identifies a hierarchical class label structure, with the future goal of applying this to prevent crisis situations.
Veteran community engagement is an evolving discipline informed by traditional community-based pa... more Veteran community engagement is an evolving discipline informed by traditional community-based participatory research, veteran studies, and veterans themselves. This Special Issue suggests that research collaborations including military veterans, soldiers, and their families as co-researchers is a critical next step toward a designing thinking perspective in social and healthcare systems for this population. This Special Issue was conceptualized through a veteran community-academic partnership formed over a decade ago. We briefly describe the activities of this partnership from 2008 to present in order to frame the praxis considerations within this issue. The partnership hosted several Warrior Summit conferences from 2013 to present, with the last of this series calling for academic contributions. The resulting papers drawn from the conference and other authors form this issue, and include a wide range of topics: Arts-and theater-based interventions for PTSD; engaging veteran college students in higher education; combining strengths
Several attempts have been made at creating mobile solutions for patients with mental disorders. ... more Several attempts have been made at creating mobile solutions for patients with mental disorders. A preemptive approach would definitely outdo a reactive one. This project seeks to ensure better crisis detection, by assigning patients (veterans) to caregivers (mentors). This is called the mentor-mentee approach. Enhanced with the use of mobile technology, veterans can stay connected in their daily lives to mentors, who have gone through the same traumatic experiences and have overcome them. A mobile application for communication between veterans and their mentors has been developed, which helps mentors get constant feedback from their mentees about their state of well-being. However, being able to make good deductions from the data given as feedback is of great importance. Under-representing or over-representing the data could be dangerously misleading. This paper WiPe Paper – Community Engagement & Healthcare Systems Proceedings of the 16th ISCRAM Conference – València, Spain May 20...
PUBLIC: Arts, Humanities, Design , 2017
This " practice biography " of a participatory performance and anti-stigma classroom educational ... more This " practice biography " of a participatory performance and anti-stigma classroom educational tool, Tracings of Trauma, illuminates the important role of emotion in intellectual work. It is rooted in interview data from Iraq and Afghanistan combat veterans and illustrates how artistic translations of research provide social scientists ways to contemplate their work subjectively. Beyond benefits to the researcher, these translations can flow into the emotional landscape of audiences in ways that encourage reflection. This practice of transforming emotion and judgment into artistic products connects us more deeply to the people we work with and can be applied in ways that are relevant and accessible to those who help to produce the findings. The public practice of these interventions in our broader communities produces social change in ways that often escape traditional academic forms of dissemination.
The cross-fertilization between art and science gives birth to interesting forms of disseminating data that connect us to new audiences, but also allow for rapid change in the communities in which we work. This "practice biography" looks at the evolution of one of these forms and the role of emotion in scholarship. It traces my experience as an anthropologist doing research with Iraq and Afghanistan veterans and my growing responsibility to the participants I work with to share the burden of war with the public through non-academic mediums. I will argue that arts-based scholarship offers many opportunities for anthropologists and other social science scholars to develop a public practice that moves us. It moves us to connect on deeper levels with our participants and forges better relationships with them. Most importantly, it generates a knowledge production that is meaningful to the people we work with. These products can teach about social and cultural difference in a manner that nurtures empathy and compassion—the very social experiences that connect us as humans.
Journal of Humanistic Psychology - Call for Papers
This special issue is motivated by experiences of the COVID-19 pandemic, and a desire to explore ... more This special issue is motivated by experiences of the COVID-19 pandemic, and a desire to explore an increasingly transdisciplinary view of public health, integrating ideas as decolonial praxis from psychology, ethnography, anthropology, economics, cultural, arts, and communications studies. Our intent is to build on conversations about inclusive and equitable disaster recovery that place individual and lived experiences of communities - within the context of the broader disaster event - at the forefront of the discussion.
Humanistic psychology presents a unique and open framework for exploring how human potential, actualization, and strengths can be leveraged in challenging situations. The COVID-19 pandemic exposed how profound inequities in social determinants of health lead to increased disease incidence, morbidity and mortality in Black, Indigenous, Hispanic, Asian and other communities, reflecting generations of colonization and epistemicide. Bridging humanistic psychology, public health, and communities can provide important insights about attuning person- and neighborhood-centered public health strategies for major crisis events to particular cultures, languages, and value systems.
This special issue will emphasize completed projects that demonstrate real-world application of the ideas drawn from these disciplines in applied pandemic response and/or recovery. We are looking for specific response examples that show significant and sustained attention to equity, community health concerns, and culturally attuned public health messaging during the pandemic. Projects that explicitly navigate issues around individual, community, and institutional power are encouraged.
The psychiatric costs of war have contributed to an ‘epidemic of suicide’ linked to PTSD among Un... more The psychiatric costs of war have contributed to an ‘epidemic of suicide’ linked to PTSD among United States military service personnel. Current research identifies ‘self-stigma as the barrier to care’ and dominant thinking surrounding interventions focuses on overcoming self- stigma to obtain mental health services. The research and programming is grounded in leading social- cognitive and behavioral models that focus on individual interactions. This descriptive analysis of high-profile AWOL cases provides a counter-narrative to this predominant biomedical discourse. In these cases, soldiers chance increased stigmatization through risking dishonorable discharge in their pursuit of care. The question emerges, is lack of help-seeking taking place due to self-stigmatizing or due to broader structural elements that restrict choices? And more critically, are dominant theories of health behavior that focus on individual choice relevant in contexts where there is limited autonomy? Preliminary ethnographic research with veterans and active duty soldiers in addition to content analysis of online military blogs and investigative news reports explore these questions. Anthropological models are introduced to provide a more fixed consideration of structural influences on individuals’ actions and to offer an alternative approach to intervention.
Community Engagement & Healthcare Systems Proceedings of the 16th ISCRAM Conference, 2019
Several attempts have been made at creating mobile solutions for patients with mental disorders. ... more Several attempts have been made at creating mobile solutions for patients with mental disorders. A preemptive approach would definitely outdo a reactive one. This project seeks to ensure better crisis detection, by assigning patients (veterans) to caregivers (mentors). This is called the mentor-mentee approach. Enhanced with the use of mobile technology, veterans can stay connected in their daily lives to mentors, who have gone through the same traumatic experiences and have overcome them. A mobile application for communication between veterans and their mentors has been developed, which helps mentors get constant feedback from their mentees about their state of well-being. However, being able to make good deductions from the data given as feedback is of great importance. Under-representing or over-representing the data could be dangerously misleading. This paper
Proceedings IEEE 43rd Annual Computer Software and Applications Conference (COMPSAC), 2019
This research focuses on establishing a psychological treatment system especially for Milwaukee b... more This research focuses on establishing a psychological treatment system especially for Milwaukee based veterans outside the traditional clinical environment of Veterans Affairs (VA). As part of this process, a 12-week intervention had been made. Data had been collected related to different health aspects and psychological measurements. With the help of expert veterans and psychologist, we had defined early warning signs, acute crisis and long-term crisis from this dataset. We had used different algorithms to predict long term crisis using acute crisis and early warning signs. At the end, we had established a clinical decision-making rule to assist peer mentor veterans to help their fellow mentee veterans especially those suffering from PTSD.
The discussion group series is purposefully designed to provide Veterans the time and support to ... more The discussion group series is purposefully designed to provide Veterans the time and support to reflect on and discuss experiences with war and moral injury. This 5-week program combines the graphic novel genre with contemporary war poetry as an entry point for difficult moral and spiritual dialogues. Max Uriarte’s novel, The White Donkey, is the main source. Each week is organized around a 90-minute session, beginning with a collective reading of sections from the novel and followed by semi-structured questions facilitated by a leader. Please see the accompanying Discussion Leader Guide for this Warriors Path series.
The discussion group series is purposefully designed to provide Veterans the time and support to ... more The discussion group series is purposefully designed to provide Veterans the time and support to reflect on and discuss experiences with war and moral injury. This 5-week program combines the graphic novel genre with contemporary war poetry as an entry point for difficult moral and spiritual dialogues. Max Uriarte’s novel, The White Donkey, is the main source. Each week is organized around a 90-minute session, beginning with a collective reading of sections from the novel and followed by semi-structured questions facilitated by a leader. Please see the accompanying Discussion Leader Guide for this Warriors Path series.
The discussion group series is purposefully designed to provide Veterans the time and support to ... more The discussion group series is purposefully designed to provide Veterans the time and support to reflect on and discuss experiences with war and moral injury. This 5-week program combines the scenes from Shakespeare’s plays with contemporary war poetry as an entry point for difficult moral and spiritual dialogues. Scenes from Coriolanus, Henry V, Henry IV, and Henry VI are the main sources. Each week is organized around a 90-minute session, beginning with a collective reciting of scenes, with lines from the scenes fed to participants. This scenework is followed by semi-structured questions facilitated by a leader. Please see the accompanying Discussion Leader Guide for this Warriors Path series.
The discussion group series is purposefully designed to provide Veterans the time and support to ... more The discussion group series is purposefully designed to provide Veterans the time and support to reflect on and discuss experiences with war and moral injury. This 5-week program combines the scenes from Shakespeare’s plays with contemporary war poetry as an entry point for difficult moral and spiritual dialogues. Scenes from Coriolanus, Henry V, Henry IV, and Henry VI are the main sources. Each week is organized around a 90-minute session, beginning with a collective reciting of scenes, with lines from the scenes fed to participants. This scenework is followed by semi-structured questions facilitated by a leader. Please see the accompanying Discussion Leader Guide for this Warriors Path series.
Community Engagement Conference: Creative Care for Vulnerable Populations, 2020
Moral injuries can contribute to severe mental health issues for some Veterans reintegrating afte... more Moral injuries can contribute to severe mental health issues for some Veterans reintegrating after war work. The goal of our community‐academic partnership was to develop a program that provided opportunities for the ethical and spiritual dialogues that are key to making sense of moral injury and the war experience. The Warriors Path: Moral Injury, War and Reclaiming the Soul trained Veteran discussion leaders to facilitate 5‐week Veteran‐to‐Veteran discussion groups. Utilizing Shakespeare's historic plays, basic acting techniques and reading circles of military graphic novels, Veterans experienced the moral injuries of characters as an entry point to embody and articulate their own experiences. We assessed if the program could change the experience ('clinical symptoms') of moral injury through administering the Moral Injury Short Form survey before and after the program. Unexpectedly, scores (symptoms) modestly increased. The modest increase in moral injury symptoms may be due to the reflective nature of the program activities and increase in the participants' ability to name, connect with, and identify feelings associated with moral injury. These results contrasted with interview findings that suggested an improvement in Veterans' self‐understanding of their moral wounds. Moral injury discussions require trust building among participants. Programming should allow for longer more sustained interactions to make sense of these complex experiences. Clinical measures may not be the best way to measure non‐clinical interventions.
Driftless Regional Psychedelic Therapy Symposium, Viroquo Wisconsin, 2017
Contemporary medical understanding of PTSD, with its focus on the biophysiology of trauma, does n... more Contemporary medical understanding of PTSD, with its focus on the biophysiology of trauma, does not capture the spiritual discord, personal disconnect and moral conflict that some veterans suffer after their military service. This phenomenon, moral injury, is experienced as a transgression of deeply held beliefs of what is right and wrong. Recent research on psychedelics focuses on its therapeutic effect on trauma within the constraints of a mental disorder (PTSD). This can be limiting for veterans who do not have a diagnosis of PTSD or refuse being labeled as mentally disordered. Instead, we explicitly use moral injury as a frame for scientific inquiry around trauma therapies and psychedelics, specifically the use of ayahuasca and toad-derived 5-MeO-DMT. This is an explorative discussion between a medical anthropologist researching alternative therapies for veterans and a former US paratrooper healing the moral injuries of his 6 deployments to Iraq and Haiti. Through this narrative research we ask, how might psychedelics provide guidance on the " Warrior's Path " to heal after experiencing the loss, guilt and shame that war work propagates? How is it possible to reclaim the " best version of yourself " (the higher self or soul) after both perpetrating and witnessing military atrocities? Our hope is to expand the considerations of health outcomes among veterans beyond measurable PTSD symptomology to include spiritual healing. The insights gained through this veteran's experience with ayahuasca illustrate the power of ritualized psychedelic use to return to a vision of the self as good and to cultivate the free will to choose this version of the self. Katinka Hooyer, PhD, MS Dan Kasza, Former Staff Sergeant, Weapons Squad Leader, 82nd Airborne Infantry Please contact Katinka.hooijer@gmail.com if you are interested in the audio of the presentation or go to the OmTerra.org website.
Veterans Affairs National Conference, Health Services Research & Development /QUERI Arlington, VA , 2017
Objectives: Many Veterans with treated post-traumatic stress disorder (PTSD) use alternative ther... more Objectives: Many Veterans with treated post-traumatic stress disorder (PTSD) use alternative therapies for persistent symptoms. We conducted a mixed methods study to identify perceived benefits and attributes of a service dog program.
Methods: We partnered with Hounds & Vets Empowered Now (HAVEN). HAVEN matches Veterans to dogs that have no training. The Veteran trains the dog with weekly supervision by a dog trainer without mental health (MH) training. We enrolled consecutive Veterans with PTSD treated at one VA Medical Center who used HAVEN. We gathered baseline utilization data by chart review and conducted one semi-structured interview with each Veteran. The first two interviews were inductively coded by two trained qualitative researchers; subsequent interviews were coded and thematically analyzed by study anthropologist (KH) and cross-checked by another study researcher (KE). The study anthropologist conducted observations of 9 training sessions.
Results: We enrolled 10 Veterans (70% male) ages 31 to 71 years. During the 12 months prior to the program, 9 Veterans had 10+ individual MH visits, 6 had 10+ group visits, 4 had participated in Cognitive Processing Therapy, and three had inpatient MH treatment. No dog had achieved certification as a service animal. In all interviews, benefits linked to calming anxiety, socialization, and a renewed sense of purpose emerged. Veterans related these benefits to providing routine care, as well as individual and group training activities. Veterans reported their dog provided personal safety, companionship, and unconditional love, enhancing their sense of self-worth and joy in life.
Conclusions: In addition to PTSD symptom reduction, this program enhanced self-efficacy and well-being, even though the dogs did not function as service dogs, suggesting these benefits were due to ownership and training rather than the dogs’ designation. Studies of the benefits of dogs should incorporate these considerations into their design.
Impact Statements: Owning and training a dog may provide Veterans with benefits not captured by standard PTSD symptom assessments or treatments. Dogs can provide social mobility where Veterans are “able to go out and do things” because the dog is “keeping watch,” allowing the Veteran to “relax and actually pay attention” to the people and activities that make life “worth living.”
Society for Applied Anthropologists, 77th Annual Meeting, 2017
The Art of Heartfelt Scholarship: What to do with the “surplus data” from Iraq and Afghanistan Ve... more The Art of Heartfelt Scholarship: What to do with the “surplus data” from Iraq and Afghanistan Veterans?
Despite the emotional connections we forge with our participants in community-engaged research, the analysis and dissemination of findings traditionally do not allow space for this emotionality. How can we use the non-intellectual part of research that emerges during fieldwork? In this presentation, I illustrate how performance ethnography creates opportunities for patients, researchers, and audiences to process and express emotions in ways that traditional research products omit or suppress. This practice of transforming feeling and judgment into arts-based health interventions can be applied in ways that are relevant and accessible to those who help to produce the findings.
Society of Teachers of Family Medicine Annual Conference on Medical Student Education, Anaheim, CA., 2017
Military Veterans are stereotyped in our popular culture as either broken human beings plagued wi... more Military Veterans are stereotyped in our popular culture as either broken human beings plagued with post-traumatic stress disorder or invincible heroes, affecting medical providers' ability to confidently interact with and connect emotionally to this patient population. The goal of this educational tool was to orient medical/allied health students to the unique experiences of military combat Veterans through theater-based interactive performance. The performance challenges existing cultural assumptions and bridges gaps between Veterans and civilians to develop empathy and potentially enhance future clinical encounters. A brief didactic presentation of theater-based strategies in health education and the study results of the Tracings of Trauma performance will provide a platform for the audience to participate in this interactive performance and discuss its implications.
This short book is an experiment in public anthropology. The story is a longstanding one. It is a... more This short book is an experiment in public anthropology. The story is a longstanding one. It is about objectivity, judgment and the place of emotion in one's work. The book itself is an "object of deployment", intertwining three voices: the metanarrative of the analytically aware anthropologist, the surplus data of the politicized civilian and the personal narratives of Iraq veterans.
In the performance of this book, I speak in the first two voices. The third voice is of an attending civilian audience who recite veterans' opinions, feelings and actions. The intention is to play with new forms of data dissemination and engaged ways to create personal meaning. The participatory reading of the book challenges the notion that something gets lost or distorted in anthropological translation.
Key words: Stigma, trauma, reflexivity, PTSD, veterans, data disssemination
Almost Sunrise follows two Iraq veterans, Tom Voss and Anthony Anderson, both tormented by depres... more Almost Sunrise follows two Iraq veterans, Tom Voss and Anthony Anderson, both tormented by depression for years after they returned home and pushed to the edge of suicide. The two embark on an extraordinary journey – a 2,700 mile walk across the country from Wisconsin to California, in order to reflect on their haunting experiences of war and to ultimately, save themselves. Katinka Hooyer, Tom's partner and a research scientist offers her personal and professional insight to translate the complex experience of PTSD and moral injury for a civilian audience.
https://well.blogs.nytimes.com/2016/06/06/war-wounds-that-time-alone-cant-heal/
FULL FILM DESCRIPTION and STREAMING:
http://www.pbs.org/pov/almostsunrise/
IMAPCT CAMPAIGN:
http://sunrisedocumentary.com/impact-campaign/
This evocative participatory performance highlights Veterans’ unique perspectives of military ser... more This evocative participatory performance highlights Veterans’ unique perspectives of military service, going to war and returning home. Through reciting excerpts from interviews Katinka conducted with Iraq and Afghanistan Veterans, the audience gains a more profound understanding of Vets’ lives, moral injury and the transformative effects of war work.
In this way, audiences, including civilians, have the opportunity to delve more deeply into veterans' experiences and discover common values and deeper connections with all those who serve. The performance challenges popular stereotypes that the media perpetuates while offering moments to reflect on the personal costs of war.
Dear Veteran is a public art project that gives civilians an opportunity to acknowledge Veterans ... more Dear Veteran is a public art project that gives civilians an opportunity to acknowledge Veterans in their lives and communities, sometimes for the first time. Inspired by the Shinto shrines of Japan where devotees write their wishes and prayers on small wooden plaques, and the prayer trees of Tibet, Dear Veteran cards are placed on trees in public places as gestures of tribute and hope.
This project collaborates with other Veteran-focused art that aims to bridge the military-civilian cultural divide through storytelling.
@dearveteran
https://www.facebook.com/Dearveteran/
www.dearveteran.com/