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Evaluation ViewAttendees 1

LGBTQ+
Symposia

Symposium 40 - Do Ask, Do Tell: Strategies for improving mental health for sexual and gender minority military veterans

Friday, November 15, 2024
12:30 PM – 2:00 PM EST
Location: Franklin 8, Level 4, Downtown Marriott
CE: 1.5

Keywords: LGBTQ+, Veterans, Underserved Populations
Level of Familiarity: Basic to moderate
Recommended Readings: Singh, R. S., Landes, S. J., Willging, C. E., & Abraham, T. H. (2024). Implementation of LGBTQ+ affirming care policies in the Veterans Health Administration: preliminary findings on barriers and facilitators in the southern United States. Frontiers in Public Health, 11, 1251565.,   Livingston, N. A., Berke, D. S., Ruben, M. A., Matza, A. R., & Shipherd, J. C. (2019). Experiences of trauma, discrimination, microaggressions, and minority stress among trauma-exposed LGBT veterans: Unexpected findings and unresolved service gaps. Psychological Trauma: Theory, Research, Practice, and Policy, 11(7), 695.,   Rosentel, K., Hill, B. J., Lu, C., & Barnett, J. T. (2016). Transgender veterans and the Veterans Health Administration: Exploring the experiences of transgender veterans in the Veterans Affairs healthcare system. Transgender Health, 1(1), 108-116.,   Blosnich, J. R., Gordon, A. J., & Fine, M. J. (2015). Associations of sexual and gender minority status with health indicators, health risk factors, and social stressors in a national sample of young adults with military experience. Annals of epidemiology, 25(9), 661-667.,   Hilgeman, M. M., Cramer, R. J., Kaniuka, A. R., Robertson, R., Bishop, T., Wilson, S. M., ... & Lange, T. M. (2023). Moderators of Treatment Outcomes for LGBTQ+ Military Veterans in the PRIDE in All Who Served Health Promotion Group. medRxiv, 2023-02.

Mental health literature has increasingly focused on the intensified burden of those who have intersecting identities, such as sexual and gender minority (SGM) veterans. Compared to heterosexual and cisgender Veterans, SGM veterans are at least twice as likely to report suicidal thoughts and behaviors, 1.55-to-2.40 times more likely to have probable posttraumatic stress disorder, 1.43-to-2.18 times more likely to have probable depression, and 1.30-to-3.16 more likely to have elevated anxiety. These disproportionate experiences of mental health challenges likely result in part from the marginalization of SGM veterans in broader veteran and SGM community spaces. Despite mounting evidence of these disparities, SGM veterans continue to be understudied, particularly regarding protective factors and strategies to boost mental health despite this marginalization.
In accordance with the theme of ABCT 2024, this symposium focuses on advancing CBT for SGM populations, firstly by understanding unique barriers to accessibility among SGM populations, and secondly, by identifying innovative strategies to further promote SGM engagement in and benefit from these therapies. First, Mx. Rashkovsky will present on coping strategies that SGM community veterans commonly utilize and the relationship between these strategies and mental health outcomes. Second, Dr. Chang will address mental health utilization differences amongst VA and non-VA SGM veterans, highlighting specific avenues for advocacy and innovation to improve SGM veterans’ engagement in care. Third, consistent with a community-based participatory approach, Dr. Harper will present user (i.e., SGM Veterans) feedback on an expressive writing intervention to target discrimination-related distress and the incorporation of this feedback to optimize intervention delivery. Finally, Dr. Brennan will present on strategies to improve social connection and mental health in transgender, gender expansive, and consensually non-monogamous veterans, emphasizing the highly under-researched intersections between these identities.Overall, this symposium proposes to emphasize strategies that may begin to fill the gap of evidence-based care to improve SGM veteran mental health. Dr. Danielle Berke, the discussant of this symposium, has conducted nationally recognized research and clinical work with SGM, veteran, and SGM veteran populations. She will contextualize the findings from each presentation, providing potential applications for findings to improve the impact of both community and VA-based care on SGM veterans. This symposium has the potential to facilitate intervention development and research that highlights the unique experiences of SGM veterans.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Discuss therapeutic techniques that may be particularly beneficial for SGM veterans.
  2. Identify strategies that may facilitate SGM veteran engagement and retention in therapeutic spaces.
  3. Consider how cognitive behavioral strategies may be tailored to address the unique needs of SGM veterans.
  4. Discuss the inclusion of understudied SGM identities (i.e., transgender people) in veteran-centered SGM research.
  5. This symposium will further attendee's knowledge of methods that they may apply in their own clinical work to engage SGM veterans in treatment.
  6. This symposium aims to highlight unique considerations for and provide directed tools for use in treatment with SGM veterans.

Presentations:

  • 12:30 PM – 2:00 PM EST
    (SYM 40) Coping Mechanisms & Mental Health in Sexual Minority Community Veterans

    Speaker: Katerine Rashkovsky, B.S. (they/them/theirs) – VA San Diego Healthcare System

    Co-author: Katerine Rashkovsky, B.S. (they/them/theirs) – VA San Diego Healthcare System

    Co-author: Tamara Wachsman, B.A. – VA San Diego Healthcare System

    Co-author: Cindy Chang, PsyD (she/they) – VA San Diego Healthcare System

    Co-author: Kayla Knopp, Ph.D. (she/her/hers) – VA San Diego Healthcare System/University of California, San Diego

  • 12:30 PM – 2:00 PM EST
    (SYM 40) Sexual Orientation Moderates the Association Between Healthcare Utilization-related Factors and Mental Health Service Non-utilization Among United States Military Veterans

    Speaker: Cindy Chang, PsyD (she/they) – VA San Diego Healthcare System

    Co-author: Cindy Chang, PsyD (she/they) – VA San Diego Healthcare System

    Co-author: Ian Fisher, PhD – Yale School of Medicine

    Co-author: Kelly Harper, Ph.D. (she/they) – National Center for PTSD

    Co-author: Nicholas Livingston, Ph.D. – Boston University School of Medicine & National Center for PTSD

    Co-author: Colin Depp, PhD – VA San Diego Healthcare System

    Co-author: Sonya Norman, PhD – San Diego VA Healthcare System

    Co-author: Robert Pietrzak, PhD, MPH – Yale School of Medicine

  • 12:30 PM – 2:00 PM EST
    (SYM 40) Community-based Feedback on an Expressive Writing Intervention for LGBQ+ Veterans

    Speaker: Kelly Harper, Ph.D. (she/they) – National Center for PTSD

    Co-author: Katherine Kelton, PhD – VA Boston Healthcare System

    Co-author: Nicholas Livingston, Ph.D. – Boston University School of Medicine & National Center for PTSD

    Co-author: Katherine Iverson, Ph.D. – National Center for PTSD

    Co-author: Brian Marx, PhD – National Center for PTSD

  • 12:30 PM – 2:00 PM EST
    (SYM 40) Queering a Caring Cosmology: Improving Interpersonal Health and Social Connection for LGBTQ+ and Consensually Non-monogamous Veterans

    Speaker: James Michael M. Brennan, Ph.D. (they/them/theirs) – US Department of Veterans Affairs

    Co-author: James Michael M. Brennan, Ph.D. (they/them/theirs) – US Department of Veterans Affairs

    Co-author: Sree Sinha, PhD (she/they/ze/hir/hirs) – San Francisco VA Healthcare System

    Co-author: Jared Boot-Haury, PsyD, MBA (he/him/his) – San Francisco VA Healthcare System

    Co-author: Kaela Joseph, PhD (they/she) – San Francisco VA Healthcare System