Whole Warrior, Whole Health: Holistic Approaches to Veteran Well-Being

We’ve seen enhanced academic progress based on engaging veterans in holistic approaches and in addition the approaches that are deeply supportive to their overall wellbeing, such as making sure that they are going to their VA appointments, that they understand policies that can support them in terms of taking time off class to do that. Because often, a veteran might be at the VA a whole day and that means they are missing classes and may not know how to negotiate that when they first get into the university with their professors. So, we’ve seen academic progress correlated with engaging veterans in a variety of holistic approaches. Also, at our university, we do have a social component to our work with veterans. For example, we have academic guides and tutors who are veterans. We also have practiced hiring student veterans in different departments as peer support veterans so that they can be the warm handoffs when people refer veterans to the department. They can show the veteran how to be successful. We also have a big outreach to community organizations on our campus, and we bring them in regularly to address certain information and issues such as adventure therapy, the benefits of exercise, and meditation. These can include informational sessions, basic core services, such as how you use your VA loan when you get out. So those have all been looked at in terms of higher rates of engaging veterans on campus and getting them to engage because what we know, especially in the first two years, is if a veteran is engaged on campus, and are committed, they will stay and be retained and not leave the campus.

Each Veteran, or each person, is going to have different past and current experiences, so each veteran is going to define what matters most to them differently than what matters most to somebody else. The most important thing we can do when working with veterans is to ask them, ‘What does wellness mean to you?,’ ‘What matters most to you?,’ [and] ‘What does healthy mean to you?’ It’s so important to learn what matters most to them without making assumptions from broad definitions. This same principle applies for fostering resilience within the many domains of life and growth. We must first understand how they define resilience, what matters most to them within the context of their personal well-being, and how they perceive their own growth. What strengths do they draw upon to remain resilient? What barriers stand in the way of their growth? By centering the veteran’s own voice, values, and lived experiences, we can ensure that both the veteran and canine are a good fit and that both will benefit.”

In order for us to truly optimize those positive health outcomes, we need to work alongside and with our communities to determine what their needs are and how we can support them. As a researcher, like I mentioned before, this emphasis on research with and alongside our veterans, not on or just about our veterans is important. While we all are experts and scholars in a specific area, that doesn’t mean that every single veteran is going to benefit or need what we have to offer. So, hearing and providing those opportunities for veteran communities to share what they need, how they conceptualize well-being is imperative.

We recently developed a Military and Veteran Services Office in which we have VA coordinators embedded, along with counselors from the university. This has helped to bridge the engagement gap between veteran/military students and the university. It has not solved all the issues, but it has definitely helped. One of the biggest impacts this office has had was empowering the veterans’ voice by developing scholarship positions called Military Community Advocates (MCAs). These MCAs are individuals who are in the process of getting their education and are military-connected; mostly veterans, or other members of the military community. They serve as educational and informational points of contact for the university and for military-connected students in their associated areas. They are liaisons between the military and academic worlds and truly give power to the veterans’ voice in a way that didn’t exist before the Miliary and Veterans Services Office. OSU currently has over 30 MCAs embedded across the university in different schools, departments, and offices, all serving in unique ways but all working together to provide avenues to engage military-connected students and ensure that their voices are incorporated into university decision-making; including health and wellness options. Veteran well-being is always going to be maximized when holistic and conventional care are integrated and not separated into non-communicative silos. Recognition and engagement of veterans’ views in decision-making across the university allows for holistic and conventional approaches to be integrated in university actions that impact veterans’ well-being. This has helped OSU bridge the military-to-academia transition gap that veterans traditionally had to navigate on their own.

One factor that I think is really key in any programmatic effort is to emphasize coordination across those different modalities of working and supporting the veteran…that the veteran experiences the holistic elements, instead of just the individual elements at many different locations and settings. It’s that coordination—if you can implement “one-stop shop” approaches or use a mechanism such as a case management approach, especially for involving community veteran service organizations, that’s more effective. The case management approach, if possible, [is] a mentor or one person that helps coordinate for the veteran is ideal. That would be one person that they know that they trust, that they have an established relationship with, that doesn’t change and reduce the turnovers of those. These programmatic efforts that need to happen within the systems and the bureaucracies of the university in terms of infrastructure and policies that are inevitably involved, are very important in terms of supporting an interdisciplinary, holistic approach across the organization.

In our veteran research projects, we make sure that any project that we have alongside veterans/student veterans are engaged in that entire process. So, for our VA grant, we have 12 student veterans who we’ve been able to hire and are meeting with them to understand their challenges. It is really eye-opening to us and I think being able to employ them and work alongside them gives another avenue for student veterans to share those experiences, and for us to support them, and for us to communicate that, as well as to share resources for other community providers. In addition, I think, also hiring student veterans and having them part of research projects helps give them some of that identity and that purpose, especially when they’re doing veteran-related research projects. Also, I think we also emphasize with our student veteran teams are the resources that are available through that community capacity. So, our student veterans, by working with us, might learn about other agencies or service providers that they might not have come into contact with if they hadn’t worked with our project. I just want to really emphasize that key piece, because it might not be that the main role of hiring student veterans is to holistically support them, but I think we’re able to do that informally by having them as part of our team and being involved in the research process.

I taught undergraduate students and had the privilege of teaching a select few veterans who had recently transitioned out of military service. Initially, I didn’t even know they were veterans, but I noticed some students were struggling academically. As their professor, I reached out and asked how I could support them. What followed was a series of deeply meaningful conversations. Through that dialogue, what they shared was both eye-opening and humbling as their challenges weren’t what I had expected. Many of them struggled with seemingly simple things. For example, how to talk with classmates, how to create folders on a computer, or how to save and organize PDFs. They shared how challenging it was to transition from a rigid, structured environment into a college classroom. One particular veteran told me that talking to classmates was awkward saying, ‘I know I’m making people uncomfortable, but I just don’t know how to talk about anything other than my time in the service.’ These may sound like small issues but they’re foundational to academic success. That experience taught me so much, not just about potential challenges veterans may face, but about the importance of being present, listening deeply, and understanding their world through their lens. It reinforced for me how important it is to create spaces of belonging, not just support.

Photovoice methodology is participatory research where Veterans engage in the research process. Veterans take pictures with their iPhones and portable devices, and this helps tell their stories via photos. Then either individually or as a group, they are asked to reflect on those images that they took and you ask them to reflect on different aspects such as in the study that Dr. Clary and I did. You ask them to reflect on their well-being across different communities, here at the university, in the family, and in the larger community context. This method can be used to really explore their views and emotions on many different topics. Well-being was the topic that we used…[s]o it’s easy to explore very differing perspectives and to also use with individuals or in groups. Photovoice methodology also helps reduce the threatening manner of traditional therapies, because they are participating actively in the research and taking the images that have meaning to them. These hands-on techniques are helpful in engaging veterans because we know that veterans often are used to applied, very hands-on activities/tasks. Ultimately, you’re engaging with them through prompts and questions throughout their discussion. For example, several veterans in our well-being study took photos of food, and, at first, I wondered why so many photos of food?…[t]hen when we discussed the meaning of their photos, I realized that they would tell us, that those pictures of food, meant freedom to them. It was very poignant to listen to the things in their lives that they took pictures of and expressed their feelings about. But again, full circle, back to freedom, and how they could not eat what they wanted to in the military, that their weight was also controlled by the military. Also, there was a lot about pets. They took lots of pictures of their pets, and of course, many of them could not have pets in the military. These were very poignant discussions. I must say that after I closed out several of the individual interviews, I would have to go to my office and reflect on how unique their different perspectives were. It was amazing how much they shared using the photos as prompts to guide their discussions. So, just to be able to understand their meaning, it’s obvious that they had a different opportunity to tell their own story using photovoice methodology. In photovoice methods, they could control their own story. They also were able to understand and explore their own voice, which they had not been able to do while they were in the military. This tool also creates a common experience which they can share across individuals and groups, and it really helps cement for them; the power of storytelling. It’s a unique way to teach them the skills of storytelling and then to identify different hurdles and challenges that they are experiencing. Because we asked them to talk about the plusses in their well-being and the negatives in their well-being across these communities. It clarifies for them the purpose of the research and increases their participation. Probably one of the biggest advantages to this technique is that it is much easier to help them make the connections with the stories that we want them to be able to tell, not just about their past and their present, but about their future, because we’ve found that, as veterans, those stories can help guide them and shine a light for them to the future.

There’s one story that has stayed with me. I spoke with a veteran who was married for 39 years. He was a combat veteran who had served on active duty for 26 years and struggled with sleep, nightmares, and reliving traumatic experiences. It wasn’t until three years ago he went to a shelter, got a dog, and said he wished he knew what a difference the dog would make sooner. Before the dog, he slept with pillows between him and his wife to protect his wife from episodes at night. Now, the dog responds to any distress from the veteran at night by nudging the veteran, laying on him, sensing the change. If the veteran doesn’t start to come out of it, the dog then nudges the wife to wake her up. What stuck with me the most is how this simple intervention––a rescue dog––transformed, not just his quality of sleep, but his marriage and daily life. It’s a powerful example that healing doesn’t always mean replacing one thing with another but rather complementing with approaches that address the whole-person, and in this case, the whole family.

C-P.A.W.W. has explored canines and veterans, measuring a range of outcomes including PTSD symptom severity, stress biomarkers, and overall psychological well-being. The research has consistently shown improved PTSD, anxiety, and depression. Specifically, reductions in insomnia and improved sleep quality when compared to control groups. Veteran participants have also shown decreased suicidal ideation and normalized cortisol awakening responses, an important indicator of stress regulation and overall well-being. These findings underscore just how important holistic, veteran-engaged approaches can be when integrated into a comprehensive care model.

A lot of the results suggest that there is a very strong mindfulness and flow aspect to beekeeping. Handling these bees, of course, requires you to be calm, be alert, and present in the moment; similar to other mindfulness activities like meditation or yoga. This can help lower anxiety by focusing the veteran’s attention on being present there at the hive, and focusing on what they are doing. Pairing this with other mindfulness practices, like we’ve seen through the HIVES Initiative through the VA and some other programs, seems to only enhance these qualities. Pairing beekeeping with other mindfulness activities has the added benefit of providing alternative avenues for building community, partial participation, and gaining benefits for individuals, which may not be able to or wish to participate fully in beekeeping. Additionally, beekeeping practices can increase emotional calmness (Ciraulo et al., 2024). There is anecdotal evidence that the sound of the buzzing has rhythmic soothing quality that may trigger relaxing responses akin to natural sound therapy. Whether or not it is due to the bees’ buzzing or other factors that have yet to be identified, at our apiary, veterans are telling us that simply engaging with bees and being outdoors and in structured activities, consistently reduces self-reports of stress.