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Evaluation

Military and Veterans Psychology
Session Type:: Symposia

Symposium 75 - Identification and Assessment of Factors Affecting Veterans' Therapeutic Engagement

Sunday, November 23, 2025
2:00 PM - 3:30 PM CST
Location: Strand 12 A&B, Level 2
CE: 1.5

Keywords: Veterans, Treatment, PTSD (Posttraumatic Stress Disorder)
Level of Familiarity: All
Recommended Readings: Johnson, E. M., & Possemato, K. (2019). Correlates and predictors of mental health care utilization for veterans with PTSD: A systematic review. Psychological Trauma: Theory, Research, Practice, and Policy, 11(8), 851-860. https://doi.org/10.1037/tra0000461,   Sherrill, A. M., Wiese, C. W., Abdullah, S., & Arriaga, R. I. (2025). Teaming with Artificial Intelligence to learn and sustain psychotherapy delivery skills: Workplace, ethical, and research Implications. Journal of Technology in Behavioral Science, 1-9. https://doi.org/10.1007/s41347-025-00484-4,   Parry, K. J., Hicken, B. L., Chen, W., Leng, J., Allen, S., & Burningham, Z. (2023). Impact of moral injury and posttraumatic stress disorder on health care utilization and suicidality in rural and urban veterans. Journal of traumatic stress, 36(1), 117-128. https://doi.org/10.1002/jts.22889,   McGuire, A. P., Rodenbaugh, M., Howard, B. A. N., & Contractor, A. A. (2024). Response styles to positive affect during a positive psychology intervention for veterans with PTSD and moral injury: Preliminary results from a moral elevation intervention pilot trial. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0001774,   Rauch, S. A. M., Yasinski, C. W., Post, L. M., Jovanovic, T., Norrholm, S., Sherrill, A. M., Michopoulos, V., Maples-Keller, J. L., Black, K., Zwiebach, L., Dunlop, B. W., Loucks, L., Lannert, B., Stojek, M., Watkins, L., Burton, M., Sprang, K., McSweeney, L., Ragsdale, K., & Rothbaum, B. O. (2021). An intensive outpatient program with prolonged exposure for veterans with posttraumatic stress disorder: Retention, predictors, and patterns of change. Psychological Services, 18(4), 606–618. https://doi.org/10.1037/ser0000422

Prevalence rates of PTSD and other mental disorders in United States’ veterans are substantial and range up to 26% (Trivedi et al., 2015). Unfortunately, other findings suggest that mental health treatment utilization among veterans in Veterans Health Administration (VHA) and non-VHA clinics is low, often falling below 30% (Johnson & Possemato, 2019; Kline et al., 2021). Of veterans who initiate mental health care, only a small number persist to completion and dropout rates are substantial and range from 12-48% (Steencamp et al., 2020). These numbers suggest barriers in both initiation of and retention in mental health care treatment of veterans (Johnson & Possemato, 2019). Although numerous investigations have assessed factors associated with mental health utilization in veterans (see Johnson & Possemato, 2019 for review), individual veteran factors affecting low initiation of and attrition from mental health remain largely unexamined (Karlin & Brenner, 2020).

This symposium provides an overview of strategies identifying individual veteran characteristics affecting mental health care initiation and retention. Presentations will describe the utility of leveraging technology to assess and facilitate therapeutic engagement by veterans. Other presentations will describe how veterans’ individual characteristics and perception of group coherence are associated with treatment persistence. The presentations are unique in their coverage of a diverse range of strategies, veteran characteristics, and treatment modalities as a means of understanding veterans’ mental health treatment utilization.

The first presentation reports on the assessment of moral injury (MI) by generative artificial intelligence-large language models (GAI-LLMs), with a focus on determining if GAI-LLMs can effectively identify MI in veterans experiencing traumatic combat experiences. The second presentation describes the use of a phone-based application for prolonged exposure (PE), and the utility of the app in affecting veterans’ engagement in PE. The third presentation will highlight how personality factors affect longitudinally assessed symptom trajectories and treatment satisfaction in veterans participating in an intensive outpatient treatment program. The final presentation will describe the effect moral elevation has on group cohesiveness in veterans attending group psychotherapy for PTSD as well as how moral elevation affects PTSD symptoms over time.

The discussant will use her extensive research and clinical knowledge with veterans, PTSD, and implementation science and provide an integrative overview and recommendations for leveraging technology and engaging veterans in mental health care to enhance their mental health care utilization.

These findings from these presentations have substantial public health ramifications as the identification of unique suicide risks can lead to improved strategies for identification and mitigation of deaths by suicide.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Describe the efficacy of GAI-LLMs in assessing moral injury in veterans.
  2. Identify how use of a phone app facilitates veteran engagement in prolonged exposure therapy.
  3. Discuss how personality influences responses to an intensive outpatient treatment program for veterans.
  4. Identify how moral elevation influences perceived group cohesion and change in traumatic symptoms for veterans attending group therapy for PTSD.

Presentations:

  • 2:06 PM - 2:27 PM CST
    (SYM 75) Generative Artificial Intelligence-large Language Models' Ability to Detect Moral Injury in Combat-experienced Veterans

    Speaker: Randee M. Schmitt, M.A. (she/her/hers) – University of Houston – Clear Lake

    Co-author: Randee M. Schmitt, M.A. (she/her/hers) – University of Houston – Clear Lake

    Co-author: Sean A. Lauderdale, Ph.D. (he/him/his) – University of Houston – Clear Lake

    Co-author: Julian A. Wieck, B.S. – University of Houston – Clear Lake

    Co-author: Maheen Maiya, B.S. – University of Houston-Clear Lake

    Co-author: Vaishnavi Konda, B.S. – University of Houston-Clear Lake

    Co-author: Zane Shamsher, B.S. – University of Houston-Clear Lake

  • 2:27 PM - 2:48 PM CST
    (SYM 75) I Felt My Therapist's Presence During Exposures: Insights on Using Active and Passive Mobile Sensing to Enhance Patient Engagement

    Speaker: Nathaniel Swinger, B.S. – Georgia Institute of Technology

    Co-author: Nathaniel Swinger, B.S. – Georgia Institute of Technology

    Co-author: Barbara O. Rothbaum, ABPP, Ph.D. (she/her/hers) – Emory University School of Medicine

    Co-author: Sheila A.M. Rauch, Ph.D., ABPP – Emory University

    Co-author: Rosa I. Arriaga, Ph.D. – Georgia Institute of Technology

    Co-author: Andrew M. Sherrill, Ph.D. (he/him/his) – Emory University

  • 2:48 PM - 3:09 PM CST
    (SYM 75) Do Cohort Personality Characteristics Predict Treatment Outcomes in a Military Intensive Outpatient Program? A Registered Report

    Speaker: Nate L. Phillips, M.S. (he/him/his) – University of Georgia

  • 3:09 PM - 3:30 PM CST
    (SYM 75) The Effects of Feeling Inspired by Group Members in a Veteran PTSD Residential Program: Examining Associations of Weekly Moral Elevation with Weekly Group Climate and Pre-post Outcomes

    Speaker: Adam McGuire, Ph.D. (he/him/his) – US Department of Veterans Affairs

    Co-author: Alexander Riera, MS – VISN 17 Center of Excellence for Research on Returning War Veterans

    Co-author: Elizabeth Nosen, PhD – G.V. (Sonny) Montgomery VA Medical Center