The Promise of a Retreat: Perspectives of U.S. Women Veterans and Interdisciplinary Experts on the Development of a Retreat-Based Suicide Prevention Program for Violence-Exposed Women Veterans
Restricted accessResearch articleFirst published online January, 2026
The Promise of a Retreat: Perspectives of U.S. Women Veterans and Interdisciplinary Experts on the Development of a Retreat-Based Suicide Prevention Program for Violence-Exposed Women Veterans
To supplement the mental health programming offered to women veterans within the Veterans Health Administration, a retreat-based suicide prevention program could foster healing through social connection and holistic health. However, no study has investigated retreat-based suicide prevention program components relevant for violence-exposed women veterans. To address this gap, we conducted focus groups with women veterans and semi-structured interviews with interdisciplinary subject matter experts to examine perceptions, beliefs, concerns, and preferences related to a retreat-based suicide prevention program for women veterans. Emergent themes included interest and appeal, concerns about program execution, and program preferences. Findings suggest that both women veterans and experts agree that a retreat-based suicide prevention program for women veterans is a promising and welcomed prevention strategy that may reduce suicide risk. Both interest groups emphasized that programming should be trauma-informed with training for program facilitators and attention to group dynamics.
AverillJ. B. (2002). Matrix analysis as a complementary analytic strategy in qualitative inquiry. Qualitative Health Research, 12(6), 855–866. https://doi.org/10.1177/104973230201200611
3.
BeautraisA. L.CollingsS. C. D.EhrhardtP.HenareK. (2005). Suicide prevention: A review of evidence of risk and protective factors, and points of effective intervention. Ministry of Health.
4.
BendaB. B. (2005). Gender differences in predictors of suicidal thoughts and attempts among homeless veterans that abuse substances. Suicide and Life-Threatening Behavior, 35(1), 106–116. https://doi.org/10.1521/suli.35.1.106.59262
5.
BokhourB. G.HaunJ. N.HydeJ.CharnsM.KliglerB. (2020). Transforming the veterans affairs to a whole health system of care: Time for action and research. Medical Care, 58(4), 295–300. https://doi.org/10.1097/MLR.0000000000001316
6.
BrignoneE.SorrentinoA. E.RobertsC. B.DichterM. E. (2018). Suicidal ideation and behaviors among women veterans with recent exposure to intimate partner violence. General Hospital Psychiatry, 55, 60–64. https://doi.org/10.1016/j.genhosppsych.2018.10.006
7.
BrysN. A.WhittleJ.SafdarN. (2018). Development of a veteran engagement toolkit for researchers. Journal of Comparative Effectiveness Research, 7(6), 595–602. https://doi.org/10.2217/cer-2017-0101
8.
ConboyL. A.EdshteynI.GarivaltisH. (2009). Ayurveda and panchakarma: Measuring the effects of a holistic health intervention. The Scientific World Journal, 9, 272–280. https://doi.org/10.1100/tsw.2009.35
9.
DeCouC. R.ComtoisK. A.LandesS. J. (2019). Dialectical behavior therapy is effective for the treatment of suicidal behavior: A meta-analysis. Behavior Therapy, 50(1), 60–72. https://doi.org/10.1016/j.beth.2018.03.009
10.
deKleijnM.Lagro-JanssenA. L.CaneloI.YanoE. M. (2015). Creating a roadmap for delivering gender-sensitive comprehensive care for women veterans: Results of a national expert panel. Medical Care, 53(4 Suppl 1), S156–S164. https://doi.org/10.1097/MLR.0000000000000307
11.
DennesonL. M.TrevinoA. Y.KenyonE. A.OnoS.PfeifferP. N.DobschaS. K. (2019). Feasibility and acceptability of health coaching as an upstream suicide prevention approach: A pilot study among post-9/11 veterans. Military Behavioral Health, 7(4), 436–447. https://doi.org/10.1080/21635781.2019.1598524
12.
DennesonL. M.WilliamsH. B.KaplanM. S.McFarlandB. H.DobschaS. K. (2016). Treatment of veterans with mental health symptoms in VA primary care prior to suicide. General Hospital Psychiatry, 38, 65–70. https://doi.org/10.1016/j.genhosppsych.2015.08.007
13.
FisherM. P.HamerM. K. (2020). Qualitative methods in health policy and systems research: A framework for study planning. Qualitative Health Research, 30(12), 1899–1912. https://doi.org/10.1177/1049732320921143
14.
HamiltonA. B.FinleyE. P. (2019). Qualitative methods in implementation research: An introduction. Psychiatry Research, 280, Article 112516. https://doi.org/10.1016/j.psychres.2019.112516
15.
HanishK. K.MarguliesI.CoganA. M. (2019). Evaluation of an occupation-based retreat for women after pregnancy or infant loss. The American Journal of Occupational Therapy, 73(5), 7305345030p1–7305345030p6. https://doi.org10.5014/ajot.2019.034025 https://doi.org/10.5014/ajot.2019.034025
16.
HoffmireC. A.DennesonL. M.MonteithL. L.DichterM. E.GradusJ. L.CappellettiM. M.BrennerL. A.YanoE. M. (2021). Accelerating research on suicide risk and prevention in women veterans through research-operations partnerships. Medical Care, 59, S11–S16. https://doi.org/10.1097/MLR.0000000000001432
17.
HollidayR.ForsterJ. E.SchneiderA. L.MillerC.MonteithL. L. (2021). Interpersonal violence throughout the lifespan: Associations with suicidal ideation and suicide attempt among a national sample of female veterans. Medical Care, 59, S77–S83. https://doi.org/10.1097/MLR.0000000000001447
18.
IlgenM. A.BohnertA. S.IgnacioR. V.McCarthyJ. F.ValensteinM. M.KimH. M.BlowF. C. (2010). Psychiatric diagnoses and risk of suicide in veterans. Archives of General Psychiatry, 67(11), 1152–1158. https://doi.org/10.1001/archgenpsychiatry.2010.129
19.
KatzL. S.JensenG. (2022). Outcomes of a five-day warrior renew retreat to reduce symptoms related to military sexual trauma for women veterans. Journal of Contemporary Psychotherapy, 52(4), 311–318. https://doi.org/10.1007/s10879-022-09545-8
20.
KeenS.Lomeli-RodriguezM.JoffeH. (2022). From challenge to opportunity: Virtual qualitative research during COVID-19 and beyond. International Journal of Qualitative Methods, 21, 1–11. https://doi.org/10.1177/16094069221105075
21.
KenistonA.McBethL.AstikG.AuerbachA.BuschJ.KangelarisK. N.KulkarniS. A.LinkerA. S.SakumotoM.LeykumL. (2023). Practical applications of rapid qualitative analysis for operations, quality improvement, and research in dynamically changing hospital environments. The Joint Commission Journal on Quality and Patient Safety, 49(2), 98–104. https://doi.org/10.1016/j.jcjq.2022.11.003
22.
KimerlingR.Makin-ByrdK.LouzonS.IgnacioR. V.McCarthyJ. F. (2016). Military sexual trauma and suicide mortality. American Journal of Preventive Medicine, 50(6), 684–691. https://doi.org/10.1016/j.amepre.2015.10.019
23.
KimerlingR.PavaoJ.GreeneL.KarpenkoJ.RodriguezA.SaweikisM.WashingtonD. L. (2015). Access to mental health care among women veterans: Is VA meeting women’s needs?Medical Care, 53(4 Suppl 1), S97–S104. https://doi.org/10.1097/MLR.0000000000000272
24.
KlapR.DarlingJ. E.HamiltonA. B.RoseD. E.DyerK.CaneloI.HaskellS.YanoE. M. (2019). Prevalence of stranger harassment of women veterans at veterans affairs medical centers and impacts on delayed and missed care. Women’s Health Issues, 29(2), 107–115. https://doi.org/10.1016/j.whi.2018.12.002
25.
KrejciL. P.CarterK.GaudetT. (2014). Whole health: The vision and implementation of personalized, proactive, patient-driven health care for veterans. Medical Care, 52, S5–S8. https://doi.org/10.1097/mlr.0000000000000226
26.
LeamyM.BirdV.Le BoutillierC.WilliamsJ.SladeM. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445–452. https://doi.org/10.1192/bjp.bp.110.083733
27.
LehavotK.SimpsonT. L.ShipherdJ. C. (2016). Factors associated with suicidality among a national sample of transgender veterans. Suicide and Life-Threatening Behavior, 46(5), 507–524. https://doi.org/10.1111/sltb.12233
28.
LevineE. G.LevenbergS.WardlawL.MoyerA. (2001). The efficacy of a retreat for low-income women with breast cancer. Health Promotion Practice, 2(2), 143–154. https://doi.org/10.1177/152483990100200210
29.
LuomaJ. B.VillatteJ. L. (2012). Mindfulness in the treatment of suicidal individuals. Cognitive and Behavioral Practice, 19(2), 265–276. https://doi.org/10.1016/j.cbpra.2010.12.003
30.
McCarthyJ. F.BlowF. C.IgnacioR. V.IlgenM. A.AustinK. L.ValensteinM. (2012). Suicide among patients in the veterans affairs health system: Rural–urban differences in rates, risks, and methods. American Journal of Public Health, 102(S1), S111–S117. https://doi.org/10.2105/AJPH.2011.300463
MonkJ. K.OgolskyB. G.BrunerV. (2016). Veteran couples integrative intensive retreat model: An intervention for military veterans and their relational partners. Journal of Couple & Relationship Therapy, 15(2), 158–176. https://doi.org/10.1080/15332691.2015.1089803
33.
MonteithL. L.BahrainiN. H.MatarazzoB. B.SoberayK. A.SmithC. P. (2016). Perceptions of institutional betrayal predict suicidal self-directed violence among veterans exposed to military sexual trauma. Journal of Clinical Psychology, 72(7), 743–755. https://doi.org/10.1002/jclp.22292
34.
MonteithL. L.HollidayR.DichterM. E.HoffmireC. A. (2022). Preventing suicide among women veterans: Gender-sensitive, trauma-informed conceptualization. Current Treatment Options in Psychiatry, 9(3), 186–201. https://doi.org/10.1007/s40501-022-00266-2
35.
MonteithL. L.HollidayR.MillerC.SchneiderA. L.HoffmireC. A.BahrainiN. H.ForsterJ. E. (2020). Suicidal ideation, suicide attempt, and non-suicidal self-injury among female veterans: Prevalence, timing, and onset. Journal of Affective Disorders, 273, 350–357. https://doi.org/10.1016/j.jad.2020.04.017
36.
MonteithL. L.HollidayR.SchneiderA. L.ForsterJ. E.BahrainiN. H. (2019). Identifying factors associated with suicidal ideation and suicide attempts following military sexual trauma. Journal of Affective Disorders, 252, 300–309. https://doi.org/10.1016/j.jad.2019.04.038
37.
Institute of Medicine (US) Committee on Prevention of Mental Disorders, MrazekP. J.HaggertyR. J. (Eds.). (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. National Academies Press (US).
38.
Murray-SwankN. A.DauschB. M.Murray-SwankA. B. (2020). The implementation of a mindfulness-oriented retreat intervention for rural women veterans. Mindfulness, 11(1), 333–349. https://doi.org/10.1007/s12671-019-01234-3
RonzittiS.LoreeA. M.PotenzaM. N.DeckerS. E.WilsonS. M.AbelE. A.HaskellS. G.BrandtC. A.GouletJ. L. (2019). Gender differences in suicide and self-directed violence risk among veterans with post-traumatic stress and substance use disorders. Women’s Health Issues, 29(Suppl 1), S94–S102. https://doi.org/10.1016/j.whi.2019.04.010
43.
SadlerA. G.BoothB. M.MengelingM. A.DoebbelingB. N. (2004). Life span and repeated violence against women during military service: Effects on health status and outpatient utilization. Journal of Women’s Health, 13(7), 799–811. https://doi.org/10.1089/jwh.2004.13.799
44.
St. GeorgeS. M.HarknessA. R.Rodriguez-DiazC. E.WeinsteinE. R.PaviaV.HamiltonA. B. (2023). Applying rapid qualitative analysis for health equity: Lessons learned using “EARS” with Latino communities. International Journal of Qualitative Methods, 22, Article 16094069231164938. https://doi.org/10.1177/16094069231164938
45.
StraussJ. L.MillerL. J.StricklandS. (2021). Applying research to advance suicide prevention in women veterans. Medical Care, 59, S6–S8. https://doi.org/10.1097/MLR.0000000000001434
46.
ThomasD. R. (2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27(2), 237–246. https://doi.org/10.1177/1098214005283748
47.
VellaE. J.MilliganB.BennettJ. L. (2013). Participation in outdoor recreation program predicts improved psychosocial well-being among veterans with post-traumatic stress disorder: A pilot study. Military Medicine, 178(3), 254–260. https://doi.org/http:/doi.org/10.7205/MILMED-D-12-00308
48.
Vindrola-PadrosC.JohnsonG. A. (2020). Rapid techniques in qualitative research: A critical review of the literature. Qualitative Health Research, 30(10), 1596–1604. https://doi.org/10.1177/1049732320921835
49.
VitaleA.BymaL.SunS.PodolakE.WangZ.AlterS.GalfalvyH.GeraciJ.LanghoffE.KlingbeilH. (2021). Effectiveness of complementary and integrative approaches in promoting engagement and overall wellness toward suicide prevention in veterans. The Journal of Alternative and Complementary Medicine, 27(S1), S14–S27. https://doi.org/10.1089/acm.2020.0245
50.
WashingtonD. L.Bean-MayberryB.RiopelleD.YanoE. M. (2011). Access to care for women veterans: Delayed healthcare and unmet need. Journal of General Internal Medicine, 26(Suppl 2), 655–661. https://doi.org/10.1007/s11606-011-1772-z
51.
WashingtonD. L.YanoE. M.SimonB.SunS. (2006). To use or not to use: What influences why women veterans choose VA health care. Journal of General Internal Medicine, 21(S3), S11–S18. https://doi.org/10.1111/j.1525-1497.2006.00369.x
52.
WhitlockJ.WymanP. A.MooreS. R. (2014). Connectedness and suicide prevention in adolescents: Pathways and implications. Suicide and Life-Threatening Behavior, 44(3), 246–272. https://doi.org/10.1111/sltb.12071
53.
YanoE. M.HayesP.WrightS.SchnurrP. P.LipsonL.Bean-MayberryB.WashingtonD. L. (2010). Integration of women veterans into VA quality improvement research efforts: What researchers need to know. Journal of General Internal Medicine, 25(Suppl 1), 56–61. https://doi.org/10.1007/s11606-009-1116-4
54.
YorkJ.LamisD. A.FriedmanL.BermanA. L.JoinerT. E.McintoshJ. L.SilvermanM. M.KonickL.GutierrezP. M.PearsonJ. (2013). A systematic review process to evaluate suicide prevention programs: A sample case of community-based programs. Journal of Community Psychology, 41(1), 35–51. https://doi.org/10.1002/jcop.21509
