By Tim Hoyt, Ph.D.
Jan. 27, 2020
Photo by Justin Connaher
The "walkabout" is a hallmark of front-line military psychology. Walkabouts are informal individual or small group health promotion activities initiated by behavioral health providers outside the clinic setting in which at least one principle of psychological wellness is discussed. Walkabouts do not establish formal provider-patient roles and are not documented in the medical record. These activities can be conducted by both credentialed providers and behavioral health technicians.
Although no clinical trials have been conducted on walkabouts, this technique of engaging service members in their natural environment (such as in the motor pool, on guard towers, or while smoking cigars) has been used for several decades. Walkabouts provide an opportunity for behavioral health providers to observe operational conditions as they relate to the psychological state of a military unit, get members of the unit used to seeing and talking to behavioral health personnel, take advantage of opportunities for short teachable moments that focus on wellness and resiliency, and gather information for leadership on ways to mitigate operational stress.
For example, an informal chat during routine weapons maintenance might provide an opportunity for a platoon sergeant to ask a psychologist about ways to decrease personality conflicts in the shared tent. Or providers engaging in physical training alongside other service members can give them the opportunity to ask a question "for a friend" who is struggling with relationship problems during the unit's deployment. Positive interactions in these informal settings, help to demystify the process of seeking care for psychological concerns. Service members may be more likely to subsequently seek formal care during a crisis, which could in turn decrease the stigma of help seeking among other unit members.
Getting out of the clinic and into the work spaces of military personnel is crucial for front-line behavioral health personnel to establish relationships with service members and commanders. Too often, medical officers can be perceived as not being "one of us" by service members and leaders alike because of tendencies to stay secluded in clinics. Spending a few hours in the motor pool may not make a psychologist an expert at military vehicle maintenance, but junior service members will see that the psychologist is willing to meet them on their level. Leaders will see behavioral health personnel who are willing to learn about the profession of warfighting rather than narrowly focusing on their own expertise, making the leaders more likely to respond to recommendations related to psychological health. Culturally connecting in these ways can foster trust in the psychologist, give the provider a better idea of working conditions and job requirements, and erode barriers to care.
In short, walkabouts can be a great method to establish trust with service members and leaders through informal engagements that promote psychological health on the front lines. Get out of the clinic and try a walkabout today!
Dr. Hoyt is a former Army psychologist who is chief of Psychological Health Promotion and supervisor of the Combat and Operational Stress Control mission at the Psychological Health Center of Excellence.