A Warm Water Immersion Intervention for Symptoms of PTSD in Military Veterans: A Qualitative Descriptive Study

For nursing students

Study summary

Post-traumatic stress disorder (PTSD) affects a large number of military veterans, and even with evidence-based treatments like trauma-focused therapy, many veterans continue to live with symptoms such as intrusive thoughts, hyperarousal, and chronic pain. This qualitative descriptive study, published in the Canadian Journal of Nursing Research, looked at how veterans experienced a novel, non-drug intervention: warm water immersion. Researchers Rebecca Day Benfield, Catherine Dingley, Andrew Thomas Reyes, Reimund Serafica, and Alicia Brown, a US-based team affiliated with the University of Nevada, Las Vegas School of Nursing, wanted to understand what it was actually like for veterans to go through this intervention, in their own words.

The intervention itself was simple and standardized: participants were immersed in warm water, 33°C (92°F), up to the chest for 45 minutes. After the session, researchers conducted semi-structured interviews with 13 veterans, ranging in age from 23 to 41. Because the goal was to capture lived experience rather than measure outcomes with scales or numbers, the team used a qualitative descriptive design informed by phenomenology. This means they let the veterans' own words guide the analysis, then grouped common ideas into themes using thematic analysis, applying accepted criteria for rigor along the way.

Five themes emerged from the interviews. The first, "the rhythm of relaxed," described a settling, steady sense of calm that built as the immersion continued. The second, "embracing the properties of the water," captured how veterans noticed and appreciated specific physical qualities of the water itself, such as its warmth, buoyancy, and pressure. The third theme, "the pain floats away," reflected reports of physical pain easing during and after immersion. The fourth, "acclimatize to calmness," described how veterans adjusted over the course of the session, moving from initial unfamiliarity toward a steadier calm state. The fifth theme, "a place to set your mind," described the intervention as offering veterans a mental space where they could quiet intrusive thoughts and redirect their attention.

Across these themes, participants consistently described feeling relaxed and calm, having less pain, and gaining a tool to manage intrusive thoughts, at least temporarily. Every single participant said they would recommend the intervention to other veterans, and many offered specific suggestions for how the researchers could refine or improve it for future use. The authors describe this qualitative work as one component of a larger research effort; a companion paper by the same team, published in the International Journal of Clinical Practice, reports quantitative outcomes from the broader project, but those numeric results are a separate study and are not the focus of this qualitative descriptive report.

The authors conclude that warm water immersion shows promise as a fast-acting, non-stigmatizing adjunct therapy, meaning it could be layered on top of standard PTSD treatments rather than replacing them, especially for veterans who remain symptomatic despite completing evidence-based care. Because it does not require talking about traumatic memories directly and does not carry the same stigma some veterans associate with seeking mental health treatment, it may appeal to veterans who are hesitant to engage with conventional therapy.

For nursing students, this study is a useful example of how qualitative descriptive research can surface the human experience behind a clinical intervention, information that surveys and biomarkers cannot fully capture. It also illustrates that novel, low-cost, low-risk interventions like water immersion deserve serious research attention, particularly for populations, like veterans with treatment-resistant PTSD, who need more options. Although this research was conducted with US veterans and led by a US-based team, it appears in a Canadian nursing journal and speaks to a concern shared by Canadian nurses, who also support military and RCMP veterans living with PTSD through Veterans Affairs Canada programs and community mental health services. When appraising this study, keep in mind that a sample of 13 participants from a specific age range and a single intervention protocol means these themes describe the experiences of this group and may not automatically apply to all veterans, older adults, or people with more severe or complex trauma histories. As with any single qualitative study, replication and larger, more diverse samples will help confirm whether these themes hold up broadly before this intervention becomes part of routine, guideline-based care for veterans experiencing PTSD symptoms.

For educators

Teaching and appraisal notes

This qualitative descriptive study by Benfield, Dingley, Reyes, Serafica, and Brown, published in the Canadian Journal of Nursing Research, examines veterans' lived experience of a standardized warm water immersion intervention (33°C/92°F to the chest, 45 minutes) as a novel adjunct approach to persistent PTSD symptoms. The research team is based at the University of Nevada, Las Vegas School of Nursing, situating the work within an applied, US veteran-focused practice context even though it appears in a Canadian nursing journal.

Methodologically, the authors used a qualitative descriptive design informed by phenomenology and conducted semi-structured interviews with 13 veterans (ages 23–41) following a single immersion session. Thematic analysis, with attention to established rigor criteria, generated five themes: "the rhythm of relaxed," "embracing the properties of the water," "the pain floats away," "acclimatize to calmness," and "a place to set your mind." Collectively these themes describe a progression from initial unfamiliarity to a settled calm, physical pain relief, and a subjective sense of control over intrusive thoughts. Notably, all 13 participants indicated they would recommend the intervention, and participants offered concrete refinement suggestions, information the authors describe as directly informing revisions for future protocol iterations.

This paper is explicitly framed as one qualitative component of a larger research program; a companion paper, "The Positive Effects of Water Immersion for Symptoms of PTSD in Veterans: A Mixed Methods Study," published in the International Journal of Clinical Practice by an overlapping author team, reports quantitative outcome measures from the broader project. Faculty should treat the two papers as complementary but distinct: this qualitative report should be appraised on its own methodological terms (credibility, thematic saturation, reflexivity) rather than by importing effect sizes or statistical outcomes from the companion study into discussions of this paper's findings.

For classroom use, this study is well suited to teaching qualitative descriptive methodology and the phenomenological orientation toward lived experience, as distinct from grounded theory or ethnography. It also offers a strong case study in intervention research for stigma-sensitive populations: warm water immersion is framed by the authors as fast-acting and non-stigmatizing, characteristics relevant to veterans who may be reluctant to engage with talk-based mental health treatment. Discussion should address how qualitative data of this kind, self-reported relaxation, pain relief, and perceived control over intrusive thoughts, can and cannot substitute for symptom-scale or physiological outcome data, and why triangulating both (as the larger mixed-methods project appears to do) strengthens the overall evidence base.

Limitations worth foregrounding in seminar discussion include the modest sample size (n = 13), the narrow and relatively young age range (23–41) which may not reflect the demographics of the broader veteran population with PTSD, the single-session design (no data on durability of effects beyond the immersion period), and the qualitative-only scope of this particular paper, which precludes claims about statistical significance or generalizable effect size. Instructors might also probe how the authors managed potential researcher bias given the phenomenological orientation, and what additional detail (interview guide, coding process, saturation rationale) would strengthen transparency for readers assessing trustworthiness. Overall, the study offers a rigorous, well-scoped example of practice-relevant nursing research that generates hypothesis-worthy themes rather than definitive clinical guidance, appropriate framing for both undergraduate and graduate research-appraisal exercises.