Denise has studied how cultural factors interact to influence illness and help seeking for over 20 years, developing a middle range theory and an ethnographic interview methodology, which examines the help-seeking trajectory. Her work has been applied to research on mental and physical illness, homelessness, and trauma recovery. Her work in trauma recovery has focused on the neurobiological and experiential state of “freezing” in relationship with shame as an internal barrier to help seeking. Her methods include grounded theory, Feminist Ethnography and Mixed Methods.