1. A randomized trial of an online, coach-assisted self-management PTSD intervention tailored for women veterans
- Author
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Alison B. Hamilton, Konstantina Yantsides, Michelle Upham, Rachel M Thomas, Brett T. Litz, Keren Lehavot, Kerry L. Beckman, Tracy L. Simpson, Anne G. Sadler, and Steven P. Millard
- Subjects
Adult ,medicine.medical_specialty ,Telemedicine ,Evidence-based practice ,MEDLINE ,PsycINFO ,Article ,law.invention ,Stress Disorders, Post-Traumatic ,Randomized controlled trial ,Phone ,law ,Intervention (counseling) ,medicine ,Humans ,Veterans ,Self-management ,Self-Management ,Middle Aged ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Physical therapy ,Female ,Psychology ,Internet-Based Intervention - Abstract
OBJECTIVE: Scalable, efficiently delivered treatments are needed to address the needs of women Veterans with PTSD. This randomized clinical trial compared an online, coach-assisted cognitive behavioral intervention tailored for women Veterans with PTSD to phone monitoring only. METHOD: Women Veterans who met diagnostic criteria for PTSD were randomized to an 8-week web-based intervention, called DESTRESS-WV, or to phone monitoring only (N=102). DESTRESS-WV consisted of online sessions and 15-minute weekly phone calls from a study coach. Phone monitoring included 15-minute weekly phone calls from a study coach to offer general support. PTSD symptom severity (PCL-5) was evaluated pre- and post-treatment, and at 3- and 6-months post-treatment. RESULTS: More participants completed phone monitoring than DESTRESS-WV (96% vs. 76%, p=0.01), although treatment satisfaction was significantly greater in the DESTRESS-WV condition. We failed to confirm the superiority of DESTRESS-WV in intent-to-treat slope changes in PTSD symptom severity. Both treatments were associated with significant reductions in PTSD symptom severity over time. However, post-hoc analyses of treatment completers and of those with baseline PCL≥33 revealed that the DESTRESS-WV group had greater improvement in PTSD symptom severity relative to phone monitoring with significant differences at the 3-month follow-up assessment. CONCLUSIONS: Both DESTRESS-WV and phone monitoring resulted in significant improvements in women Veterans’ PTSD symptoms. DESTRESS-WV may be an appropriate care model for women Veterans who can engage in the demands of the treatment and have higher baseline symptoms. Future research should explore characteristics of and methods of reliably identifying women Veterans who are most likely to benefit. PUBLIC HEALTH SIGNIFICANCE: Women Veterans have a high prevalence of PTSD, unique barriers to care, and underutilize evidence-based PTSD treatments. Findings support further exploration of both DESTRESS-WV and alternative active comparators as low-cost, feasible strategies to enhance access to PTSD care for women Veterans who are otherwise unable to access traditional mental health care.
- Published
- 2021