Symposia
Telehealth/m-Health
Eric Kuhn, Ph.D.
Clinical Psychologist
VA Palo Alto Health Care System/Stanford
Menlo Park, CA
Kyle Possemato, Ph.D.
Psychologist
syracuse VAMC
Syracuse, NY
Gregory Beehler, Ph.D.
Associate Director for Research
VA Center for Integrated Healthcare
Buffalo, New York
Kimberly Barrie, MPH, LCSW
Research Social Worker
VA Center for Integrated Healthcare
Syracuse, New York
Deloras Puran, MPH
Health Science Specialist
Dissemination and Training Division, National Center for PTSD
Menlo Park, CA
Posttraumatic Stress Disorder (PTSD) is highly prevalent among patients of VA and community primary care clinics. Unfortunately, brief evidence-based PTSD interventions that are amenable to delivering in these settings are lacking. Moreover, many primary care patients with PTSD do not accept referrals for specialty mental health care leaving their PTSD inadequately treated. Therefore, we developed Clinician-Supported (CS) PTSD Coach, an 8-week intervention combining the self-management smartphone app PTSD Coach and four 30-minute sessions (in-person or by phone) with a primary care mental health clinician. CS PTSD Coach focuses on psychoeducation about PTSD symptoms and treatment, symptom monitoring, and CBT-based symptom management. Sessions are designed to support PTSD Coach use especially practicing the symptom management strategies it offers. We recently completed data collection for a multisite randomized clinical trial comparing CS PTSD Coach to VA primary care behavioral health treatment as usual (TAU) on PTSD symptoms and other outcomes. A total of 234 VA primary care patients with PTSD were randomized (1:1) to study conditions and assessed at baseline, 8- (posttreatment), 16-, and 24-weeks after baseline. The sample had an average age of 50.9 (SD = 15.4) years, 10% were women, and 35% were non-White. Participants had moderately severe PTSD symptoms at baseline with an average PTSD Checklist 5 (PCL-5) score of 46.7 (SD = 10.4). Preliminary analyses suggest that at 8-weeks, CS PTSD Coach participants had a significantly larger reduction in PCL-5 scores than did TAU participants (-9.7 vs. -6.5, respectively, p < .05) and a significantly higher proportion (29.6% vs. 16.8%, respectively, p < .05) had clinically significant improvement (i.e., >= 15-point reduction). Impacts on other outcomes, including depression and psychosocial functioning, will be presented, as will findings of treatment effects over time (i.e., at 16- and 24-week follow-ups). Given these promising preliminary findings, as CS PTSD Coach is an easy-to-implement intervention in primary care clinics, it has the potential to improve the quality of care for veterans with PTSD being treated in these and potentially other healthcare settings.