VA Home-Based Emotional Learning With Practical Skills

VA-HELPS will include flexibility in both content and delivery to meet the needs of Home
Based Primary Care (HBPC) Veterans. Content will be modular to meet the needs of both
anxious and depressed participants. Modular skills-based treatment has been used
successfully with a range of clinical problems (Chorpita et al., 2004; Henin et al., 2001;
Wetherell et al., 2009, 2011), including our own group's work treating generalized anxiety
disorder (GAD) in primary care (Calleo et al., in press) and anxiety-depression in patients
with chronic illness (Cully et al., 2010). To further support a patient-centered treatment
approach, patients will have the opportunity to include R/S. Research points to the
importance of R/S in coping with illness, with 50-90% of patients reporting using their
belief systems to enhance coping skills (Koenig & Adams, 2008). Along with content
modifications, delivery of treatment should complement the needs of HBPC Veterans. Providing
one initial in-home session, followed by telephone contact for subsequent sessions, allows
cost effectiveness to be taken into consideration; and greater numbers of rural HBPC
patients will have access to the intervention.

Treatment will involve approximately 6 to 8 weekly sessions lasting approximately 30-40
minutes each. After the first in-person session, all sessions will be delivered via
telephone. At least one booster call (15-20 minutes) will occur during the month following
completion of active treatment. All participants will complete assessments at baseline, 8
weeks, and 12 weeks.

Inclusion Criteria:

- Age 18 or older

- Part of Home-Based Primary Care

- Reside in a rural community, as defined by the US Census Bureau

- Symptoms of anxiety and/or depression

Exclusion Criteria:

- Significant cognitive impairment

- Active suicidal intent

- Current uncontrolled psychosis, bipolar, or substance-abuse disorders within the past
month