Clinician-Supported PTSD Coach vs. Self-Managed PTSD Coach
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | April 2013 |
| End Date: | December 2014 |
Clinician-Supported PTSD Coach vs. Self-Managed PTSD Coach: A Pilot Feasibility Trial
PTSD Coach is a mobile application (app) that aims to teach individuals self-management
strategies for symptoms of Post-traumatic Stress Disorder (PTSD). Despite PTSD Coach's use
of evidence-based cognitive behavioral strategies there is still a need to test the
effectiveness of the app in managing PTSD symptoms. There is research evidence that
self-management programs are often underutilized, but that clinician contact can increase
patient involvement. The addition of clinician support may enhance the utilization and
effectiveness of the PTSD Coach. In Phase 1 the investigators propose to conduct stakeholder
interviews with primary care (PC) and mental health (MH) leadership staff to investigate
barriers and facilitators to implementing Clinician-Supported (CS-PTSD Coach) to increase
the uptake, use, and impact of PTSD Coach by PC patients. The interviews will inform the
development of a CS-PTSD Coach protocol and manual that will be used in phase 2. In phase 2
the investigators propose to conduct a feasibility study where 30 (20 eligible) PC Veterans
with diagnostic-level or subthreshold PTSD symptoms will be randomized to receive
Self-Managed (SM) PTSD Coach or CS-PTSD Coach. The investigators' specific aims are to 1)
investigate the feasibility of recruiting and retaining participants and delivering the SM
and CS conditions and 2) conduct a preliminary investigation of the efficacy of SM vs. CS.
The investigators predict that CS will lead to greater treatment gains than SM. Effect sizes
will be generated for the following outcomes: a) reductions in PTSD, depression, and general
distress, and increases in health-related functioning, b) increases in knowledge about PTSD
symptoms, PTSD management strategies, and patient coping self-efficacy, c) increases in
initiation of tradition PTSD treatments.
strategies for symptoms of Post-traumatic Stress Disorder (PTSD). Despite PTSD Coach's use
of evidence-based cognitive behavioral strategies there is still a need to test the
effectiveness of the app in managing PTSD symptoms. There is research evidence that
self-management programs are often underutilized, but that clinician contact can increase
patient involvement. The addition of clinician support may enhance the utilization and
effectiveness of the PTSD Coach. In Phase 1 the investigators propose to conduct stakeholder
interviews with primary care (PC) and mental health (MH) leadership staff to investigate
barriers and facilitators to implementing Clinician-Supported (CS-PTSD Coach) to increase
the uptake, use, and impact of PTSD Coach by PC patients. The interviews will inform the
development of a CS-PTSD Coach protocol and manual that will be used in phase 2. In phase 2
the investigators propose to conduct a feasibility study where 30 (20 eligible) PC Veterans
with diagnostic-level or subthreshold PTSD symptoms will be randomized to receive
Self-Managed (SM) PTSD Coach or CS-PTSD Coach. The investigators' specific aims are to 1)
investigate the feasibility of recruiting and retaining participants and delivering the SM
and CS conditions and 2) conduct a preliminary investigation of the efficacy of SM vs. CS.
The investigators predict that CS will lead to greater treatment gains than SM. Effect sizes
will be generated for the following outcomes: a) reductions in PTSD, depression, and general
distress, and increases in health-related functioning, b) increases in knowledge about PTSD
symptoms, PTSD management strategies, and patient coping self-efficacy, c) increases in
initiation of tradition PTSD treatments.
Inclusion Criteria:
1. Enrolled in primary care at the Syracuse VAMC,
2. Significant PTSD symptoms. Total PTSD Checklist Score ≥ 40.
Exclusion Criteria:
1. Gross cognitive impairment (as measured by the Blessed
Orientation-Memory-Concentration; BOMC)
2. Suicide attempt or intent to commit suicide in the last two months (as measured by
the Columbia- Suicide Severity Rating Scale
3. Psychotherapy or mental health counseling for PTSD in the last two months that was
received outside of VA primary care
4. A new psychotropic medication or a change in dose of a psychotropic medication for
PTSD in the last two months that was received outside of VA primary care
5. Intent to begin PTSD treatment in specialty care
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