Resilience and Well-Being Pilot Study

To participate in this study, Veterans must first be enrolled in the Resilience and
Well-Being Program, a 5-week, group-based positive psychology program held at VA Puget Sound
as part of standard care. After enrollment, Veterans may choose to enroll in this research
study which evaluates the effectiveness of, and satisfaction with, the Resilience and
Well-Being Program.

This research study includes two study visits at VA Puget Sound and three assessments over
the phone.

Informed Consent Process

This process will take place at the VA Puget Sound. A research staff member will review the
details of the study with the participant and answer any questions s/he may have to see if
they are interested in participating.

Assessments

1. Baseline Assessment: A research staff member will ask the participant a number of
standard questions. The most straightforward of these questions will ask about age,
gender, race, ethnicity, education level, employment status, marital status, and
military service. Participants will also be asked questions about their medical and
mental health treatment use, and any other health problems they may experience.
Participants will also be asked questions about potentially stressful life experiences.

2. Post-Group Satisfaction Survey: This survey will happen following the completion of the
5-week group as long as a participant has attended at least one session. Participants
will be asked to complete this survey in-person at the end of Session 5. In this survey,
participants will be asked questions about how satisfying, engaging, and helpful they
thought the program was; what they thought about the program, and whether they
experienced any negative effects from participating in the program.

3. Telephone Assessments: Throughout participation in the study, participants will be asked
to complete three telephone assessments. Within each assessment, participants will be
asked questions relating to:

- How the participant is feeling

- Satisfaction with life and well-being

- Positive and negative emotions

- Participation and satisfaction with social activities

- Problems related to very stressful experiences

- Physical pain and how it is affecting the participant's life

- Current and past mental health treatment use

- How likely the participant is to seek mental health treatment

- Changes in medications, psychological treatment, or new major life events

- How illness/injury has impacted the participant's life

- Whether the participant noticed any changes in their life after the group (once the
group is over)

The three telephone assessments will occur at the following stages of the study:

- Pre-Group Assessment must be completed before the first group session.

- Post-Group Assessment will occur at the end of the 5-week group period.

- 5-Week Follow-Up Assessment will occur about 5 weeks after the end of the 5-week group
period.

Focus Group (Optional)

Participants will be invited to complete a focus group that will last about 60-90 minutes six
to eight weeks after the completion of the group to talk about their experiences and
satisfaction with the program. Completing the focus group is optional, but encouraged, as
researchers would like to receive participant feedback through open discussion to better
improve this program for other Veterans. The focus group leaders will use prepared questions
to help guide the flow of discussion.

Inclusion Criteria:

1. Veteran status (defined as prior service in the US Armed Forces and eligible to
receive health care services through Veterans Health Affairs)

2. 18 years of age or older

3. Enrolled, or eligible and willing to enroll, in the Resilience and Well-Being group
treatment program (offered as part of standard clinical care in VA Puget Sound
Rehabilitation Care Services)

4. Able to read, speak, and understand English

5. Has been seen at least once in the past 12 months in a VAPSHCS clinic that provides
rehabilitation services to individuals with rehabilitation needs related to conditions
including (but not limited to) multiple sclerosis (MS), traumatic brain injury (TBI),
amyotrophic lateral sclerosis (ALS), spinal cord injury (SCI), stroke, myocardial
infarction, limb loss, polytrauma, neuromuscular conditions, musculoskeletal problems,
impairing but medically unexplained symptoms, and/or pain, OR has a diagnosis of such
a condition

6. Positive screen for depression, PTSD, or chronic pain

Exclusion Criteria:

1. Primary psychotic or major thought disorder as listed in participant's medical record
or self-reported

2. Psychiatric or behavioral conditions in which symptoms were unstable or severe (e.g.,
current delirium, mania, psychosis, suicidal ideation, homicidal ideation, active
substance use disorder, psychiatric hospitalization) as listed in participant's
medical record or self-reported within the past six months

3. Any behavioral, cognitive, or psychiatric issues that would indicate the participant
may be inappropriate in a group setting or for this particular group-format
intervention, subject to clinician discretion

4. Difficulties or limitations communicating over the telephone