Telephone Monitoring and Support For Veterans with Chronic Posttraumatic Stress Disorder: A Pilot Study

National Center for Posttraumatic Stress Disorder, Clinical Laboratory and Education Division, VA Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA 94304-1207, USA.
Community Mental Health Journal (Impact Factor: 1.03). 11/2006; 42(5):501-8. DOI: 10.1007/s10597-006-9047-6
Source: PubMed


Dropout from outpatient mental health treatment may contribute to high rates of relapse and rehospitalization among veterans with chronic posttraumatic stress disorder (PTSD). In a quasi-experimental cohort study, 87 male and 17 female veterans discharging from residential PTSD treatment received either standard referral to outpatient care (N = 77) or standard referrals supplemented by biweekly telephone calls (N = 27). Telephone monitoring and support was feasible and acceptable to 85% of clients. Compared to prior patient cohorts, clients receiving telephone support were twice as likely (88% vs. 43%) to complete an outpatient visit within 1 month of discharge and reported higher satisfaction with care.

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    • "These studies yielded limited results. Interventions included a telephone monitoring program (Rosen et al., 2006), a self-defense program (David, Simpson, & Cotton, 2006), PTSD educational/treatment sessions (Schnurr et al., 2009), mind–body intervention and massage treatments (Price, McBride, Hyerle, & Kivlahan, 2007), and case management for homelessness (Desai, Harpaz-Rotem, Najavits, & Rosenheck, 2008). The majority of these studies had small sample sizes and no controls. "
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    ABSTRACT: Female veterans, the fastest growing segment in the military, have unique pre-military histories and military experiences that are associated with post-military physical and mental health service needs. Successful treatment is contingent on a clearer understanding of the processes underlying these experiences. Data from 20 female veterans who served post-Gulf War were analyzed to generate a substantive theory of the process of women who entered, served in, and transitioned out of the military. Coping with transitions emerged as the basic psychosocial process used by female veterans. The Coping with transitions process is comprised of seven categories: Choosing the Military, Adapting to the Military, Being in the Military, Being a Female in the Military, Departing the Military, Experiencing Stressors of Being a Civilian, and Making Meaning of Being a Veteran-Civilian. The results of this study provide a theoretical description of the process female veterans experience when transitioning from a civilian identity, through military life stressors and adaptations, toward gaining a dual identity of being a veteran-civilian.
    Social Work in Mental Health 11/2014; 13(2):141217143250004. DOI:10.1080/15332985.2013.870102
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    • "Cell phones are now used by 90% of American adults [15], and one-third of SMs not willing to seek in-person counseling services report willingness to engage in technologybased services [16]. Telephone-based healthcare interventions often result in high satisfaction [16] [17] as well as efficacy [18] [19] [20] [21]. "
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    ABSTRACT: Military service members (SMs) and veterans who sustain mild traumatic brain injuries (mTBI) during combat deployments often have co-morbid conditions but are reluctant to seek out therapy in medical or mental health settings. Efficacious methods of intervention that are patient-centered and adaptable to a mobile and often difficult-to-reach population would be useful in improving quality of life. This article describes a new protocol developed as part of a randomized clinical trial of a telephone-mediated program for SMs with mTBI. The 12-session program combines problem solving training (PST) with embedded modules targeting depression, anxiety, insomnia, and headache. The rationale and development of this behavioral intervention for implementation with persons with multiple co-morbidities is described along with the proposed analysis of results. In particular, we provide details regarding the creation of a treatment that is manualized yet flexible enough to address a wide variety of problems and symptoms within a standard framework. The methods involved in enrolling and retaining an often hard-to-study population are also highlighted. Copyright © 2014 Elsevier Inc. All rights reserved.
    Contemporary Clinical Trials 11/2014; 40C:54-62. DOI:10.1016/j.cct.2014.11.001 · 1.94 Impact Factor
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    • "According to the British NICE clinical guideline it is recommended to use a brief screening instrument for PTSD routinely one month post-trauma [6]. In smaller populations affected by a disaster, telephone monitoring seems to be a viable approach for coming into contact with PTSD patients in order to encourage them to seek out treatment [7]. However, a routine screening could easily be stretched to its limits in terms of expert resources, costs and effort. "
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    ABSTRACT: In the aftermath of the Tsunami disaster in 2004, an online psychological self-assessment (ONSET) was developed and made available by the University of Zurich in order to provide an online screening instrument for Tsunami victims to test if they were traumatized and in need of mental health care. The objective of the study was to report the lessons learnt that were made using an Internet-based, self-screening instrument after a large-scale disaster and to discuss its outreach and usefulness. Users of the online self-assessment decided after finishing the procedure whether their dataset could be used for quality control and scientific evaluation Their answers were stored anonymously only if they consented (which was the case in 88% of the sample), stratified analyses according to level of exposure were conducted. A total of 2,914 adult users gave their consent for analysis of the screenings. Almost three quarter of the sample filled out the ONSET questionnaire within the first four weeks. Forty-one percent of the users reported direct exposure to the Tsunami disaster. Users who were injured by the Tsunami and users who reported dead or injured family members showed the highest degree of PTSD symptoms. ONSET was used by a large number of subjects who thought to be affected by the catastrophe in order to help them decide if they needed to see a mental health professional. Furthermore, men more frequently accessed the instrument than women, indicating that Internet-based testing facilitates reaching out to a different group of people than "ordinary" public mental health strategies.
    BMC Public Health 01/2011; 11(1):18. DOI:10.1186/1471-2458-11-18 · 2.26 Impact Factor
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