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

ArticleinCommunity Mental Health Journal 42(5):501-8 · November 2006with7 Reads
DOI: 10.1007/s10597-006-9047-6 · Source: PubMed
Abstract
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.
    • "Searching to reconnect and find " a new normal " Homecoming theory posits that reestablishing connections is critical to a successful transition [3] . Although social support has been related to lower risk of mental health and related problems among veterans3132333435363738394041, our research brings a nuanced perspective to those findings, highlighting that many veterans face substantial obstacles in navigating to a situation in which they are supported. Many veterans felt alienated from family and friends, and mistreated by institutions that might have provided support. "
    [Show abstract] [Hide abstract] ABSTRACT: Afghanistan and Iraq veterans experienced traumas during deployment, and disrupted connections with friends and family. In this context, it is critical to understand the nature of veterans' transition to civilian life, the challenges navigated, and approaches to reconnection. We investigated these issues in a qualitative study, framed by homecoming theory, that comprised in-depth interviews with 24 veterans. Using an inductive thematic analysis approach, we developed three overarching themes. Military as family explored how many veterans experienced the military environment as a "family" that took care of them and provided structure. Normal is alien encompassed many veterans experiences of disconnection from people at home, lack of support from institutions, lack of structure, and loss of purpose upon return to civilian life. Searching for a new normal included strategies and supports veterans found to reconnect in the face of these challenges. A veteran who had successfully transitioned and provided support and advice as a peer navigator was frequently discussed as a key resource. A minority of respondents-those who were mistreated by the military system, women veterans, and veterans recovering from substance abuse problems-were less able to access peer support. Other reconnection strategies included becoming an ambassador to the military experience, and knowing transition challenges would ease with time. Results were consistent with and are discussed in the context of homecoming theory and social climate theory. Social support is known to be protective for veterans, but our findings add the nuance of substantial obstacles veterans face in locating and accessing support, due to disconnection and unsupportive institutions. Larger scale work is needed to better understand how to foster peer connection, build reconnection with family, and engage the broader community to understand and support veterans; interventions to support reconnection for veterans should be developed.
    Full-text · Article · Jul 2015
    • "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. "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Nov 2014
    • "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]. "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Nov 2014
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