Newsletter | South Central MIRECC
Spring 2019, Volume 21, Issue 2 - In this Issue
Thoughts on the VA Research Experience from a Veteran’s Point of View
Research to Practice | Increasing Participation of Iraq- and Afghanistan Veterans in Research
New Clinical Demonstration Project TheraMetrics Begins
Researchers Awarded Pilot Study Research Grants
Pilot Study Research Program Applications Due July 1
Implementation, Design and Analysis Support Available for Affiliates
Researchers Awarded Pilot Study Research Grants
Pilot studies are an important first-step in taking an idea or theory from curiosity to a grant that health research agencies want to fund. Our Pilot Study Research Program helps VISN 16 and 17 investigators lay the foundation for projects that make mental health treatment easier for Veterans to access, understand, and benefit from. We recently awarded four projects that are testing new and modified treatments for telehealth and evidence-based therapy for behavioral health and medication management.
In line with the SC MIRECC mission, these studies prioritize Veterans who live in rural communities or face barriers to receiving VA care as research participants. VISN16 and 17 investigators who want to learn more about this program should visit the SC MIRECC Research webpage.
- Development and Pilot Testing of Video-based Delivery of Brief Cognitive Behavioral Therapy for Anxiety
Principal Investigators: Jeff Cully, PhD and Terri Fletcher, PhD
Co-Investigators: Lindsay Martin, PhD. Shubhada Sansgiry, PhD, Darrell Zeno, MS, and Andy Robinson, MS
About: This project develops and tests intervention materials for brief cognitive behavioral therapy for anxiety. This VA Video Connect to the Home intervention is being tested for acceptability by and preliminary effectiveness for research participants. It targets shared symptoms from across several anxiety diagnoses, including panic, and generalized and social anxiety. It incorporates exposure techniques to maximize the effectiveness of the intervention. It is expected to be found feasible for use in primary care and community-based outpatient clinic (CBOC) settings.
Significance: Increasing the delivery of mental health services through video to home technology is important to VHA. This study aims to help by increasing access, decreasing barriers like distance, transportation, travel time, stigma, and child care, and providing more Veteran-centric care. This is a flexible evidence-based approach that fits within primary care and CBOC settings and offers innovative delivery strategies for anxiety treatment.
Impact: This study can significantly contribute to the well-being and care of Veterans with anxiety by offering evidence-based telehealth treatments. Data collected from this study will support a larger grant submission to VA HSR&D. It may also enhance implementation and quality improvement efforts for anxiety treatment.
- Partnered Development of Internet-Assisted Cognitive Behavioral Therapy for Co-occurring Mental Health Disorders and Substance Use Disorders for Rural Veterans
Principal Investigator: Anthony Ecker, PhD
Co-Investigators: Jeffrey Cully, PhD and Michael Cucciare, PhD
Consultant: Carolyn Greene, PhD
Coordinator: Matt Escamilla
About: This project adapts Coordinated Anxiety Learning and Management (CALM), a computer-assisted therapy program, to help rural mental health providers use cognitive behavioral therapy to treat co-occurring anxiety and substance use disorders. Stakeholders, such as treatment content experts, mental health providers and Veterans, will give us feedback to ensure that the program is usable and Veteran-centric.
Significance: Anxiety disorders and substance use co-occur at high rates. They often create a vicious cycle that makes both disorders more severe and difficult to treat and it can be difficult to coordinate the multiple treatments that Veterans need. This program aims to empower providers to use high quality psychotherapy to break the cycle.
Impact:We hope that by expanding an effective treatment program to include substance use disorders, providers will have access to more evidence-based practices to treat Veterans caught in a loop of anxiety and substance use.
- Evaluating the Utility of a Brief Computerized Anxiety Sensitivity Intervention for Opioid Use Disorders: A Pilot Investigation
Principal Investigator: Amanda M. Raines, PhD
Co-Investigator: Nicholas P. Allan, PhD
Clinical Consultant: C. Laurel Franklin, PhD
Research Assistant: Shelby J. McGrew
About: This study tests the acceptability and feasibility of Cognitive Anxiety Sensitivity Treatment (CAST), a brief, one-session computerized anxiety sensitivity intervention, with Veterans seeking treatment for an opioid use disorder. We will gather data on the effects of CAST on symptom change and attendance and retention rates in a substance use disorder treatment program.
Significance: The U.S. opioid epidemic impacts Veterans disproportionately to the general population. Veterans are twice as likely to die from an accidental opioid overdose, even after accounting for gender and age distribution. Although many individuals with an opioid addiction seek treatment, a large number drop out prematurely and/or relapse. Thus, there is a need to identify modifiable factors that contribute to Veterans leaving treatment.
Impact:Anxiety sensitivity may be a useful variable in understanding why a person leaves addiction treatment. It is a psychological risk factor that leads to individuals fearing anxious arousal because they think it will cause harmful physical, mental, and/or social consequences. It is elevated in opioid use populations and predicts treatment dropout among users. Research suggests that anxiety sensitivity is highly malleable but, to our knowledge, no published research to date has systematically explored its utility among opioid users. This study will contribute to this knowledge base.
- A Pilot Study to Assess Efficacy, Safety, and Feasibility of Quetiapine as an Adjunctive Treatment to Prolonged Exposure Therapy for PTSD in Veterans
Principal Investigator: Muhammad R. Baig, MD
Co-Investigators: John D. Roache, PhD and Jim Mintz, PhD
Collaborators: Jennifer A. Lemmer, PhD, Jennifer L. Wilson, PhD, Robert D. Beck, PhD, and Rebecca N. Tapia, MD
About: This study tests the effect of quetiapine as an adjunct in prolonged exposure treatment. It will help us understand if quetiapine can improve management of arousal disturbances and safely and effectively improve Veteran engagement and retention in treatment.
Significance: This study is innovative and significant because positive results could lead to new guidelines for clinical practice. It could show that medication-related improvements in patient engagement and retention may be the most effective approach to ensure VA resources achieve the best possible outcome for Veterans.
Impact:This study has the potential to help VA achieve greater remission rates for Veterans suffering from comorbid PTSD. It will allow us to establish an appropriate dosing schedule of quetiapine and plan recruitment for a larger, full-scale trial.
Last updated: April 29, 2019