Development of StressCheck: A telehealth motivational enhancement therapy to improve voluntary engagement for PTSD treatment among active-duty service members

Kaysen, Debra; Walton, Thomas O.; Rhew, Isaac C.; Jaffe, Anna E.; Pierce, Adam; Walker, Denise D.

doi:10.1016/j.cct.2022.106841

Cited by 3 publications

(4 citation statements)

References 37 publications

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“…This study is a secondary analysis of data collected for a randomized clinical trial of a brief motivational enhancement intervention designed to support active‐duty service members with untreated PTSD in their exploration of treatment options. The trial protocol and primary outcomes are presented elsewhere (Kaysen et al., 2022; Walker et al., 2023). Participants were recruited through advertisements placed in major social media platforms as well as print media posted locally at a large military installation in the Pacific Northwest.…”

Section: Methodsmentioning

confidence: 99%

Alcohol use disorder as a moderator of the relationship between posttraumatic stress disorder and suicidality among military personnel

Walton,

Graupensperger,

Walker

et al. 2024

Alcohol, Clinical and Experimental Research

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BackgroundAlcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and suicide are substantial public health concerns among military service members, yet the nature of their relationships is not well understood. Here, we tested the hypothesis that AUD moderates the relationship between PTSD symptom severity and suicidal ideation.MethodsThis secondary analysis uses data collected at baseline for a randomized clinical trial. The sample consists of 160 active‐duty service members from three service branches (Army, Air Force, and Navy). All participants met diagnostic criteria for PTSD and were not engaged in evidence‐based PTSD treatment at the time of enrollment. Zero‐inflated Poisson generalized linear regression models were used to test the associations of PTSD and AUD symptom severity with the presence and severity of suicidal ideation.ResultsFindings suggest that AUD symptom severity moderates (i.e., amplifies) the relationship between PTSD symptoms and severity of suicidal ideation among military personnel with untreated PTSD. Among service members with mild or absent AUD, we found no significant association between PTSD symptoms and the severity of suicidal ideation. However, when AUD severity was average (i.e., sample mean) or high (mean + 1SD), PTSD symptoms were significantly positively associated with the severity of suicidal ideation.ConclusionsThis study highlights the importance of assessing AUD and PTSD as a part of suicide risk evaluations of veterans. The results also provide strong support for the maintenance and further development in the military health system of treatment programs that simultaneously address AUD and PTSD comorbidity.

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Section: Methodsmentioning

confidence: 99%

Alcohol use disorder as a moderator of the relationship between posttraumatic stress disorder and suicidality among military personnel

Walton,

Graupensperger,

Walker

et al. 2024

Alcohol, Clinical and Experimental Research

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“…Data were collected between January 2018 and September 2021. For a full description of the parent trial, see Kaysen et al (2022). All participants provided informed consent prior to enrollment.…”

Section: Methodsmentioning

confidence: 99%

“…The protocol for the parent clinical trial is available at Kaysen et al. (2022; ClinicalTrials.gov identifier: NCT03423394). The secondary analysis reported in this article was not formally preregistered.…”

Section: Open Practices Statementmentioning

confidence: 99%

Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members

Jaffe

Walton

Walker

et al. 2023

Journal of Traumatic Stress

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Evidence‐based treatments for posttraumatic stress disorder (PTSD) are underutilized by active duty service members in the United States. Social support may help service members overcome avoidance and facilitate treatment utilization. In turn, treatment utilization may improve social support. To evaluate these possibilities, the aim of the current study was to examine potential reciprocal associations between social support and treatment utilization among service members. Secondary analyses were conducted on a randomized controlled trial of 161 U.S. military service members with PTSD. Participants completed assessments of perceived social support and attendance at individual therapy sessions at baseline and 3‐ and 6‐month follow‐ups. To determine reciprocal relations between social support and treatment utilization, a Bayesian approach was used to estimate a random‐intercept cross‐lagged panel model with a two‐part variable for treatment utilization (i.e., any therapy, and if so, dose). There were no between‐person associations between average social support and treatment utilization. One prospective cross‐lagged within‐person association emerged as significant: social support at 3 months was negatively associated with any therapy use at 6 months; the model explained 26.1% of the variance in this observed variable. The findings revealed that low social support promoted subsequent treatment utilization, but such treatment did not lead to changes in social support. This suggests service members with PTSD may have been motivated to attend individual therapy in pursuit of social connection and support. Future research is needed to determine if reciprocal associations between various forms of social support and therapy utilization differ by treatment modality.

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“…were distributed widely throughout the installation. Recruitment messaging was based on prior check-up interventions with military personnel (Walker et al, 2017; Walton et al, 2013) and refined through focus group feedback to attract individuals experiencing symptoms of PTSD who may be ambivalent about change (Kaysen et al, 2022). After 1 year of a 2-year recruitment period, we obtained the necessary approvals to expand eligibility to Navy personnel and recruit nationally.…”

Section: Methodsmentioning

confidence: 99%

Improving voluntary engagement for posttraumatic stress disorder treatment among active-duty service members using motivational enhancement therapy.

Walker,

Walton,

Jaffe

et al. 2023

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Posttraumatic stress disorder (PTSD) prevalence in the military is high and effective treatments are underutilized. Motivational enhancement therapy (MET) “check-ups” are brief interventions to elicit treatment uptake for those who are nontreatment seeking. The aim of the current study was to test the efficacy of a novel MET intervention designed to promote treatment engagement among active-duty U.S. military personnel with untreated PTSD. Method: One hundred and sixty-one active-duty service members who met the criteria for PTSD were randomized to MET or treatment as usual (TAU, treatment resource and referral). MET participants (n = 82) received up to three 30–90 min telephone sessions. TAU participants (n = 79) were mailed PTSD resources and referrals. Follow-up assessments were conducted 6-week, 3- and 6-month postbaseline. Results: Mixed effect model results indicated treatment uptake significantly increased over time but there were no significant differences between conditions or interactions. PTSD symptom severity significantly decreased for both conditions. There was also a significant three-way interaction with baseline readiness-to-change confidence. Those low in baseline readiness-to-change saw more favorable effects of MET (relative to TAU) at 6-month follow-up. Conclusions: Results suggest both MET and high-quality referral options have promise as a means of increasing evidence-based treatment uptake and decreasing PTSD for service members with PTSD. MET may be particularly useful for individuals with low confidence in their ability to address PTSD. Given the individual and societal costs of PTSD, there is a need for interventions facilitating treatment uptake.

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Development of StressCheck: A telehealth motivational enhancement therapy to improve voluntary engagement for PTSD treatment among active-duty service members

Cited by 3 publications

References 37 publications

Alcohol use disorder as a moderator of the relationship between posttraumatic stress disorder and suicidality among military personnel

Alcohol use disorder as a moderator of the relationship between posttraumatic stress disorder and suicidality among military personnel

Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members

Improving voluntary engagement for posttraumatic stress disorder treatment among active-duty service members using motivational enhancement therapy.

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