MIRECC / CoE

Oh, the Places Your South Central MIRECC Product Can Go…

By Amanda Raines, PhD

Have you ever wondered just how far your South Central MIRECC product can go? Well, as a Core Investigator and Co-Site Lead at the New Orleans VA, I can attest that they can go pretty far. While completing my post-doctoral residency at the New Orleans VA in 2017, I recognized that although there were many empirically supported treatments available to treat anxiety and related disorders, many Veterans, particularly those residing in rural and underserved areas, did not have access to quality mental health care due to the lack of providers and hours needed to deliver time-intensive monotherapies.

Recognizing the utility of group-based protocols for anxiety, I applied for and was awarded a South Central MIRECC pilot grant designed to examine the acceptability, feasibility, and utility of a transdiagnostic treatment delivered to rural Veterans. This protocol, initially developed by my graduate student mentor Dr. Brad Schmidt, focused on the identification and elimination of safety aids – that is, cognitive or behavioral strategies used to prevent, reduce, or circumvent anxiety. Results from this pilot trial revealed meaningful decreases in anxiety, depression, and safety aid usage which were maintained throughout a brief follow-up window. Further, overall recommendation and retention rates suggested that the treatment was well-tolerated by Veterans (to read more about this study, visit the Cognitive Behavior Therapy Journal website).

In 2018, I applied for and was awarded a South Central MIRECC clinical educator grant to update and expand the unpublished treatment manual. Specifically, I sought to expand this safety aid treatment across a wider array of diagnoses and ensure that the treatment was Veteran-centric. This manual, which is now freely available for clinicians within and outside the VA, offers a simplified approach to treating a wide range of disorders, particularly during the same clinical hour. The manual has been downloaded 2,837 times and has been presented at several grand rounds, including:

• South Central MIREC CBOC Grand Rounds
• VA Ann Arbor Mental Health Grand Rounds
• Ohio University Department of Psychology Colloquium
• Iowa City VA Psychology Department Psychotherapy Didactic Seminar
• Southeast Louisiana Veterans Health Care System Mental Health Grand Rounds
• Association for Behavioral and Cognitive Therapist Mini Workshop
• Louisiana Psychology Association Annual Convention

More recently, my safety aid reduction treatment was selected as the 2023-2024 pilot implementation project by the VA/DOD's practice-based implementation network (PBIN). The PBIN, which was established in 2012, seeks to promote evidence-based practices (EBPs) that, if adopted, will close the gap between science and practice and improve the lives of service members, Veterans, and their families. Each year, they select a knowledge solution (or EBP) to conduct an implementation pilot project on with the goal of it being “rolled out” in the military health service (MHS). I will be an integral part of the implementation project, helping to train military providers on the delivery of this safety aid reduction treatment at MHS locations throughout the United States and overseas.

I believe that much like the VA, military settings are an ideal venue through which to disseminate transdiagnostic treatments given the prevalence of and impairment associated with untreated anxiety and related disorders in such settings.

Last updated: January 23, 2024