MIRECC / CoE

Publication Highlights

Articles and books authored by our affiliates enable us to share research and knowledge about mental health treatment with our Veteran, caregiver, provider and research communities.

Highlighted Articles

Drs. Jennifer "Jenn" Bryan (first author) and Ali Abbas Asghar-Ali published the article “Addressing Veteran Suicide: Evaluation of an Interactive Online Educational Training Module” in the Journal of Technology and Behavior Science. Their project evaluates a novel 1-h educational interactive module for clinicians on assessing and managing Veterans at risk for suicide. Participants were clinicians who completed a mandatory Veterans Health Administration training and posttraining evaluation during August 2020 (n = 13,990). A randomly selected subset was invited to take the 5-month posttraining evaluation (n = 5000). After training completion, participants reported they would be able to assess for suicide risk, discuss suicide risk with Veterans, and implement a treatment plan. Five months posttraining, 428 participants completed the evaluation. Clinicians reported they were successful in implementing the previously mentioned skills. This interactive training module was effective in providing clinicians with skills to talk with Veterans about suicide risk, assess risk, and manage those at risk. The free training is available at https://www.train.org/vha/course/1090912/details?activeTab=about.

Drs. Amanda Raines (first author), Mary Shapiro, Claire Houtsma, Joseph "Jay" Boffa, Chelsea Ennis, and Laurel Franklin published the article “Cognitive processing therapy: A meta-analytic review among Veterans and military personnel with PTSD” in Cognitive Therapy and Research. In addition to the meta-analytic review of CPT for PTSD among military personnel and Veterans, the authors examined potential moderators of treatment outcomes including type of comparison condition (e.g., active trauma-focused, active non-trauma-focused), CPT version (i.e., CPT with and without the written trauma account), sample type (Veteran or military personnel), age, gender, and race. Nine articles with 1,804 participants were retained for this meta-analysis.

The authors found that CPT, when compared to all comparison conditions, exhibited a medium effect on PTSD symptom reduction (Hedge’s g = − 0.48, 95% CI: -1.05, 0.08). Regarding moderators, the effect was larger for non-trauma-focused active comparators versus trauma-focused active comparators (Qbetween = 16.69, pbetween < 0.001, Hedge’s g = − 0.57 and − 0.14, respectively). Further, CPT with the written trauma account outperformed CPT without the written trauma account (Qbetween = 4.53, pbetween = 0.03, Hedge’s g = − 0.86 and − 0.23, respectively), and Veteran samples saw slightly more symptom reduction than military personnel (Qbetween = 15.50, pbetween < 0.001, Hedge’s g = − 0.51 and − 0.45, respectively). Notably, age, gender, and race did not moderate the effect of CPT on PTSD. Findings support the continued use of CPT for PTSD symptoms among Veterans and military personnel and call into question the removal of the written trauma account.

Drs. Rajinder "Sonia" Singh (first author), Sara Landes, Traci Abraham , Michael Kauth and JoAnn Kirchner published the article “Implementation of LGBTQ+ affirming care policies in the Veterans Health Administration: Preliminary findings on barriers and facilitators in the southern United States” in Frontiers in Public Health. The project examined providers’ barriers and facilitators to providing LGBTQ+ affirming care and LGBTQ+ Veterans’ barriers and facilitators to receiving LGBTQ+ affirming care. Data collection and analysis were informed by the Consolidated Framework for Implementation Research, which was adapted to include three health equity domains. Data collection involved telephone interviews conducted with 11 VA providers and 12 LGBTQ+ Veterans at one rural and one urban VA medical center, and one rural VA community clinic. Qualitative data were rapidly analyzed using template analysis, a data reduction technique.

Allowing more time and capacity for education and engaging LGBTQ+ Veterans in determining how to improve their healthcare may be the path forward to increase adherence to LGBTQ+ affirming care policies. Engaging patients, especially those from marginalized backgrounds, in strategies focused on the uptake of policy may be a path to improve policy implementation. It is possible that creating truly collaborative structures in which patients, staff, providers, leadership, and policymakers can work together towards policy implementation may be a useful strategy. In turn, improved policy implementation would result in increased physical and mental health for LGBTQ+ Veterans.

Last updated: April 17, 2024