Problem-solving training for Veterans in home based primary care: an evaluation of intervention effectiveness
Affiliations.
- 1 Psychiatry Service, Sierra Pacific Mental Illness, Research, Education and Clinical Centers (MIRECC), Veterans Affairs Palo, Alto Health Care System, Palo Alto, CA, USA.
- 2 Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
- 3 Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs Central Office, Washington, DC, USA.
- 4 VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.
- 5 Department of Psychiatry, University of Rochester, Rochester, NY, USA.
- 6 Department of Psychology, Drexel University, Philadelphia, PA, USA.
- 7 Mental Health Service, Home-Based Primary Care, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
- 8 Department of Psychiatry, University of California, San Diego, CA, USA.
- PMID: 33455603
- DOI: 10.1017/S104161022000397X
Background: Veterans enrolled in Veterans Health Administration (VHA) Home Based Primary Care (HBPC), a program providing in-home medical and mental health care by an interdisciplinary care team, often face substantial physical, cognitive, and mental health challenges. This program evaluation examined the impact of a brief problem-solving intervention on depressive symptoms, quality of life, and problem-solving abilities for Veterans enrolled in HBPC.
Design: Pre- and post-intervention outcomes for Veterans, and qualitative feedback from Veterans and clinicians regarding program satisfaction.
Participants and setting: A total of 230 HBPC patients (mean age in years = 72.1, SD = 11.6) within the U.S. national VHA health care system.
Intervention: Six-session, individual Problem-Solving Training (PST-HBPC).
Method: Licensed psychologists and social workers (n = 115) completed training and administered the treatment with HBPC Veterans between 2014 and 2017.
Measurements and results: From baseline to post-intervention, Veterans completing five or more PST-HBPC sessions (n = 199) reported significant reductions in depressive symptoms on the Patient Health Questionnaire 9-item (PHQ-9), in difficulty functioning due to depressive symptoms (PHQ-9 item 10), and in thoughts of death (PHQ-9 item 9). They also reported more effective problem-solving on the Social Problem-Solving Inventory - Revised: Short form (total score and subscales), and improved quality of life across life domains on the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale. Both clinicians and Veterans also reported satisfaction with the program.
Conclusions: Preliminary findings support the continued dissemination and implementation of this brief PST intervention for HBPC Veterans, and its potential for use with non-VA home care populations with complex comorbidities.
Keywords: cognitive behavioral therapy; community care; depression.
Publication types
- Research Support, Non-U.S. Gov't
- Research Support, U.S. Gov't, Non-P.H.S.
- Home Care Services*
- Primary Health Care
- Problem Solving
- Quality of Life
- Veterans* / psychology
IMAGES
VIDEO
COMMENTS
Problem-Solving Therapy (PST) PST is a therapy for Veterans who are experiencing depression or suicidal thoughts. PST can help you recover from the effects of experiencing difficult situations and learn skills for coping with challenging life circumstances and chronic daily stressors. ... U.S. Department of Veterans Affairs | 810 Vermont Avenue ...
Moving Forward is designed for Veterans and Service Members with stressful problems. Apply for and manage the VA benefits and services you've earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more. ... Problem Solving Worksheet. Use this worksheet to help solve life challenges you are facing ...
U.S. Department of Veterans Affairs. Acceptance and Commitment Therapy For Depression in Veterans ... knowledge is all that goes on "in the mind" - describing, planning, problem solving, imagining, creating, predicting, talking, reading, writing, communicating, and etc. ... patients work to . Acceptance and Commitment Therapy For ...
This article describes the development and evaluation of an innovative Veterans Affairs program, Moving Forward, which focuses on building resilience and reducing emotional distress. Moving Forward is based on the principles of problem-solving therapy that have been adapted for use in a four-session, classroom-based training program for veterans.
This web tool, developed by Departments of Defense (DoD) and Veterans Affairs (VA), teaches problem-solving skills to overcome obstacles and manage life's challenges. While these modules were designed specifically for Veterans and Servicemembers, they are helpful to anyone. They offer tools to reduce stress and avoidance, increase optimism ...
This study is sponsored by the Veterans Administration Clinical Science Research and Development (CSR&D) and Health Services Research and Development (HSR&D). COLLABORATIVE SPECIALTY CARE FOR VETERANS WITH GULF WAR ILLNESS: Problem-Solving Treatment Veteran Workbook Updated 12 -14 2022 VA Central IRB Effective Date: March 20, 2023
Objectives: To summarize adaptations due to COVID-19 for VA Problem Solving Training (PST) for clinicians serving medically complex patients and to compare patient mental health outcomes in the year before (2019) and during COVID-19 (2020). Methods: Clinicians attended a multi-day workshop and up to 6 months of small-group consultation for two training cases.
There are multiple evidence-based therapy options available to you, depending on your specific mental health condition and treatment needs. ... The portal has tools to help Veterans work on problem-solving skills, manage anger, develop parenting skills, and more, in an entirely anonymous environment. ... U.S. Department of Veterans Affairs ...
Methods . Clinicians attended a multi-day workshop and up to 6 months of small-group consultation for two training cases. In 2019 and 2020, 122 Veteran patients completed baseline and posttreatment measures of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7 item), and negative problem-solving beliefs (Negative Problem Orientation Questionnaire).
It was first made publicly available in 2011, and a program evaluation found that 750 veterans accessed it in 2020. Problem-solving therapy is an evidence-based, transdiagnostic cognitive behavioral treatment that has been successfully adapted to multiple contexts, including problem-solving training for primary care patients . The intervention ...
These pilot study findings suggest that a six-to-eight session version of PST-PC may lead to improvements in mental health functioning in primary care veterans with subsyndromal depressive symptoms. Keywords: depression, problem solving therapy, veteran, mental health functioning. Go to:
Background: Veterans enrolled in Veterans Health Administration (VHA) Home Based Primary Care (HBPC), a program providing in-home medical and mental health care by an interdisciplinary care team, often face substantial physical, cognitive, and mental health challenges. This program evaluation examined the impact of a brief problem-solving intervention on depressive symptoms, quality of life ...
The purpose of HERO is to provide participant-centered, integrated behavioral health treatment to improve psychological symptoms, health behaviors, and weight management among obese Veterans with coexisting emotional distress. We examined psychological barriers to engaging in weight-management behaviors among Veterans with coexisting depression ...
Problem-solving therapy has been efficaciously used across an array of mental and physical health conditions to help people approach and effectively resolve barriers to better health. ... This project is funded by Department of Veterans Affairs Health Services Research and Development Service (ClinicalTrials.gov identifier NCT01838226). The ...
The U.S. Department of Veterans Affairs (VA)'s public health strategy combines partnerships with communities to implement tailored, local prevention plans while also focusing on evidence based clinical strategies for intervention. ... and Problem Solving Therapy) Clinically-Based Interventions Community Engagement and Partnership Coordinators ...
The contrast couldn't be more jarring when compared to the convoluted process of accessing Veteran Affairs health care. I recall, with a sense of frustration, my first visit to a VA hospital in ...