Kuhn Eric, Sayers Steven, Zimmerman Lindsey, Mackintosh Margaret-Anne, Owen Jason E, Rosen Craig S, Meis Laura A, Hagedorn Hildi J, Erbes Christopher R
Dissemination and Training Division, National Center for PTSD, Palo Alto VA Medical Center, Palo Alto, CA, United States of America; Stanford University School of Medicine, Stanford, CA, United States of America.
Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States of America; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
Contemp Clin Trials. 2025 Jul;154:107929. doi: 10.1016/j.cct.2025.107929. Epub 2025 May 2.
Many veterans with posttraumatic stress disorder (PTSD) do not seek mental health care. Their significant others, including spouses and intimate partners, could be helpful in encouraging them to enter treatment. Community reinforcement and family training (CRAFT) has been shown to increase uptake in care among treatment-resistant individuals with alcohol and substance use disorders. We have adapted CRAFT for family members of veterans with PTSD and self-guided web-delivery with telephone coaching. A pilot study of this program showed promising results.
This paper describes a randomized controlled trial of the Veterans Affairs-CRAFT (VA-CRAFT) web program coupled with four telephone coaching calls from VA's Coaching Into Care (CIC) program compared to CIC as usual. Assessments will occur at baseline, posttreatment (3-mos.), and follow-up (6-mos.). Spouses and intimate partners of veterans with perceived, untreated PTSD (N = 230) will be randomized (1:1) to study conditions. We hypothesize that compared to CIC as usual, CIC + VA-CRAFT will result in more veterans initiating mental health care (Aim 1) without compromising CIC's existing high client satisfaction (Aim 2). We also will explore if participants show improved benefits in wellbeing in CIC + VA-CRAFT relative to CIC as usual (Exploratory Aim 1). Lastly, we will explore potential mediators and moderators of intervention effects (Exploratory Aim 2).
We expect results of this innovative trial will provide efficacy evidence for VA-CRAFT plus telephone coaching. If successful, findings can help support implementation efforts of VA-CRAFT into family services for veterans with PTSD who are reluctant to seek care.
ClinicalTrials.govNCT04501328.
许多患有创伤后应激障碍（PTSD）的退伍军人不寻求心理健康护理。他们的重要他人，包括配偶和亲密伴侣，可能有助于鼓励他们接受治疗。社区强化和家庭训练（CRAFT）已被证明能提高对酒精和物质使用障碍的难治性个体的护理接受率。我们已将CRAFT改编用于患有PTSD的退伍军人的家庭成员，并通过电话辅导进行自我引导的网络交付。该项目的一项试点研究显示了有希望的结果。
本文描述了一项退伍军人事务部 - CRAFT（VA - CRAFT）网络项目的随机对照试验，该项目与退伍军人事务部的“辅导进入护理”（CIC）项目的四次电话辅导相结合，并与常规CIC进行比较。评估将在基线、治疗后（3个月）和随访（6个月）时进行。患有未治疗的PTSD的退伍军人的配偶和亲密伴侣（N = 230）将被随机（1:1）分配到研究条件中。我们假设，与常规CIC相比，CIC + VA - CRAFT将使更多退伍军人开始接受心理健康护理（目标1），同时不影响CIC现有的高客户满意度（目标2）。我们还将探讨与常规CIC相比，参与者在CIC + VA - CRAFT中是否在幸福感方面表现出更好的益处（探索性目标1）。最后，我们将探索干预效果的潜在中介因素和调节因素（探索性目标2）。
我们预计这项创新试验的结果将为VA - CRAFT加电话辅导提供疗效证据。如果成功，研究结果可有助于支持将VA - CRAFT纳入为不愿寻求护理的患有PTSD的退伍军人的家庭服务的实施工作。
ClinicalTrials.govNCT04501328。
