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Feasibility of a Skills-Based Group Reintegration Workshop for OEF/OIF Veterans: STEP-Home
Catherine Brawn Fortier1, Alexandra Kenna, Kristen Dams-OʼConnor
1Translational Research Center for TBI and Stress Disorders (Drs Fortier, Kenna, Fonda, Milberg, and McGlinchey and Mss Levin, Hursh, and Franz) and Geriatric Research, Education, and Clinical Center (Drs Fortier, Milberg, and McGlinchey), VA Boston Healthcare System, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (Drs Fortier, Milberg, and McGlinchey); and Brain Injury Research Center, Mount Sinai Injury Control Research Center, and Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York (Dr Dams-O'Connor).
Objective:
To evaluate the feasibility of a newly developed reintegration workshop for Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) Veterans that is based on an evidence-based rehabilitation program shown to be effective in treating mild traumatic brain injury-related symptoms in civilians. Underutilization and resistance to mental health treatment remain a significant problem for OEF/OIF Veterans. Innovative, integrative, transdiagnostic, and acceptable interventions are needed, particularly for this heterogeneous group.
Participants:
Eighty-four OEF/OIF/Operation New Dawn Veterans (74 male and 10 female)-mean age = 35; standard deviation = 7.4.
Setting:
VA Healthcare System.
Intervention:
A 12-week, 2-hour/wk, group skills-based workshop with individual skill building to assist all OEF/OIF Veterans (with and without psychiatric and/or traumatic brain injury) in reintegration after military service.
Main Measures:
Primary outcomes were feasibility measures including treatment fidelity, acceptability, tolerability/adherence, and treatment-related skill acquisition. Secondary outcomes were interest and engagement in future treatment and reintegration status.
Results:
Veterans' enrollment, adherence, and attrition data indicated that Short-Term Executive Plus adapted for Veteran civilian reintegration (STEP-Home) was acceptable and tolerable. Pre-/postintervention differences in attention, problem-solving, and emotional regulation skills demonstrated treatment-related skills acquisition. Secondary outcome data demonstrated Veterans who were hesitant to participate in mental health treatments before enrollment were more open to treatment engagement after STEP-Home, and reintegration status improved.
Conclusions:
This study demonstrated that the STEP-Home workshop is feasible in OEF/OIF Veterans and changes in treatment-related skill acquisition and reintegration status were observed. STEP-Home has potential to facilitate readjustment and serves as a gateway to additional, critically needed Veterans Administration services.
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