Problem Solving Training for Veterans with Complex Comorbidities: Treatment Delivery Adaptations during COVID-19

Area of Science:

• Clinical Psychology
• Mental Health Interventions
• Healthcare Adaptations

Background:

• The COVID-19 pandemic necessitated rapid adaptations in healthcare delivery.
• Problem Solving Training (PST) is a key intervention for medically complex patients.
• Understanding the impact of pandemic-related adaptations on PST is crucial.

Purpose of the Study:

• To document adaptations made to VA Problem Solving Training (PST) during the COVID-19 pandemic.
• To compare mental health outcomes for Veterans before (2019) and during (2020) the pandemic.
• To assess the effectiveness of adapted PST for medically complex Veterans.

Main Methods:

• Clinicians participated in PST workshops and consultations.
• 122 Veterans completed pre- and post-treatment measures for depression, anxiety, and problem-solving beliefs.
• Qualitative data explored clinician challenges in pandemic-era treatment delivery.

Main Results:

• Adaptations addressed challenges in remote delivery (phone, video), recruitment, and privacy.
• Veterans in both 2019 and 2020 cohorts showed significant improvements in depression, anxiety, and problem-solving.
• No significant differences in outcome improvement were observed between the pre-pandemic and pandemic cohorts.

Conclusions:

• Pandemic-induced flexibilities in PST delivery overcame implementation barriers.
• Treatment adaptations did not diminish the intervention's effectiveness.
• Findings support the continued use of flexible PST delivery models post-pandemic.