Protocol for remote Tai Chi and wellness for PTSD and pain in veterans

Background: Posttraumatic stress disorder (PTSD) is a debilitating psychological disorder that is associated with a host of psychosocial and health ailments, including chronic pain. Although evidence-based psychological therapies are recommended as first-line PTSD treatments, a large proportion of individuals either drop out and/or do not achieve a therapeutic response. PTSD is increasingly recognized as a systemic disorder that impacts both physical and mental health, and mind-body approaches, such as Tai Chi, have shown promise. However, to date there have been no randomized clinical trials examining Tai Chi as a treatment for PTSD.Objective: To conduct a fully remote two-phased study designed to adapt, refine, and standardize two group treatments, Tai Chi and a Wellness comparison, for Veterans diagnosed with PTSD and chronic pain.Method: We deploy the project in two phases. In Phase One, we adapt both interventions for delivery via a videoconferencing platform. We then pilot the interventions in a 'dry run' with non-random assignment of 12 participants to Tai Chi or a Wellness comparison group. In Phase Two, we randomize 36 participants to one of the two group interventions. The feasibility and acceptability of the two remotely delivered interventions and assessment protocols are evaluated.Conclusions: This is the first study to our knowledge to evaluate the feasibility, acceptability, adherence, and participant burden of the Tai Chi and Wellness comparison interventions for PTSD and chronic pain in Veterans. This information will facilitate the development of a future large, randomized control trial to evaluate the efficacy of Tai Chi to address PTSD and chronic pain in Veterans.