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Promoting mental health treatment initiation of veterans with PTSD using internet-based family training and telephone

Eric Kuhn¹, Steven Sayers², Lindsey Zimmerman³

¹Dissemination 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.

Contemporary Clinical Trials

|May 4, 2025

Abstract

Background:

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.

Methods:

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).

Conclusion:

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.

Clinical Trial Registration Number:

ClinicalTrials.govNCT04501328.

Keywords:

Caregiver burden Mental health services Posttraumatic stress disorder Quality of life Telephone coaching Veterans Web-based interventions

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