Bringing veteran mental health promotion and suicide prevention efforts upstream: The THRiVE study protocol

Transition from military to civilian life presents both opportunities and challenges. Although existing programs provide newly separated veterans (NSVs) with career transition support, these programs do not fully address psychosocial aspects of reintegrating into civilian life. This is problematic because the military transition is a time during which NSVs are at higher risk for mental health disorders and suicide. Behavioral Activation (BA), an evidence-based psychotherapy that holds potential for optimizing psychosocial well-being during the military transition, could be adapted into an upstream mental health promotion and suicide prevention program to fill this gap. This study involves a one-arm trial to pilot test a BA-based program, called Transition Health and Resilience through Valued Experiences (THRiVE), for NSVs.

Up to 40 NSVs will receive THRiVE delivered virtually to small groups by a veteran peer facilitator. Self-report assessments will be administered at baseline, immediately post-THRiVE, and 3 months after THRiVE. Primary outcomes assess program feasibility and acceptability. Secondary outcomes explore preliminary effects on mental health symptoms, risk factors for suicidal ideation, and psychosocial functioning. Consistent with community-based participatory research models, the investigative team is partnering with a veteran Advisor and a Community Advisory Board composed of veterans and veteran spouses.

If successful, this trial would point toward potential means for optimizing mental health outcomes during the military transition. Positive findings would lay groundwork for testing the efficacy of THRiVE in larger and diverse samples. This study is registered in ClinicalTrials.gov (NCT06778278).