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Brief Anxiety Skills Training Intervention for Veterans in Primary Care

CompletedNA

Sponsor: VA Office of Research and Development

Conditions: Anxiety

Interventions: Veterans Anxiety Skills Training Intervention, PCMHI Usual Care

Countries: United States

Anxiety symptoms are common among primary care patients, but anxiety is undertreated. Brief behavioral (non-medication) anxiety treatments are needed. The purpose of this study is to evaluate whether a brief anxiety treatment designed for VA primary care is more effective at reducing anxiety symptoms and impairment in Veterans compared to usual care. The brief anxiety treatment, Veterans Anxiety Skills Training (VAST), was designed to be evidence-based (emphasis on cognitive-behavioral skills), transdiagnostic (applicable to a wide range of anxiety symptoms), feasible for integrated primary care (no more than 6 brief \[30-minute\] sessions), and Veteran-centered (tailored to Veterans and personalized to individual patients). A total of 170 adult Veteran primary care patients from the Syracuse and Western New York VA healthcare systems who are experiencing anxiety symptoms will be recruited and randomly assigned to receive the brief anxiety treatment or usual care. The investigators will compare anxiety symptom severity and functional impairment between the two groups at baseline and at post-assessment (at 16 weeks) and follow-up assessment (at 28 weeks). The investigators will also examine predictors of treatment response among those receiving VAST and whether providers deliver VAST as intended.

Eligibility overview

Sex: ALL

Age: 18 Years to —

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria

Patient Inclusion Criteria:

* Veteran,
* Age \>=18 years,
* Seen in the Syracuse or Western New York VAMC or CBOC primary care clinic in the past 12 months,
* Screen positive for current (past 2 weeks) clinically significant anxiety symptoms (\>= 8 on GAD7)

Provider Inclusion Criteria:

* Current behavioral health provider working in Primary Care-Mental Health Integration (PCMHI) at the VA Syracuse or VA Western New York healthcare system, including full-time, part-time, and trainee status

Patient Exclusion Criteria:

* Inability to communicate in English (as assessed by study staff);
* Hearing impairment that precludes completion of telephone eligibility screening (as assessed by study staff);
* Cognitive impairment that precludes informed consent, defined as any of the following:

  * not able to comprehend the study description or eligibility screening as assessed by study staff,
  * diagnosis of dementia or severe cognitive impairment per self-report, primary care provider, or Problem List, or
  * screen positive for cognitive impairment (\>= 3 errors on screener);
* Diagnosis of Obsessive-Compulsive Disorder (OCD) or serious mental illness (SMI, i.e., psychotic disorders, bipolar disorder) in Problem List;
* Encounter diagnosis of Posttraumatic Stress Disorder (PTSD) within the past 2 years or screen positive for PTSD (\>= 4 for men or \>= 5 for women on the Primary Care PTSD Screen for DSM-5;
* Currently in psychotherapy/counseling for anxiety and/or depression, defined as any of the following within the past 30 days:

  * attending \>= 1 non-intake specialty mental health session,
  * attending \>= 2 PCMHI sessions, or
  * being hospitalized for mental health treatment;
* Current (past 2 weeks) severe depressive symptoms (\>= 20 on PHQ9);
* At imminent risk of suicide, defined as being in need of intensive treatment (e.g., hospitalization) to ensure safety, based on study staff's suicide risk assessment (verified by the PI);
* Started or had dosage change in psychotropic medication for anxiety or depression in the past 30 days

Provider Exclusion Criteria:

* None

Locations (2)

Buffalo, New York, United States
Syracuse, New York, United States