Enhanced Problem-Solving Training
(E-PST Trial)

Recruiting in Palo Alto (17 mi)

Overseen byPaul R. King, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: VA Office of Research and Development

No Placebo Group

Trial Summary

What is the purpose of this trial?

Mild traumatic brain injury (mTBI) is among the most common injuries sustained by Veterans of Operations Enduring and Iraqi Freedom. It is also highly co-morbid with mental health conditions, such as post-traumatic stress disorder and depression. While mTBI alone is not typically thought to cause lasting deficits in personal functioning or cognitive abilities, Veterans with a history of mTBI nonetheless report chronic psychological distress, as well as subjective difficulties with attention, concentration, poor frustration tolerance, and decision-making. Although current clinical practice guidelines for mTBI emphasize primary care-based symptom management, there are presently no evidence-based interventions to treat mental health symptoms in this setting. This research proposal therefore seeks to adapt and pilot test a brief, primary care-based intervention (E-PST) to reduce psychological distress in Veterans with mTBI by augmenting problem-solving skills, and helping them to develop specific cognitive and behavioral skills to improve upon their self-reported cognitive inefficiencies. The investigators hypothesize that Veterans who complete E-PST will report improvements in psychological distress compared to participants in the control condition.

Research Team

Paul R. King, PhD

Principal Investigator

VA Western New York Healthcare System, Buffalo, NY

Eligibility Criteria

Inclusion Criteria

Brief Symptom Inventory-18 (BSI-18) T-score > 53

enrolled in VA primary care (appointment within last 12 months)

English speaking, able to read and write, and able to comprehend study materials

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Exclusion Criteria

You are experiencing thoughts of harming yourself right now.

You have a severe mental illness such as schizophrenia, bipolar disorder, or severe depression with psychotic features.

inpatient psychiatric hospitalization within the past 12 months

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Treatment Details

Interventions

Enhanced Problem-Solving Training (Behavioural Intervention)
Enhanced Problem-Solving Training (E-PST) (Behavioural Intervention)
Healthy Living Messages (Behavioural Intervention)

Participant Groups

3Treatment groups

Experimental Treatment

Active Control

Group I: E-PST (randomized)Experimental Treatment1 Intervention

Enhanced Problem-Solving Training (E-PST) arm. E-PST is a combined treatment that is comprised of brief problem-solving training and compensatory cognitive skills training. Randomized participants were assigned 1:1 to E-PST or HLM.

Group II: E-PST (non-randomized)Experimental Treatment1 Intervention

Enhanced Problem-Solving Training (E-PST) arm. E-PST is a combined treatment that is comprised of brief problem-solving training and compensatory cognitive skills training. Non-randomized participants were assigned to E-PST only.

Group III: Control (randomized)Active Control1 Intervention

Healthy Living Messages (Control) arm. Healthy Living Messages (HLM) are primary care-congruent messages that consist of simple advice regarding general health behaviors and preventive care. Randomized participants were assigned 1:1 to E-PST or HLM.