Journal
GENERAL HOSPITAL PSYCHIATRY
Volume 34, Issue 5, Pages 450-459Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.genhosppsych.2012.04.007
Keywords
War veterans; Treatment engagement; Trial; Posttraumatic stress disorder; Motivational interviewing
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Funding
- Department of Veterans Affairs (VA), Clinical Sciences Research and Development [MN078889-01]
- VA Health Services Research and Development (HSR&D) Research Enhancement Award Program at the San Francisco VA Medical Center
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Objective: To test the efficacy of telephone-administered motivational interviewing (MI) to enhance treatment engagement in Iraq and Afghanistan veterans with mental health (MH) problems. Method: Between April 23, 2008, and February 25, 2011, 73 Iraq and Afghanistan veterans who screened positive for >= 1 MH problem(s) on telephone-administered psychometric assessment, but were not engaged in treatment, were randomized to either personalized referral for MH services and four sessions of telephone MI or standard referral and four neutral telephone check-in sessions (control) at baseline, 2, 4 and 8 weeks. Blinded assessment occurred at 8 and 16 Results: In intent-to-treat analyses, 62% assigned to telephone MI engaged in MH treatment compared to 26% of controls [relative risk (RR)=2.41, 95% confidence interval (CI)=1.33-4.37, P=.004], which represented a large effect size (Cohen's h=0.74). Participants in the MI group also demonstrated significantly greater retention in MH treatment than controls [MI mean visits (S.D.)=1.68 (2.73) and control mean visits (S.D.)=0.38 (0.81), incidence rate ratio (IRR)=4.36, 95% CI=1.96-9.68, P<.001], as well as significant reductions in stigma and marijuana use at 8 weeks (P<.05). Conclusions: Telephone MI enhances MH treatment engagement in Iraq and Afghanistan veterans with MH problems. Published by Elsevier Inc.
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