Improving Money Management Skills for Veterans With Psychiatric Disabilities
Condition: Psychiatric Problem
Study type: Interventional

Summary: 
      Veterans with psychiatric disabilities face unique challenges concerning money management.
      Financial strain, money mismanagement, and homelessness have been well documented among
      veterans with psychiatric disabilities and linked to poor outcomes. The investigators'
      long-term goal is to promote recovery among veterans with psychiatric disabilities by
      addressing an 'unmet need' of developing basic money skills necessary for independent
      functioning in living, working, and social environments. The investigators' objective in the
      current application is to rigorously evaluate a pilot-tested, stakeholder-informed
      intervention grounded in principles of psychiatric rehabilitation designed to help develop
      money management skills and informed financial judgment among veterans with psychiatric
      disabilities. $teps for Achieving Financial Empowerment ($AFE) is an individualized,
      psycho-educational intervention that aims to teach veterans with psychiatric disabilities how
      to save money, create a viable budget, avoid money scams and financial exploitation, and
      access vocational and mental health resources. To evaluate the $AFE, the investigators will
      randomly assign N=200 veterans with psychiatric disabilities to either (a) the $AFE
      intervention (n=100); or (b) a "usual care" control (n=100). The investigators will interview
      veterans with psychiatric disabilities at baseline and six months. The investigators' central
      hypothesis, based on strong preliminary data, is that by fostering financial skills and
      judgment, the $AFE will concurrently increase employment, boost work motivation, and reduce
      disablement. If these outcomes are met, the investigators hypothesize the intervention will
      also lead to reduced psychiatric symptoms and homelessness among veterans with psychiatric
      disabilities.
    

Detailed description: 
      Veterans with psychiatric disabilities face unique challenges concerning money management.
      Not only do they encounter problems as do non-veterans with psychiatric disabilities; for
      example, they may possess limited financial experience due to longstanding dependence on
      family or have limited money skills related to cognitive deficits. But since veterans can
      receive disability benefits from both the Veteran's Administration (VA) and the Social
      Security Administration (SSA), the added income paradoxically exposes veterans to greater
      risk of severe debt and financial exploitation. To compound this problem, VA and SSA policies
      for working while disabled differ, often change, and thus can be misunderstood in ways that
      potentially reduce incentives to seek employment.

      Financial strain, money mismanagement, and homelessness have been well documented among
      veterans with psychiatric disabilities and linked to poor outcomes. Hundreds of thousands of
      veterans have psychiatric disabilities - a number likely to grow as a substantial proportion
      of troops return from Iraq and Afghanistan. Yet little systematic research has examined how
      to help veterans with psychiatric disabilities learn tangible skills needed to maintain
      financial stability in the community. Our long-term goal is to promote recovery among
      veterans with psychiatric disabilities by addressing an 'unmet need' of developing basic
      money skills necessary for independent functioning in living, working, and social
      environments.

      Our objective in the current application is to rigorously evaluate a pilot-tested,
      stakeholder-informed intervention grounded in principles of psychiatric rehabilitation
      designed to help develop money management skills and informed financial judgment among
      veterans with psychiatric disabilities. $teps for Achieving Financial Empowerment ($AFE) is
      an individualized, psycho-educational intervention that aims to teach veterans with
      psychiatric disabilities how to save money, create a viable budget, avoid money scams and
      financial exploitation, and access vocational and mental health resources.

      To evaluate the $AFE, the investigators will randomly assign N=200 veterans with psychiatric
      disabilities to either (a) the $AFE intervention (n=100); or (b) a "usual care" control
      (n=100). The investigators will interview veterans with psychiatric disabilities at baseline
      and six months. Our central hypothesis, based on strong preliminary data, is that by
      fostering financial skills and judgment, the $AFE will concurrently increase employment,
      boost work motivation, and reduce disablement. If these outcomes are met, the investigators
      hypothesize the intervention will also lead to reduced psychiatric symptoms and homelessness
      among veterans with psychiatric disabilities.

      The investigators are well prepared to pursue this study because of our peer-reviewed
      research in this area and success in completing large-scale empirical studies of veterans and
      non-veterans with psychiatric disabilities. The current research is innovative because it
      will lead to a brief, targeted, cost-effective, feasible procedure for helping veterans
      potentially become less reliant on disability funds and more likely to work, gaining
      independence in the community.

      At the end of this project, the investigators expect to show that a systematic,
      evidence-based approach can greatly bolster self-determination and empowerment for veterans
      with psychiatric disabilities. The investigators plan to construct a user-friendly,
      transportable manual so clinicians can readily implement the $AFE intervention. The
      investigators anticipate the primary impact of this study will be evaluation of a novel and
      effective method to promote independent living and employment and maximize full society
      integration among veterans with psychiatric disabilities.
    

Intervention name(s): $AFE
Intervention type(s): Behavioral
Intervention description(s): $teps for Achieving Financial Empowerment ($AFE) is an individualized, psycho-educational intervention that aims to teach veterans with psychiatric disabilities how to save money, create a viable budget, avoid money scams and financial exploitation, and access vocational and mental health resources.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research