ACT Workshops: A Novel Delivery Modality to Increase Access to Care for Rural Veterans

Study Overview
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Brief Summary
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This study investigates access, effectiveness, and acceptability of 1-day ACT workshops on problematic mental health symptoms.

Detailed Description
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This study proposes to investigate access, effectiveness, and acceptability of 1-day ACT workshops delivered in 2 rural VA primary clinics with 32 Veterans with problematic mental health symptoms (i.e., depression, PTSD, or anxiety) that are risk factors for suicide.

Official Title
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ACT Workshops: A Novel Delivery Modality to Increase Access to Care for Rural Veterans

Conditions
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Access to Care, Psychological Distress

Intervention / Treatment
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* Behavioral: Acceptance and Commitment Therapy (ACT) Workshop
* Behavioral: Treatment as usual (TAU)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1) current mental health symptoms as measured by one of the following indicators: PHQ-9 ≥ 10, PCL-5 ≥ 30, or GAD-7 ≥ 10. Exclusion Criteria: cognitive impairment measured by BOMC, current psychosis or mania as evidenced in the medical record, current suicidal intent as measured by the P4, use of mental health services within or outside of VA in the last 6 months as measured by CPRS and the non-VA services questionnaire.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: two intervention randomized clinical trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: VA primary care patients<br>VA primary care patients with psychological distress are being enrolled | Behavioral: Acceptance and Commitment Therapy (ACT) Workshop<br>* ACT workshops are single-day workshops that last 5-6 hours. The workshops will 1) Acceptance and Mindfulness Training emphasizing new ways of managing troubling thoughts, feelings, and physical sensations (e.g., learning how to recognize, and develop cognitive distance from unhelpful thoughts) and strategies to willingly face experiences that cannot be changed; and 2) Committed Action Training to help Veterans clarify what matters most to them (e.g., valued domains including family, friends, spirituality, career) and what they want to stand for in life, how they want to behave, and what strengths and qualities they want to develop. Within this context, the workshop will encourage engagement in, rather than avoidance of, actions consistent with valued directions, including engagement in healthcare. Workshop participants will be given homework related to implementing a key coping skill.<br>Behavioral: Treatment as usual (TAU)<br>* TAU will consist of a consult to a mental health provider at their rural clinic. The patient will then be scheduled for an intake and offered traditional mental health treatment options. Treatment options are likely to include outpatient individual psychotherapy, psychotherapy groups, or medication management.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Access to mental health care | Access to care is measured by hours of active treatment Veterans receive within and outside of VA. | 1 month | 
| Psychological Distress | Psychological distress as measured by the Depression, Anxiety, and Stress Scale (DASS-21). Score range on 0-42. Higher scores indicate greater psychological distress. | 1 month |