Impact of VVV Group for Veterans With SMI

Study Overview
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Brief Summary
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Veterans with Serious Mental Illness (SMI) struggle with social integration - participation in work, housing, and citizenship - due to symptoms, stigma, and psychosocial challenges. Despite considerable VA efforts to provide mental health care to Veterans with SMI, programs that promote social integration are lacking. Veterans with SMI are at especially high risk for poor social integration and suicidal ideation during the COVID-19 pandemic. This project addresses this need with a group-based, peer specialist (PS) co-facilitated psychosocial intervention for Veterans with SMI, called Veteran Voices and Visions (VVV). VVV targets Veterans with SMI who experience psychosis, a group particularly in need of support with social integration. Virtual VVV groups are co-led by VA mental health clinicians (MHCs) and PSs via online video conference. The approach facilitates group cohesion around and normalization of the common psychotic symptoms of SMI: hallucinations, delusions, and social isolation. This intervention has the potential to create and foster a supportive community that improves the social integration of participants by reducing their distress and self-stigma, and increasing self-efficacy.

Official Title
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Impact of Veteran Voices & Visions Peer Support Groups on Social Integration for Veterans With SMI/Psychosis

Conditions
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Psychotic Disorders, Veterans

Intervention / Treatment
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* Behavioral: Support group
* Behavioral: Healthy Lifestyles


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: DSM 5 diagnoses of schizophrenia, schizoaffective disorder, bipolar with psychosis, depression with psychosis, unspecified psychosis Exclusion Criteria: Substance-induced psychosis, clinically significant neurological disease, history of serious head injury with loss of consciousness > 1 hour.

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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Accepts Healthy Volunteers

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: This is a randomized control trial evaluating the feasibility and acceptability of the manualized protocol the investigators develop. The investigators will compare the VVV group with a Healthy Lifestyles group.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Veteran Voices & Visions (VVV)<br>This is the experimental condition, testing the manual the investigators have developed. | Behavioral: Support group<br>* This is a group-based, peer specialist and clinician co-facilitated psychosocial intervention for Veterans with SMI, called Veteran Voices and Visions (VVV). VVV is an adaptation of a community-based support group model called the Hearing Voices (HV) approach. The approach facilitates group cohesion around and normalization of the common psychotic symptoms of SMI: hallucinations, delusions, and social isolation.<br>|
| Active Comparator: Healthy Lifestyles<br>This is the control condition, matched for location, format, degree of interaction, and duration. | Behavioral: Healthy Lifestyles<br>* This will be a group matched with the experimental condition for location, format, degree of interaction, and duration, but with a distinct content, that focuses on nutrition and lifestyle.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Psychotic Symptoms Rating Scale (PSYRATS-AHS) | PSYRATS-AHS is an 11-item scale which assesses the frequency, duration, severity, loudness, location, negative content, and controllability of voices, intensity of distress, and beliefs about origin of voices and disruptiveness. Range of score is 0-44. The investigators will be assessing for within-subject change. Any decrease in overall score is indicative of decreased distress. | Twenty weeks after the initiation of the intervention. |