Expanding Reach of Evidence-based Psychotherapy for Veterans With Co-occurring Anxiety and Substance Use Disorders.

Study Overview
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Brief Summary
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The current study seeks to better understand how to improve access to evidence-based psychotherapy (EBP) for rural Veterans with co-occurring anxiety and substance use disorders (SUD) using a web-based cognitive behavioral therapy tool (VA Coordinated Anxiety Learning and Management, Substance Use Version; VA CALM-S).

Official Title
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Expanding Reach of Evidence-based Psychotherapy for Rural Veterans With Co-occurring Anxiety and Substance Use Disorders.

Conditions
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Anxiety Disorders, Substance Use Disorders

Intervention / Treatment
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* Behavioral: VA Coordinated Anxiety Learning and Management- Substance Use Version
* Behavioral: Usual care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: current anxiety disorder diagnosis current SUD Exclusion Criteria: current substance withdrawal such that medically supervised detoxification is necessary (determined by evaluation of substance use history and report of current symptoms), acute suicidality current delusions/hallucinations.

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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: VA CALM-S<br>Active psychotherapy using VA CALM-S, a weekly (9-12 sessions) cognitive behavioral therapy addressing co-occurring anxiety and substance use disorders, using disorder specific and transdiagnostic tools. | Behavioral: VA Coordinated Anxiety Learning and Management- Substance Use Version<br>* VA Coordinated Anxiety Learning and Management- Substance Use Version (VA CALM-S) is a cognitive behavior therapy (CBT) program that employs computer assistance to empower providers to deliver CBT with high fidelity. The computer program guides both providers and patients in a course of CBT, and in this study the content will focus on using transdiagnostic treatment elements to address co-occurring anxiety and substance use disorders.<br>|
| Active Comparator: Usual Care<br>Participants in usual care will engage with VA healthcare using standard procedures of their facility. | Behavioral: Usual care<br>* Veterans will engage in VA care using the standard procedures of their facility.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Generalized Anxiety Disorder-7 | Self report measure of anxiety symptoms (score range 0-21), higher scores indicate greater anxiety (i.e., poorer outcome). | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Substance use frequency | Number of substance use days | 12 weeks |