**Please be advised that I am not the author of this article, nor do I have the actual source (possibly a VA press release). It was received through a work e-mail and I felt it important enough to post here.**
WASHINGTON (August 31, 2009) – The Suicide Prevention campaign of the department of Veterans Affairs (VA) is expanding its outreach to all Veterans by piloting an online, one-to-one “chat service” for Veterans who prefer reaching out for assistance using the Internet.Called “Veterans Chat,” the new service enables Veterans, their families and friends to go online where they can anonymously chat with a trained VA counselor. If a “chatter” is determined to be in a crisis, the counselor can take immediate steps to transfer the person to the VA Suicide Prevention Hotline, where further counseling and referral services are provided and crisis intervention steps can be taken. “This online feature is intended to reach out to all Veterans who may or may not be enrolled in the VA health care system and provide them with online access to the Suicide Prevention Lifeline,” said Dr. Gerald Cross, VA’s Acting Under Secretary for Health. “It is meant to provide Veterans with an anonymous way to access VA’s suicide prevention services.”Veterans, family members or friends can access Veterans Chat through the suicide prevention Web site www.suicidepreventionlifeline.org. There is a Veterans tab on the left-hand side of the website that will take them directly to Veteran resource information. On this page, they can see the Hotline number (1-800-273-TALK), and click on the Veterans Chat tab on the right side of the Web page to enter.
Veterans retain anonymity by entering whatever names they choose once they enter the one-on-one chat. They are then joined by a counselor who is trained to provide information and respond to the requests and concerns of the caller.If the counselor decides the caller is in a crisis, the counselor will encourage the Veteran to call the Suicide Prevention Hotline, where a trained suicide prevention counselor will determine whether crisis intervention techniques are required.
The pilot program, which has been in operation since July 3, has already had positive results. In one instance, the online counselor determined that a Veteran in the chat required immediate assistance. The counselor convinced the Veteran to provide the counselor with a home telephone number and then remained in the chat room with the Veteran while the hotline staff called the number and talked to the Veteran’s mother. The hotline counselor worked with the Veteran’s mother to convince the Veteran to be admitted to a medical facility for further treatment.
“The chat line is not intended to be a crisis response line,” said Dr. Janet Kemp, VA’s National Suicide Prevention Coordinator at the VA medical center in Canandaigua, N.Y., where VA’s trained counselors staff the chat line 24 hours a day, seven days a week. VA’s suicide prevention hotline is also staffed continuously.
“Chat responders are trained in an intervention method specifically developed for the chat line to assist people with emotional distress and concerns,” Kemp said. “We have procedures they can use to transfer chatters in crisis to the hotline for more immediate assistance.”
Both Veterans Chat and the VA’s Suicide Prevention Hotline have been established under the National Suicide Prevention Lifeline, which was established through collaboration between VA and the Substance Abuse and Mental Health Services Administration (SAMHSA) of the Department of Health and Human Services.
Since becoming operational in July 2007, VA’s Suicide Prevention Hotline has received more than 150,000 calls, resulting in 4,000 rescues.
]]>The authors compared the effectiveness of the Seeking Safety group, cognitive–behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women’s Health Education [WHE]) within the National Institute on Drug Abuse’s Clinical Trials Network. The authors randomized 353 women to receive 12 sessions of Seeking Safety (M = 6.2 sessions) or WHE (M = 6.0 sessions) with follow-up assessment 1 week and 3, 6, and 12 months posttreatment. Primary outcomes were the Clinician Administered PTSD Scale (CAPS), the PTSD Symptom Scale–Self Report (PSS-SR), and a substance use inventory (self-reported abstinence and percentage of days of use over 7 days). Intention-to-treat analysis showed large, clinically significant reductions in CAPS and PSS-SR symptoms (d = 1.94 and 1.12, respectively) but no reliable difference between conditions. Substance use outcomes were not significantly different over time between the two treatments and at follow-up showed no significant change from baseline. Study results do not favor Seeking Safety over WHE as an adjunct to substance use disorder treatment for women with PTSD and reflect considerable opportunity to improve clinical outcomes in community-based treatments for these co-occurring conditions. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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]]>A recent randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In this article, the authors seek to identify the variables that were associated with response across both treatments as well as variables that predicted superior response in one treatment over the other. The sample consisted of 180 depressed outpatients: 60 of whom were randomly assigned to cognitive therapy; 120 were assigned to antidepressant medications. Treatment was provided for 16 weeks. Chronic depression, older age, and lower intelligence each predicted relatively poor response across both treatments. Three prescriptive variables—marriage, unemployment, and having experienced a greater number of recent life events—were identified, and each predicted superior response to cognitive therapy relative to antidepressant medications. Thus, 6 markers of treatment outcome were identified, each of which might be expected to carry considerable clinical utility. The 3 prognostic variables identify subgroups that might benefit from alternative treatment strategies; the 3 prescriptive variables identify groups who appear to respond particularly well to cognitive therapy. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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]]>In this article, the authors examine whether delayed substance initiation during adolescence, achieved through universal family-focused interventions conducted in middle school, can reduce problematic substance use during young adulthood. Sixth-grade students enrolled in 33 rural midwestern schools and their families were randomly assigned to 3 experimental conditions. Self-report questionnaires provided data at 7 time points for the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years (PDFY), and control groups through young adulthood. Five young adult substance frequency measures (drunkenness, alcohol-related problems, cigarettes, illicit drugs, and polysubstance use) were modeled as distal outcomes affected by the average level and rate of increase in substance initiation across the adolescent years in latent growth curve analyses. Results show that the models fit the data and that they were robust across outcomes and interventions, with more robust effects found for ISFP. The addition of direct intervention effects on young adult outcomes was not supported, suggesting long-term effects were primarily indirect. Relative reduction rates were calculated to quantify intervention-control differences on the estimated proportion of young adults indicating problematic substance use; they ranged from 19% to 31% for ISFP and from 9% to 16% for PDFY. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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]]>Spirituality is a multidimensional construct, and little is known about how its distinct dimensions jointly affect well-being. In longitudinal studies (Study 1, n = 418 breast cancer patients; Study 2, n = 165 cancer survivors), the authors examined 2 components of spiritual well-being (i.e., meaning/peace and faith) and their interaction, as well as change scores on those variables, as predictors of psychological adjustment. In Study 1, higher baseline meaning/peace, as well as an increase in meaning/peace over 6 months, predicted a decline in depressive symptoms and an increase in vitality across 12 months in breast cancer patients. Baseline faith predicted an increase in perceived cancer-related growth. Study 2 revealed that an increase in meaning/peace was related to improved mental health and lower cancer-related distress. An increase in faith was related to increased cancer-related growth. Both studies revealed significant interactions between meaning/peace and faith in predicting adjustment. Findings suggest that the ability to find meaning and peace in life is the more influential contributor to favorable adjustment during cancer survivorship, although faith appears to be uniquely related to perceived cancer-related growth. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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]]>This study was a randomized clinical trial of Project Support, an intervention designed to reduce conduct problems among children exposed to intimate partner violence. Participants were 66 families (mothers and children) with at least 1 child exhibiting clinical levels of conduct problems. Families were recruited from domestic violence shelters. The Project Support intervention involves (a) teaching mothers child management skills and (b) providing instrumental and emotional support to mothers. Families were randomly assigned to the Project Support intervention condition or to an existing services comparison condition. They were assessed on 6 occasions over 20 months, following their departure from the shelter. Children in families in the Project Support condition, compared with those in the comparison condition, exhibited greater reductions in conduct problems. Mothers in the Project Support condition, compared with those in the comparison condition, displayed greater reductions in inconsistent and harsh parenting behaviors and psychiatric symptoms. Changes in mothers’ parenting and psychiatric symptoms accounted for a sizable proportion of Project Support’s effects on child conduct problems at the end of treatment. Clinical and policy implications are discussed. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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]]>The authors examined the effectiveness of motivational interviewing (MI) on club drug use and risky sex in non-treatment-seeking men who have sex with men (MSM). MSM (N = 150) were assessed and randomly assigned to 4 sessions of MI or an educational control intervention. Follow-up occurred at quarterly intervals for 1 year. Primary outcomes were days of any club drug use and number of unsafe sex acts. On average, club drug use declined during follow-up. A significant interaction effect showed that MI was associated with less club drug use during follow-up compared with education but only among participants with lower severity of drug dependence (p < .02; small to medium effect size). MI did not result in a significant reduction in risky sex relative to education. The results support the use of MI targeting club drug use in at-risk or mildly dependent users not seeking treatment but not in more severely dependent users. MI does not appear effective in reducing risky sexual behavior in this population. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
]]>Nineteen staff and clients in a Native American healing lodge were interviewed regarding the therapeutic approach used to address the legacy of Native American historical trauma. On the basis of thematic content analysis of interviews, 4 components of healing discourse emerged. First, clients were understood by their counselors to carry pain, leading to adult dysfunction, including substance abuse. Second, counselors believed that such pain must be confessed in order to purge its deleterious influence. Third, the cathartic expression of such pain was said by counselors to inaugurate lifelong habits of introspection and self-improvement. Finally, this healing journey entailed a reclamation of indigenous heritage, identity, and spirituality that program staff thought would neutralize the pathogenic effects of colonization. Consideration of this healing discourse suggests that one important way for psychologists to bridge evidence-based and culturally sensitive treatment paradigms is to partner with indigenous programs in the exploration of locally determined therapeutic outcomes for existing culturally sensitive interventions that are maximally responsive to community needs and interests. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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]]>Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the current study was to examine the association between negative affect and drinking behavior in the 1st year following alcohol treatment. The authors applied an associative latent transition analysis to the Project MATCH outpatient data (n = 952) and then replicated the model in the Project MATCH aftercare data (n = 774). Changes in drinking following treatment were significantly associated with current and prior changes in negative affect, and changes in negative affect were related to prior changes in drinking (effect size range = 0.13–0.33). The results supported the hypothesis that negative affect and alcohol lapses are dynamically linked and suggest that targeting the relationship between negative affect and alcohol use could greatly decrease the probability of lapses and improve alcohol treatment outcomes. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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]]>This randomized clinical trial (N = 253) evaluated the efficacy of a theory-based intervention designed to reduce both alcohol use and incidence of unprotected sexual behaviors among HIV-positive men who have sex with men with alcohol use disorders. An integrated, manualized intervention, using both individual counseling and peer group education/support, was compared with a control condition in which participants received resource referrals. The intervention was based on the transtheoretical model’s stages and processes of change, and motivational interviewing was used to enhance client readiness for change. Major findings include treatment effects for reduction in number of drinks per 30-day period, number of heavy drinking days per 30-day period, and number of days on which both heavy drinking and unprotected sex occurred. Practitioners employing this intervention may achieve enhanced client outcomes in reduction of both alcohol use and risky sexual behavior. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
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