Piloting Specialized Mental Health Care for Rural Women Veterans Using STAIR Delivered via Telehealth: Implications for Reducing Health Disparities

Azevedo, Kathryn; Weiß, Bernd; Webb, Katie; Gimeno, Julia; Cloitre, Marylène

doi:10.1353/hpu.2016.0189

Cited by 15 publications

(28 citation statements)

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“…Data for this report were collected as part of an evaluation program supported by the VHA Office of Rural Health (ORH; for details, see Azevedo, Weiss, Webb, Gimeno, & Cloitre, ). All procedures involved in the evaluation were reviewed and exempted by the local academic institutional review board (Stanford University, Stanford, CA).…”

Section: Methodsmentioning

confidence: 99%

Telemental Health Delivery of Skills Training in Affective and Interpersonal Regulation (STAIR) for Rural Women Veterans Who Have Experienced Military Sexual Trauma

Weiß

Azevedo

Webb

et al. 2018

Journal of Traumatic Stress

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This pilot study assessed the feasibility, acceptability, and initial efficacy of a skills-focused treatment delivered via video teleconferencing (VTC) to women veterans living in rural areas who had experienced military sexual trauma (MST). The Skills Training in Affective and Interpersonal Regulation (STAIR) program focuses on teaching emotion management and interpersonal skills in 8 to 10 sessions. The STAIR program may be a good fit for individuals in rural areas for whom social isolation and low social support are particularly problematic. Clinic-to-clinic VTC was used to connect a STAIR therapist with veterans for weekly individual therapy sessions. The participants (n = 10) reported high satisfaction with the intervention and would recommend the program to others. There were significant pretreatment to posttreatment improvements in social functioning, Hedge's g = 1.41, as well as in posttraumatic stress disorder symptoms, Hedge's g = 2.35; depression, Hedge's g = 1.81; and emotion regulation, Hedge's g = 2.32. This is the first report of the successful application of a skills-focused treatment via VTC for women veterans.

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Section: Methodsmentioning

confidence: 99%

Telemental Health Delivery of Skills Training in Affective and Interpersonal Regulation (STAIR) for Rural Women Veterans Who Have Experienced Military Sexual Trauma

Weiß

Azevedo

Webb

et al. 2018

Journal of Traumatic Stress

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“…All studies included in this review were published in 2005 or later and investigated OVT in the US VA. The majority of studies presented findings from semi-structured interviews [ 18 , 19 , 22 , 24 , 36 ], or were case study reports [ 23 , 25 , 37 ]. One study [ 17 ] collected data using a survey and there was also one review [ 38 ] included.…”

Section: Resultsmentioning

confidence: 99%

“…Study quality was weak overall; this was likely as a consequence of studies using only post-implementation data collection methods. One study [ 18 ] received a strong rating, three studies [ 19 , 22 , 24 ] received moderate quality assessment scores while the remaining five studies received weak scores [ 17 , 23 , 25 , 36 , 37 ]. One study [ 38 ] was a general review of the literature and was unable to be assessed.…”

Section: Resultsmentioning

confidence: 99%

“…Adler and colleagues [ 17 ] reported that all six sites involved in a pilot study of OVT suffered delays to implementation due to administrative barriers. Logistic support was also found to be a common facilitator of OVT implementation [ 19 , 23 , 36 , 37 ]. Studies reported that employing staff with roles dedicated to the OVT modality (e.g., telehealth coordinators and technicians) helped facilitate implementation.…”

Section: Resultsmentioning

confidence: 99%

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Barriers and facilitators of videoconferencing psychotherapy implementation in veteran mental health care environments: a systematic review

Muir

Boer

Nedeljkovic

et al. 2020

BMC Health Serv Res

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Background Whilst treatment for mental health issues has traditionally been conducted in-person, advances in technology has seen a recent growth in the use of online video therapy services to help overcome access-to-care barriers faced by those living in rural locations and those unable to travel. These barriers are particularly apparent in the case of veteran populations, which is the focus of this review. Whilst the research investigating the efficacy of online video therapy to treat mental health issues among veterans is promising, widespread adoption and utilisation of this modality remains low with efforts often failing to progress past the pilot phase to implementation. This review focuses on the implementation of online video therapy in veteran mental health care settings and aims to identify the potential barriers and facilitators relevant to implementing the modality in military organisations. Methods A systematic search of three databases (PsycInfo, PubMed, and Web of Science) was conducted. To be eligible for inclusion, studies had to investigate the challenges, lessons learnt, or factors operating as barriers and/or facilitators to the implementation of online video therapy in veteran health care systems. Results The initial search revealed a total of 202 articles. This was reduced to 133 when duplicates were removed. After screening the titles and abstracts a further 70 articles were excluded leaving 63 to be retrieved for full review. A total of 10 studies were included in this review. The most commonly reported barriers were related to clinician concerns, logistical problems, and technology. Other barriers included access to resources as well as challenges posed by collaborations, policy and recruitment. Facilitators included experience using the modality and having dedicated staff responsible for promoting and managing the new service (e.g., on-site champions and telehealth technicians). Conclusions This review suggests that numerous barriers must be identified and addressed before attempting to implement an online video therapy service in veteran organisations. Further research is needed to establish best practice for implementation, particularly across geographically dispersed sites. It is hoped that the findings of this review will be used to help inform future implementation efforts and research initiatives in this space.

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“…Missing sessions would have significantly affected Sheena’s progress. I recommended a course of treatment in Skills in Affective and Interpersonal Regulation‐Narrative Therapy (STAIR‐NT; Cloitre, Cohen, & Koenen, ; Cloitre et al, ), an empirically validated treatment for childhood survivors of sexual abuse that has been used in military settings for skill‐building (Azevedo, Weiss, Webb, Gimeno, & Cloitre, ). It focuses on emotion awareness, emotion regulation, and changing maladaptive interpersonal patterns.…”

Section: Case Illustration 1: Sheena Escapes Her “Invisible Cage”mentioning

confidence: 99%

A portal to healing: Treating military families and veterans through telehealth

et al. 2018

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Piloting Specialized Mental Health Care for Rural Women Veterans Using STAIR Delivered via Telehealth: Implications for Reducing Health Disparities

Cited by 15 publications

References 0 publications

Telemental Health Delivery of Skills Training in Affective and Interpersonal Regulation (STAIR) for Rural Women Veterans Who Have Experienced Military Sexual Trauma

Telemental Health Delivery of Skills Training in Affective and Interpersonal Regulation (STAIR) for Rural Women Veterans Who Have Experienced Military Sexual Trauma

Barriers and facilitators of videoconferencing psychotherapy implementation in veteran mental health care environments: a systematic review

A portal to healing: Treating military families and veterans through telehealth

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