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Developing a Peer Support Protocol for Improving Veterans’ Engagement to Computer-Delivered Cognitive Behavioural Therapy

Published online by Cambridge University Press:  22 March 2017

John M. Ray ,
Lakiesha L. Kemp ,
Amanda Hubbard  and
Michael A. Cucciare
John M. Ray*
Affiliation:
Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72114, USA VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114, USA Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Lakiesha L. Kemp
Affiliation:
Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72114, USA VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114, USA Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Amanda Hubbard
Affiliation:
Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72114, USA VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114, USA Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Michael A. Cucciare
Affiliation:
Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72114, USA VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114, USA Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
*
Correspondence to John M. Ray, Postdoctoral Research Fellow, South Central Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114–1706, USA. E-mail: john.ray2@va.gov
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Abstract

Background: Computer-delivered cognitive behavioural therapy (cCBT) is an effective alternative to provider-delivered treatment for depression and anxiety, but high attrition poses a significant challenge to its use. Peer support is a feasible approach to improving cCBT engagement, but less is known about its acceptability among Veterans. Aims: To obtain feedback from Veterans (n = 24) with depression and/or anxiety on their preferences for (a) activities of Veterans Administration Peer Support Specialists (VA PSS) in helping Veterans use Moving Forward, a cCBT-based protocol developed by VA, and (b) methods for delivering support to Veterans using this programme. Method: Four focus groups (5–7 Veterans per group) provided feedback to be used in the development of a peer-supported engagement intervention to help Veterans with depression and anxiety use Moving Forward. Content areas included roles that a VA PSS might play in supporting the use of and engagement in Moving Forward, as well as methods of delivering that support. Results: Veteran preferences for PSS activity focused on practical aspects of using Moving Forward, including orientation to the programme, technical support, and monitoring progress. Feedback also suggested that Veterans preferred more personal roles for the PSS, including emotional support, as well as application of Moving Forward to ‘real life’ problems. Conclusions: The findings extend the literature on online, patient-facing mental health protocols by identifying emotional support and ‘real life’ skills application as Veteran-preferred components of a peer-support protocol designed to enhance use of and engagement in cCBT for depression and anxiety.

Keywords

computer-based cognitive behavioural therapymental healthpeer supporttreatment engagement
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 3 , May 2017 , pp. 253 - 265
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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