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| Name | Class |
|---|---|
| Yale University | OTHER |
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This study will address the problem that claimants with psychiatric disabilities who apply for and receive disability benefits go on to work less than those whose claims are denied.
The objective of this research is to conduct a 6-month randomized clinical trial comparing participants assigned to Benefits Counseling and to those assigned to the control condition, VA Orientation. Benefits Counseling is an adaptation of two counseling approaches to foster veterans' involvement in work and work-related activity compared to the control condition, VA Orientation. The first approach helped recipients of Social Security disability benefits for psychiatric illness return to work in part by alleviating beneficiaries' concerns that they would lose their benefits if they worked. The second approach is a Motivational Interviewing approach that showed great promise in engaging veterans with psychiatric disabilities in compensated work therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 | Experimental | This counseling consists of four sessions each approximately 60 minutes each. The four sessions are organized as follows: a) Orientation to Benefits Counseling: Your Benefits and Your Goals b) Work and Claims c) Financial Review: Implications of Your Work Plan and d) Your Plans After the Benefits Notice. The first session focuses on the disability application process as a non-confrontational way to explore attitudes towards work. The second session more directly addresses the claimant's attitudes about work and beliefs about whether work will prevent receipt of disability benefits. The third session addresses the same issue as the second, ambivalence about work and disability, from a financial perspective. The fourth session occurs after the disability determination has been made, and it is possible the veteran may feel differently about a benefit that has been awarded. |
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| Arm 2 | Active Comparator | This will consist of four-session orientation with the sessions organized as follows: a) overview of VHA services, b) Primary Care c) Pharmacy and laboratory services and d) specialty services. After the description of each service, participants will be invited to discuss which services they plan to utilize. The counselor will provide telephone numbers and directions to the sites at which these services are provided. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Benefits Counseling | Behavioral | Benefits counseling is designed to improve the quality of life of disability applicants by accomplishing two functions: 1) Providing information concerning what vocational rehabilitation services are available and how they will affect receipt of disability payments, 2) Amplifying applicants' existing motivation to engage in work and related-activities, using a Motivational Interviewing approach. |
| Measure | Description | Time Frame |
|---|---|---|
| Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Baseline |
| Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Month 1 |
| Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Month 3 |
| Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Month 6 |
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Inclusion Criteria:
Has never received VBA benefits
Able to provide valid consent
Expresses willingness to discuss benefits with a counselor
Difficulty working as evidenced by a "Yes" to either (a), (b), or (c) of the question below about work-related difficulties: During the past 4 weeks, have you had any of the following problems (such as feeling depressed and anxious):
Expresses willingness to try Benefits Counseling if assigned to it
An evaluation by a psychiatrist or psychologist is scheduled
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marc I. Rosen, MD | VA Connecticut Healthcare System West Haven Campus, West Haven, CT | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| VA Connecticut Healthcare System West Haven Campus, West Haven, CT | West Haven | Connecticut | 06516 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24090622 | Result | Meshberg-Cohen S, Reid-Quinones K, Black AC, Rosen MI. Veterans' attitudes toward work and disability compensation: associations with substance abuse. Addict Behav. 2014 Feb;39(2):445-8. doi: 10.1016/j.addbeh.2013.09.005. Epub 2013 Sep 11. | |
| 25082304 | Result | Rosen MI, Ablondi K, Black AC, Mueller L, Serowik KL, Martino S, Mobo BH, Rosenheck RA. Work outcomes after benefits counseling among veterans applying for service connection for a psychiatric condition. Psychiatr Serv. 2014 Dec 1;65(12):1426-32. doi: 10.1176/appi.ps.201300478. Epub 2014 Oct 31. |
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Participants were recruited from December 2008 to December 2011. Veterans were eligible for participation if they were seeking service-connection for a psychiatric disability and they indicated that emotional problems had interfered with work in the past 28 days.
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| ID | Title | Description |
|---|---|---|
| FG000 | Benefits Counseling | Four 50-minutes sessions of individual counseling using motivational interviewing to increase veterans' desire to engage in work and related activities |
| FG001 | VA Orientation | Four sessions of VA orientation that taught veterans about the VA health care system generally and about the specific general medical and mental health services available to veterans |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Intervention |
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| Follow-up |
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| ID | Title | Description |
|---|---|---|
| BG000 | Benefits Counseling | Four 50-minutes sessions of individual counseling using motivational interviewing to increase veterans' desire to engage in work and related activities |
| BG001 | VA Orientation |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Posted | Mean | Standard Deviation | days | Baseline |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Benefits Counseling | Four 50-minutes sessions of individual counseling using motivational interviewing to increase veterans' desire to engage in work and related activities |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Marc Rosen | Yale University | 203-932-5711 | 2575 | marc.rosen@yale.edu |
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| ID | Term |
|---|---|
| D062405 | Motivational Interviewing |
| ID | Term |
|---|---|
| D037001 | Directive Counseling |
| D003376 | Counseling |
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
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| VA Orientation | Behavioral | VA Orientation is designed to provide the Veteran with information regarding the services available, how to access the services and where the service is located on the VA campus. |
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| Completed Month 3 Follow-up |
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| Completed Month 6 Follow-up |
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| COMPLETED |
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| NOT COMPLETED |
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Four sessions of VA orientation that taught veterans about the VA health care system generally and about the specific general medical and mental health services available to veterans
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Number | participants |
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| Psychiatric diagnosis | Number | participants |
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| Attitudes and beliefs: "If a person is receiving VA benefits and starts working for pay ..." | Veterans were asked to rate their agreement with three statements asserting a relationship between work and receipt of disability payments. Agreement was rated on a 4-point, forced-choice Likert scale anchored by strongly disagree (1), somewhat disagree (2), somewhat agree (3), and strongly agree (4). | Mean | Standard Deviation | Likert scale |
|
| Units | Counts |
|---|---|
| Participants |
|
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| Primary | Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Posted | Mean | Standard Deviation | days | Month 1 |
|
|
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| Primary | Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Posted | Mean | Standard Deviation | days | Month 3 |
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|
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| Primary | Days of Work and Work-related Activity | Number of days in the past 28 spent engaged in any kind of work or related activity. Measured using a timeline follow-back calendar. | Posted | Mean | Standard Deviation | days | Month 6 |
|
|
|
| 0 |
| 42 |
| 0 |
| 42 |
| EG001 | VA Orientation | Four sessions of VA orientation that taught veterans about the VA health care system generally and about the specific general medical and mental health services available to veterans | 0 | 42 | 0 | 42 |
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| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| Work for no pay |
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| Classes |
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| Vocational rehabilitation |
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| Work for no pay |
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| Classes |
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| Vocational rehabilitation |
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| Work for no pay |
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| Classes |
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| Vocational rehabilitation |
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