This R34 aims to develop and test an integrated brief intervention to reduce heavy alcohol use and PTSD severity in veterans receiving Veterans Affairs Primary Care. Standard brief alcohol interventions have been unsuccessful in reducing heavy drinking in traumatized individuals and current integrated treatment for alcohol use disorder and PTSD are too long to be delivered in Primary Care. Therefore, this application addresses this gap by developing an intervention tailored to the specific needs of heavy drinking veterans who have co- occurring PTSD.
We aim to incorporate two evidenced-based interventions: Brief Motivational Interviewing (BMI) with Prolonged Exposure for Primary Care (PE-PC). This project will apply Delphi methodology to adapt and develop an intervention protocol. Subject matter expert (SME) feedback will guide the refinement of a preliminary treatment manual that will be used in this study. The newly developed brief intervention will first be tested in an open trial to gather veteran participant feedback and develop clinician training and fidelity procedures. This will be followed by a randomized controlled trial (N=60) comparing the integrated intervention to Primary Care Treatment as Usual (PC-TAU) on percentage of heavy drinking days and PTSD severity. Results have the potential to optimize efficacy of both brief alcohol and PTSD interventions for this high risk population.
The proposed study supports a line of research that seeks to improve the health of military veterans with heavy alcohol use and post-traumatic stress disorder (PTSD) by providing brief integrated behavioral treatment in the primary care setting. The study first gathers subject matter expert and veteran feedback to develop the integrated treatment, and then investigates the feasibility of testing this intervention in a small randomized clinical trial. Results will provide support for a future, full-scale clinical trial and provide the initial ground work to improve access to efficacious brief integrated treatment for heavy drinking and PTSD in medical settings.
