MI-CBTech: A Mobile Intervention for Community Integration in Homeless-Experienced Veterans With SMI
Improving Community Integration in Homeless Veterans With Serious Mental Illness: A Pilot Study of MI-CBT Enhanced With Mobile Technology
VA Office of Research and Development
50 participants
Apr 1, 2024
INTERVENTIONAL
Conditions
Summary
This study aims to test the feasibility and acceptability of a brief behavioral intervention that combines two treatments, Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT), that have been shown to work in prior research studies. The format of the intervention will be a combination of in-person sessions and remote elements delivered via mobile phone (together called MI-CBTech). The goal of the intervention is to improve community integration in Veterans with serious mental illness (SMI) who have experienced homelessness. A time- and format-matched control arm will include remote mindfulness training. 50 Veterans with SMI experiencing homelessness will be randomized to one of the two arms (25 per arm).
Eligibility
Inclusion Criteria6
- Veterans currently residing at the VA Greater Los Angeles Mental Health Residential Rehabilitation Treatment Program (Domiciliary)
- age 18-65 years
- diagnosis of non-affective or affective psychotic illness as confirmed by chart review
- history of homelessness
- sufficiently fluent in English to consent, understand procedures, and complete assessments and intervention
- medically and clinically stable (i.e. able to participate in and complete assessments and intervention).
Exclusion Criteria4
- history of clinically significant neurological disorder determined by medical history (e.g., epilepsy)
- history of serious head injury (i.e., loss of consciousness \> 1 hr, neuropsychological sequelae, cognitive rehabilitation post head injury)
- evidence of IQ \< 70 or developmental disability
- moderate or severe substance use disorder in the past month based on chart review
Interventions
Three in-person MI sessions focused on identifying goals for community integration (in the areas of vocational, recreational, social, or independent living activities) and unhelpful thinking that tends to get in the way of those goals, building motivation for goals, introducing participants to the CBT model and its potential benefits, and downloading and orienting them to the mobile phone application. Six weeks of mobile phone application use to guide participants through CBT. Weekly content will be provided to learn and practice CBT skills to address unhelpful thinking and problem solving to address obstacles to goal attainment. There will be brief content pages worksheets to guide participants through practice. The worksheets will be tailored to each participant, framing the skills around their pre-identified goals and unhelpful thinking patterns. The application will also include access to crisis resources.
Three in-person supportive therapy sessions focused on empathic listening during client-led discussions of presenting concerns, introducing participants to mindfulness (defined as noticing and paying attention to the present moment without judgment), and downloading and orienting them to the mobile phone application. Participants will be informed of potential benefits of mindfulness, including stress reduction and increased self-awareness. Six weeks of mindfulness training mobile application use to help participants learn to practice mindfulness through a gradual, self-guided training program. The application offers a library of information about mindfulness, 12 different audio-guided mindfulness exercises, goal-setting and tracking, customizable reminders, and access to crisis resources.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06138054