VetChange Helps Veterans Control Drinking.
More than half a million veterans of the wars in Iraq and Afghanistan drink at unhealthy or unsafe levels, and as many as 400,000 suffer from PTSD—and the two issues are more entangled than many veterans realize.
“Veterans sometimes drink thinking they’re drowning their PTSD symptoms,” says David Rosenbloom, professor and chair of health law, policy & management. “In point of fact, it’s the reverse. We have found that helping people reduce their drinking reduces their PTSD symptoms in many cases.”
To address this, there is now VetChange.
Researchers and clinicians specializing in drinking and PTSD have realized clinical work only deals with part of this problem, as a significant proportion of these veterans are not in care. They may live too far away from facilities, worry about the stigma of mental health treatment, or simply not be ready to seek help.
Deborah Brief, assistant professor of psychiatry and psychology at MED, and Terence Keane, professor of psychiatry and clinical psychology at MED, had an idea: put the care online. In 2011, VetChange was created in a collaboration between MED, SPH, and the VA Boston Healthcare System, where both Brief and Keane hold staff positions. Rosenbloom and Eric Helmuth, health law, policy & management internet services director, joined the research team, bringing knowledge and experience in other web-based substance programs like QuitNet and AlcoholScreening.
To test the site’s efficacy, the team launched a randomized clinical trial that included 600 participants recruited through targeted ads on Facebook. Participants engaged in eight weekly web-based modules, each lasting about 20 minutes, that helped them better examine their drinking on their own.
After eight weeks, almost a quarter of participants had gotten their drinking down to within recommended guidelines, and the average number of heavy drinking days decreased. The participants also scored their PTSD symptoms significantly lower on average.
The trial ran from 2011 to 2012, and in 2013 a team led by Rosenbloom and Keane received a $1 million grant from Bristol-Myers Squibb Foundation to build and test a public-facing version through 2016. Additional funds from the VA’s National Center for PTSD also supported the build-out.
VetChange is still the only clinically proven online intervention to help veterans control drinking in the context of PTSD and other post-deployment factors. Now, the researchers want to see how exactly veterans use it in the real world.
One of the big changes they want to examine is giving veterans even more control: rather than spending eight weeks going through each module in a certain order, the public version of VetChange allows users to go at their own speed, in their own order, for as long as they want. The self-administered program’s flexibility is its key strength, Rosenbloom says.
“This is used by people who are in care, people who are not going to use care, people whose symptoms aren’t severe enough to be called an addiction but for whom drinking is really getting in the way of their success,” he explains.
“This is available to anybody, anyplace, anytime.”