Initial Randomized Controlled Trial of Acceptance and Commitment Therapy (ACT) for Distress and Impairment in OEF/OIF Veterans

PUBLIC ABSTRACT

It is said that everyone is changed by combat. For some military members, this takes the form of post-traumatic stress disorder (PTSD) and depression. In addition, combat in Iraq and Afghanistan has frequently involved blasts or blows to the head that may lead to head injury and post-concussive symptoms (PCS), an array of symptoms that occur after head injury. There is a strong need for effective treatment of the complex array of problems that follow combat, and many veterans and military personnel prefer to avoid the use of medications. Current psychotherapies are not effective and/or acceptable for all affected individuals, and none have been shown to be effective for this full range of problems. Thus, finding new ways to help combatants to recover from their psychological injuries is critical.

Acceptance and Commitment Therapy (ACT) is a promising psychotherapeutic approach that warrants further investigation. ACT is not tied to any particular symptom constellation, so it can be applied to a variety of presenting concerns. It conveys a compelling message that fits with military culture; individuals are asked to move forward in accordance with their values regardless of limitations. ACT offers an alternative for people who choose not to engage in therapies that rely on repeated retelling of their trauma. Because of the enthusiasm for the approach, ACT is being widely disseminated -- but this dissemination is occurring without evidence for its effectiveness for symptoms related to combat.

The primary objective of the study is to determine if ACT, as compared to a control psychotherapy, reduces Veterans' deployment-related symptoms and improves their functioning. We will also examine the acceptability of ACT and the extent to which gains are maintained after treatment. We will gather preliminary information about the impact of ACT on symptoms specific to PTSD, depression, and PCS and about the acceptability of and response to ACT in active duty service people to inform future studies.