Evaluating transdiagnostic treatment for distress and impairment in veterans: A multi-site randomized controlled trial of Acceptance and Commitment Therapy

Military personnel who engaged in the conflicts in Afghanistan and Iraq frequently present for mental health care because of the stresses of service and readjustment. Although excellent treatments are available to treat the typical presenting problems, there is a need for additional empirically supported treatment approaches for this population. Because these veterans have high levels of comorbidity, transdiagnostic treatment - treatment that applies to more than one diagnosis - may be an efficient approach for this group. Acceptance and Commitment Therapy (ACT) is one such approach that is well-known and has high face validity for veterans, but it has not been rigorously evaluated as a treatment for trauma-related mental health problems. Described herein is an ongoing multi-site randomized clinical trial of ACT as compared to a psychotherapy control. Challenges in designing an RCT to evaluate transdiagnostic treatment and in executing a multi-site psychotherapy trial are discussed.