title: Vets prevail online intervention reduces PTSD and depression in veterans with mild-to-moderate symptoms.
abstract: OBJECTIVE
  Despite heightened rates of depression and posttraumatic stress disorder (PTSD) among in Iraq/Afghanistan veterans, the majority of distressed veterans will not receive mental health care. Overcoming barriers to mental health services requires innovative approaches to broaden the reach of evidence-based treatment. The current study examined the efficacy and acceptability of an innovative and dynamic online cognitive-behavioral therapy intervention for PTSD and depression called Vets Prevail.
  
  
  METHODS
  A randomized clinical trial conducted between 2011 and 2013 assessed changes in PTSD and depression in veterans with mild-to-moderate distress. Veterans randomized to Vets Prevail (n = 209) were aged 34.2 ± 7.6 years, mostly male (81.3%), and nonminority (73.7%). Veterans randomized to adjustment as usual (n = 94) were aged 34.7 ± 8.9, mostly male (81.9%), and White (67.0%). Veterans completed the PTSD Checklist-Military Version and the Center for Epidemiological Studies Depression scale (10-item version) postintervention and at 12-week follow-up.
  
  
  RESULTS
  Veterans in the Vets Prevail condition reported significantly greater reductions in PTSD, t(250) = 3.24, p = .001 (Mreduction = 5.51, SD = 9.63), and depression, t(252) = 4.37, p = .001 (Mreduction = 2.31, SD = 5.34), at 12-week follow-up compared with veterans in the adjustment as usual condition (PTSD Mreduction = 1.00, SD = 7.32; depression Mreduction = 0.48, SD = 4.95), with moderate effect sizes for PTSD (Cohen's d = 0.42) and depression (Cohen's d = 0.56). Exploratory analysis shows that Vets Prevail may be effective regardless of combat trauma exposure, gender, and ethnic minority status.
  
  
  CONCLUSIONS
  Vets Prevail circumvents many barriers to care and effectively addresses the dire mental health needs of veterans.
authors: Rush University Medical Center.
authors: Stevan E
authors: SE
authors: Hobfoll
authors: Rush University Medical Center.
authors: Rebecca K
authors: RK
authors: Blais
authors: Rush University Medical Center.
authors: Natalie R
authors: NR
authors: Stevens
authors: Rush University Medical Center.
authors: Lisa
authors: L
authors: Walt
authors: Prevail Health Solutions.
authors: Richard
authors: R
authors: Gengler
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*