title: Using PTSD Coach in primary care with and without clinician support: a pilot randomized controlled trial.
abstract: OBJECTIVE
  This study aims to evaluate the feasibility and potential effectiveness of two approaches to using the PTSD Coach mobile application in primary care: Self-Managed PTSD Coach and Clinician-Supported PTSD Coach. This study also aims to gather preliminary data to investigate if clinician support improves the benefits of using PTSD Coach on posttraumatic stress disorder (PTSD) severity and specialty mental healthcare utilization.
  
  
  METHODS
  Twenty primary care veterans with PTSD symptoms were randomized to either Self-Managed PTSD Coach consisting of one 10-min session providing instructions for application use or Clinician-Supported PTSD Coach consisting of four 20-min sessions focused on setting symptom reduction goals and helping veterans fully engage with application content.
  
  
  RESULTS
  Research procedures and intervention conditions appear feasible as indicated by high rates of assessment and intervention retention and high clinician fidelity and satisfaction. Both treatments resulted in reductions in PTSD symptoms, with 7 Clinician-Supported PTSD Coach and 3 Self-Managed PTSD Coach participants reporting clinically significant improvements. Clinician-Supported PTSD Coach resulted in more specialty PTSD care use postintervention and possibly greater reductions in PTSD symptoms.
  
  
  CONCLUSIONS
  Both PTSD Coach interventions are feasible and potentially helpful. The addition of clinician support appears to increase the effectiveness of self-management alone. A larger-scale randomized controlled trial is warranted to confirm these encouraging preliminary findings.
authors.affiliation: Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, 800 Irving Avenue, Syracuse, NY 13210, USA. Electronic address: kyle.possemato@va.gov.
authors.forename: Kyle
authors.initials: K
authors.lastname: Possemato
authors.affiliation: National Center for Posttraumatic Stress Disorder, Dissemination and Training Division, Department of Veteran Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Kuhn
authors.affiliation: Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, 800 Irving Avenue, Syracuse, NY 13210, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Johnson
authors.affiliation: National Center for Posttraumatic Stress Disorder, Dissemination and Training Division, Department of Veteran Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Hoffman
authors.affiliation: National Center for Posttraumatic Stress Disorder, Dissemination and Training Division, Department of Veteran Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Owen
authors.affiliation: National Center for Posttraumatic Stress Disorder, Dissemination and Training Division, Department of Veteran Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
authors.forename: Nitya
authors.initials: N
authors.lastname: Kanuri
authors.affiliation: Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, 800 Irving Avenue, Syracuse, NY 13210, USA.
authors.forename: Leigha
authors.initials: L
authors.lastname: De Stefano
authors.affiliation: Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, 800 Irving Avenue, Syracuse, NY 13210, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Brooks
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods*; D012648:Self Care / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans
keywords: Mobile applications; PTSD; Primary care; Smartphone; Veterans