The STRONG STAR Training Initiative will provide partial scholarships for veteran-serving community mental health providers through funding from Boeing in EBTs for PTSD in 2020. The goal of this project is to continue to build nationwide community-level access to evidence-based treatments (EBTs) for PTSD for veterans by training mental health providers and organizations to ensure long-term sustainability of PTSD treatment programs. Funding will support the Training Initiative’s competency-based training program.
CBTI&N at West Texas Counseling and Guidance
The STRONG STAR Training Initiative will partner with West Texas Counseling and Guidance to provide this one-day training and 16-weeks of expert phone consultation in Cognitive Behavioral Therapy for Insomnia and Nightmares (CBTI&N). The goal of this project is to build regional capacity for evidence-based treatment sleep problems in conjunction with the existing PTSD client services available. Sleep problems are highly co-morbid with PTSD and are often a residual problem after PTSD treatment for war veterans (Pruiksma et al., 2016). Importantly, treatment for sleep problems can be a gateway to services for PTSD (Gutner et al., 2018).
Bob Woodruff Foundation In Partnership with the Qatar Harvey Fund
To increase community-level access to EBTs for PTSD for veterans seeking services in the Texas Gulf Coast region, the Bob Woodruff Foundation, in partnership with the Qatar Harvey Fund, is supporting the STRONG STAR Training Initiative to train mental health providers in this region and provide organizational consultation to ensure long-term sustainability of EBTs for PTSD programs. The Training Initiative will offer organizational consultation to each participating veteran-serving organization/agency. Organizational consultation is specifically designed to develop a tailored approach to developing infrastructure for success in EBT implementation and sustainability. The Training Initiative will work with the Senior Leader at the organization to develop an implementation plan prior to the in-person EBT workshop. As a part of the implementation plan, the Training Initiative team will meet with the senior leader monthly to provide implementation facilitation and technical assistance. Six months after the in-person workshop, the Training Initiative team will meet with the Senior Leader to develop an agency-specific sustainability plan to ensure long-term success of the EBT program at their organization.
Veterans Court Outreach
The Texas Veterans Court system requested the assistance of the STRONG STAR Training Initiative to develop and present psychoeducational training about PTSD for the non-clinical team members of a local Veteran’s Court. The training’s goal was to help the team members develop awareness of PTSD symptom presentations as well as resources for PTSD treatment, given the high rates of individuals entering into this system with PTSD. Such training allows for improved understanding of PTSD as well as tools to recognize and assist their clients who may need referrals for PTSD treatment.
Bob Woodruff Foundation Project
The project will build on the current STRONG STAR Training Initiative infrastructure to (1) continue developing the veteran-serving mental health workforce AND (2) partner with managed care companies to develop innovative strategies to incentivize the delivery of EBTs for PTSD and connect veterans with care providers offering EBTs.
Cohen Veteran Network
Cohen Veterans Network (CVN) contracted with the STRONG STAR Training Initiative to develop and present advanced trainings to support their mental health providers trained in EBTs for PTSD. Advanced trainings were didactic webinars with video content and discussion focused on the intersection of PTSD and military culture and included the topics: Advanced Training in Prolonged Exposure for Combat-Related PTSD, the Case of the Yea But’s: Engaging Ambivalent Clients, and Sharpening Socratic Skills. The goal of these trainings were to support clinical engagement and conceptualization skills with military-connected patients. CVN contacted with the Training Initiative to train a cohort of providers in Prolonged Exposure for PTSD in March 2020.
Implementing CPT for People living with HIV
With the support of a grant from The Health Resources and Services Administration entitled “Using Evidence-informed Interventions to Improve Health Outcomes among People Living with HIV” Drs. Dondanville and Moring of the STRONG STAR Training Initiative partnered with the Fenway Institute in Boston, MA to implement Cognitive Processing Therapy (CPT) for at Western North Carolina Community Health56 in Asheville, North Carolina and Positive Impact Health Centers: Decatur, Georgia. The Training Initiative consulted to create a
CPT Implementation Toolkit, provided training and consultation in CPT and consulting in the development of CPT online educational modules for organizations working with people living with HIV. For more information:
Cognitive Processing Therapy (CPT) Training for Rape Crisis Centers
The STRONG STAR Training Initiative partnered with Dr. Tonya Edmond at Washington University St. Louis on Department of Justice funded research project. Dr. Edmond is studying different methods to train counselors in rape crisis centers to implement Cognitive Processing Therapy (CPT). Dr. Edmond is comparing "No Training, Workshop + Consultation" to the STRONG STAR Training Initiative Learning Community training model. Dr. Dondanville and the Training Initiative team are collaborating on providing CPT Trainings, CPT Consultation and Organizational Consultation and support. Data from this project is currently being analyzed with results expected in the coming months.
Oceans Healthcare Training in Prolonged Exposure Therapy for PTSD
Oceans Healthcare contracted with the STRONG STAR Training Initiative to train their providers across inpatient behavioral services and intensive outpatient programs in Prolonged Exposure Therapy (PE) for PTSD. Oceans Healthcare is dedicated to providing evidence-based treatments for individuals engaged int heir treatment centers. Additionally, they have a program called the “STAR program,” which specializes in military behavioral health for adults and seniors. As of 2020, 20 providers have been trained in PE across Oceans Healthcare behavioral health hospitals.
Support Border Learning Community to Treat Post Traumatic Stress Disorder (PTSD) Using Cognitive Processing Therapy (CPT)
In 2019, Dr. Feiyu Li was awarded this grant to provided evidence-based CPT training to mental health professionals who serve the Texas borderland communities. Through this project, 43 providers received the Training Initiative’s 2-day CPT training and are now able to provide previously unavailable gold-star PTSD treatment to their communities. Some results from this project revealed providers trained in this project educated 72% of the patients with PTSD 3-months post-workshop and 84% of the patients with PTSD 6-months post-workshop. As a result, the number of clients with PTSD who initiated CPT rose from 55% at 3 months to 89% at 6 months. Client education about EBTs for PTSD is an important public health outcome and essential for the possibility of engaging a client in EBT for PTSD.
Texas Veteran Suicide Risk Prevention Project
The STRONG STAR Training Initiative received funding from the Texas Veterans + Family Alliance (TV+FA) Grant Program to train veteran-serving mental health providers in the Crisis Response Plan (CRP), a one session, evidence-based intervention for suicide prevention. Utilizing the model of comprehensive competency-building Learning Communities, the Training Initiative hosted Learning Communities in Austin, San Antonio, Dallas, Houston, and San Angelo, working with providers from approximately 75 agencies, and training over 170 mental health providers in CRP for suicide risk prevention. As a result of this project, 164 CRPs were created with clients who struggle with suicidality. Preliminary data show consistent reductions in intensity and frequency of suicidal thoughts. Full data analysis is expected to be completed in Summer 2020.
Bob Woodruff Foundation National Training Project
The STRONG STAR Training Initiative received grant funding from the Bob Woodruff Foundation to scale the Training Initiative nationwide (from its origin serving Texas providers). The Training Initiative hosted regional Learning Communities in New York, Florida, Washington, Illinois, Colorado, and Texas, training 150 veteran-serving mental health providers from 23 states and one provider in the United Kingdom. During this year-long project, over 250 individuals with PTSD received EBT for PTSD. SSTI providers submitted de-identified client outcome data. PTSD symptoms (PCL-5) and depression symptoms (PHQ-9) were assessed for clients before treatment, during treatment, and post-treatment. Clients reported moderate levels of PTSD symptoms (M = 51.8) and moderate to severe depression symptoms (M =17.8) prior to starting treatment. After completing EBT for PTSD, clients reported significant changes in PTSD symptoms (M = 21.5) and depression symptoms (M = 8.2). In summary, clients treated by SSTI providers during this project reported an average reduction of 30.4 points in PTSD symptoms and a 9.6 point mean reduction in depression symptoms.
STRONG STAR Training Initiative Texas: The Beginning
The STRONG STAR Training Initiative launched in 2017 through a grant from the Texas Health and Human Services through its Texas Veterans + Family Alliance Grant Program and a grant from the Bob Woodruff Foundation. The Texas Training Initiative's goal was to disseminate evidence-based treatments (EBTs) for PTSD to veteran-serving community providers across the state of Texas through comprehensive competency-building Learning Communities. In this first year, the SSTI hosted nine Learning Communities around the state of Texas, training over 250 mental health providers in Cognitive Processing Therapy and Prolonged Exposure. Providers participated in pre-workshop learning, a two-day in-person workshop, weekly group telephone consultation, and were provided access to our Provider Portal, which contains online resources including videos, webinars, and client tracking tools. Over the course of the one-year project, SSTI providers implemented EBTs for PTSD with 579 veterans, service members, veteran/military family members, and civilians with PTSD. SSTI providers submitted de-identified client outcome data. PTSD symptoms (PCL-5) and depression symptoms (PHQ-9) were assessed for clients before treatment, during treatment, and post-treatment. Clients reported moderate levels of PTSD symptoms (M = 55.5) and moderate to severe depression symptoms (M =18.5) prior to starting treatment. After completing EBT for PTSD, clients reported significant changes in PTSD symptoms (M = 29.9) and depression symptoms (M =10.6).
Overall STRONG STAR Training Initiative Outcomes:
• 736 (and counting!) mental health providers trained.
• Over 1100 patients have received EBTs from SSTI providers.
• 81% of SSTI providers reported continuing to implement EBT 1-year post-training.