Overall STRONG STAR Training Initiative Outcomes:
• Over 1000 mental health providers trained.
• 32 States with Trained Providers
• Over 2100 patients have received EBTs from SSTI providers.
• 81% of SSTI providers reported continuing to implement EBT 1-year post-training.
The STRONG STAR Training Initiative will provide partial scholarships for veteran-serving community mental health providers through funding from the Boeing Corporation in EBTs for PTSD. 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.
June 2020 Interim Outcomes:
125 veteran-serving community mental health providers trained
20 states reached
573 clients assessed for PTSD
"My philosophy has always been to learn form the experts to provide the best services to my clients, and the CPT training has proven to be cutting edge." Mary Jane Natividad, LPC
"The work I am doing in PE has drastically impacted the lives of the Veterans I work with in ways that cannot be overstated." Raymond Mangelsdorf, LCSW
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.
October 2020 Interim Outcomes:
12 agencies engaged in Organizational Consultation
100% of Organizational leaders reported satisfaction with consultation
98 mental health providers trained in EBTs for PTSD
22 mental health providers trained in CBT for Insomnia and Nightmares
58 Care Navigators trained in Educating Clients about PTSD
90% of Patients with PTSD on providers case loads received education about EBT for PTSDs
1043 Patients with PTSD educated about EBTs for PTSD
556 Patients with PTSD initiated an EBT for PTSD
ARBEST CPT Learning Community Collaboration
The Training Initiative is partnering with Arkansas Building Effective Services for Trauma (ARBEST) to implement CPT Learning Community for 60 Arkansas mental health providers. ARBEST is a state-funded program at the UAMS Psychiatric Research Institute which aims to improve outcomes for traumatized children and families through excellence in clinical care, training, advocacy, and evaluation.
For more information about ARBEST: https://arbest.uams.edu
Oceans Mental Health Services
The Training Initiative is partnering with Oceans Mental Health Services in New Jersey to implement EBTs for PTSD in their new Oceans Integrated Trauma Center. The Training Initiative conducted Learning Communities in Cognitive Processing Therapy and Prolonged Exposure for PTSD with their mental health providers.
The Oceans Integrated Trauma Center was developed in direct response to the effects and trauma the COVID-19 pandemic is placing on our frontline workers and the individuals and families who have suffered an impact and loss.
For more information about Oceans Integrated Trauma Center: https://oceanmhs.org/ocean-integrated-trauma-center-2020/
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.
Starting in 2020, the Training Initiative partnered with CVN to train CVN mental health providers in Prolonged Exposure for PTSD.
Implementing CPT for People living with HIV
With the support of a grant from the Health Resources and Services Administration (HRSA) 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.
Bob Woodruff Foundation National Training Project #2
The project built 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.
May 2020 Final Outcomes:
157 mental health providers trained
1495 patients with PTSD educated about EBTs for PTSD
717 patients with PTSD initiated EBTs for PTSD
201 veterans received EBTs for PTSD
45 veteran family members received EBTs for PTSD
Mean pretreatment PCL-5 and PHQ-9 scores among all veteran patients for both treatments was 45 (moderate PTSD symptoms) and 15 (moderately-severe depression symptoms), respectively; posttreatment mean score was 33 (Scores > 33 indicative of probable PTSD) and 11 (mild-moderate depression). Veteran patients who started an EBT for PTSD received on average 7 sessions with a range from 1 session to 18 sessions. Respectively, giving a mean change score of -15 for the PCL-5 and -3 for PHQ-9. Patients experiencing 10-point reductions in PCL-5 are considered clinically meaningful, and patients treated by Training Initiative providers are reporting -15 reductions in PTSD symptoms.
Managed Care Collaborations
The Training Initiative partnered with Humana Military and Optum Behavioral Health
815 clinicians, care navigators and allied health professionals received education on EBTs for PTSD
95% reported increased knowledge and confidence in the delivery of EBTs for PTSD, measured by training evaluation.
"It has been amazing to see a client have an "aha moment" in session after years of carrying their trauma. I truly appreciate all of the videos and documents that are provided to clinicians that help us support our patient’s success. The reason I wanted to get trained in CPT is bc I had a colleague doing it with our Combat Vets and they got BETTER!! It is so refreshing to be able provide a solution to a problem and not just talk about it over and over. In my opinion, CPT changes lives!" Training Initiative Provider
"I greatly value the training and consultation I have received from Strong Star. It has been wonderful to help patients face their greatest fears with bravery and to watch them get better! One of my CPT patients said this treatment changed her life... as a therapist, it doesn't get any sweeter than that!" Training Initiative Provider
"Veterans are excited to see a reduction in symptoms. Veterans learning how to identify their thoughts and emotions develop regarding index trauma. Veterans being capable of challenging stuck points and reconstructing thoughts in a healthy manner." Training Initiative Provider
CBTI&N at West Texas Counseling and Guidance
The STRONG STAR Training Initiative partnered with West Texas Counseling and Guidance to provide this training 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).
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.
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.
72% of the patients with PTSD 3-months post-workshop received education about CPT
84% of the patients with PTSD 6-months post-workshop received education about CPT
55% of clients with PTSD on providers caseloads initiated CPT at 3 months post-workshop
89% of clients with PTSD on providers caseloads initiated CPT at 6 months post-workshop.
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.
December 2019 Final Outcomes:
75 agencies supported
170 mental health providers in trained CRP for suicide risk prevention
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 Winter 2021.
Bob Woodruff Foundation National Training Project #1
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.
Final Outcomes September 2018
150 veteran-serving mental health providers trained
23 states with trained providers
443 patients with PTSD educated about EBTs for PTSD
250 patients 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. 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. In this first year, the SSTI hosted nine Learning Communities around the state of Texas.
December 2018 Final Outcomes:
250 mental health providers trained in Cognitive Processing Therapy and Prolonged Exposure
579 veterans, veteran-family members and civilians with PTSD received EBTs 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 = 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).