Research Brief
Improving Behavioral Health Treatment Outcomes for U.S. Army Personnel
Feb 3, 2020
This report identifies factors associated with changes in outcomes for soldiers who received Army behavioral health specialty care and provides recommendations to improve care and outcomes for posttraumatic stress disorder, depression, and anxiety. Analyses of 141 patient and treatment variables indicated that two treatment factors—therapeutic alliance and receipt of benzodiazepines—were associated with outcomes.
Identifying Predictors of Treatment Outcomes
Format | File Size | Notes |
---|---|---|
PDF file | 0.6 MB | Use Adobe Acrobat Reader version 10 or higher for the best experience. |
Format | File Size | Notes |
---|---|---|
PDF file | 0.1 MB | Use Adobe Acrobat Reader version 10 or higher for the best experience. |
Format | List Price | Price | |
---|---|---|---|
Add to Cart | Paperback142 pages | $30.00 | $24.00 20% Web Discount |
This report identifies factors associated with changes in outcomes for soldiers who received Army behavioral health (BH) specialty care and provides recommendations to improve BH care and outcomes. RAND researchers identified three samples of soldiers who received Army BH care with diagnoses of posttraumatic stress disorder (PTSD), depression, or anxiety and whose symptoms were assessed during their care. Multivariate analyses included 141 patient and treatment variables to identify factors associated with symptom improvement. Analyses also examined patterns in how the symptoms changed over time.
Analyses suggest that the Behavioral Health Data Portal, an online system that allows for collection of multiple patient- and clinician-reported measures, is widely used to track symptoms of PTSD, depression, and anxiety, but there are opportunities to expand symptom tracking. Two treatment factors—therapeutic alliance and receipt of benzodiazepines—were associated with treatment outcomes. Specifically, a stronger therapeutic relationship or alliance with providers, as reported by soldiers, was associated with improved PTSD, depression, and anxiety outcomes. Further, receipt of more than a 30-day supply of benzodiazepines was associated with poorer PTSD, depression, and anxiety outcomes. Many soldiers' trajectories of symptom change did not demonstrate improvement.
Recommendations include providing feedback and guidance to providers on how to strengthen alliance with their patients, expanding tracking and feedback on benzodiazepine prescribing, and increasing provider use of measurement-based BH care.
Chapter One
Introduction
Chapter Two
Methods
Chapter Three
Implementation of Treatment Outcome Monitoring and the Army's Outcome Measures
Chapter Four
Characteristics and Representativeness of Soldiers in the Multivariate Analysis Samples
Chapter Five
Identifying Pretreatment and Treatment Predictors of PTSD, Depression, and Anxiety Outcomes
Chapter Six
Trajectories of PTSD, Depression, and Anxiety Symptom Change
Chapter Seven
Summary and Recommendations
Appendix A
Variables Used in the Multivariate Models
Appendix B
PTSD, Depression, and Anxiety Outcome Models: Full Model Results
The research described in this report was sponsored by the United States Army and conducted by the Personnel, Training, and Health Program within the RAND Arroyo Center.
This report is part of the RAND Corporation Research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.
This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit www.rand.org/pubs/permissions.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.