Reducing the Burden of Depression Related Disability



Status:Completed
Conditions:Depression, Depression
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - Any
Updated:6/29/2018
Start Date:May 19, 2014
End Date:December 30, 2017

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Reducing the Burden of Depression on Employment: Improving Function and Work

The purpose of this research study is to test the effectiveness of a new telephone counseling
program for employed Veterans with depression called the Veterans Work and Health Initiative
(V-WHI). 250 participants will be recruited and randomly assigned to one of two groups: the
V-WHI experimental group or usual mental health care. The V-WHI counselors will address
mental health and job-related issues that interfere with working. This counseling is provided
solely over the phone with sessions every 2 weeks for 4 months (eight sessions total). At 8
months post-baseline, the V-WHI group is provided with a booster session. Participants in
both groups are administered follow-up questionnaires at two time-points: month five and
month nine.

With the goal of helping employed Veterans with depression to participate fully in the labor
market, this randomized controlled trial has two objectives: 1) test the effectiveness of a
new evidence-based, vocationally-focused telephonic counseling program for employed Veterans
with depression, the Veterans Work and Health Initiative (V-WHI), which was developed by this
study's research partners from the Tufts Medical Center; and 2) if the V-WHI is effective,
quantify its return on investment. This study will test the impact of the V-WHI in
combination with the Philadelphia VA's Primary Care Mental Health Integration program, the
Behavioral Health Lab (BHL).

The primary endpoints are pre/post changes in at-work performance and productivity scores
based on the validated Work Limitation Questionnaire (WLQ). Secondary endpoints include
changes in depression symptom severity (measured with the validated Patient Health
Questionnaire [PHQ-9]). A return on investment (ROI) analysis will assess costs and benefits.
For practical reasons, neither subjects nor the intervention providers will be blinded to
subject assignment.

After informed consent and eligibility screening, subjects are randomized to one of two
groups: the V-WHI intervention group or to the usual care group (BHL). 250 employed Veterans
with depression and work limitations will be enrolled (half per group). The "usual care"
group participants are assigned to standard behavioral health care. The second group,
assigned to V-WHI services, is the experimental group. Participants in this group are
assigned to an innovative program designed explicitly to address mental health and vocational
issues that interfere with working (V-WHI) in addition to standard care. V-WHI counselors
offer work coaching and modification strategies and work-focused cognitive behavioral therapy
(CBT). This counseling is provided solely over the phone with sessions every 2 weeks for 4
months (eight sessions total). At 8 months post-baseline, the V-WHI group is provided with a
booster session. Participants in both groups are administered follow-up questionnaires at two
time-points: month five (post-intervention) and month nine.

Inclusion Criteria:

Veterans will be considered eligible for study participation if the following criteria are
met:

- 18 years of age (no maximum age is specified)

- working for pay 15 hours per week

- employed in the job for 6 months (to ensure that the Veteran has sufficient
familiarity with the position and organization)

- current major depression and/or persistent depressive disorder symptoms based on DSM-5
criteria

- and current work limitations

Exclusion Criteria:

- Non-English speaking or reading

- bipolar disorder

- psychosis

- and/or planning to take maternity leave at any point in the next nine months
We found this trial at
2
sites
Coatesville, Pennsylvania 19320
Phone: 215-823-5894
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Coatesville, PA
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3900 Woodland Avenue
Philadelphia, Pennsylvania 19104
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Philadelphia, PA
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