# Assessing and Enhancing Social Support to Improve Treatment Outcomes Among Veterans with PTSD

> **NIH VA IK2** · VA PUGET SOUND HEALTHCARE SYSTEM · 2021 · —

## Abstract

Background: PTSD is a significant problem for Veterans, most of whom are initially treated for posttraumatic
stress disorder (PTSD) in Primary Care Mental Health Integration (PCMHI). Poor social support in this
population is a risk factor for suicidal ideation, all-cause mortality, and worse treatment engagement and
response. Preliminary research shows that approximately 60% of Veterans with PTSD present to specialty
care intake appointments with poor social support. However, none of the existing PCMHI-based treatments for
PTSD explicitly focus on social support generation or reengagement. Moreover, although the limited existing
research suggests that the routine assessment of social support to guide treatment planning (also known as
measurement-based care, or MBC) improves treatment outcomes in civilian populations, social support is not
routinely monitored as part of evidence-based treatments for PTSD. Thus, this CDA-2 will first identify an
appropriate instrument for routinely measuring social support in the context of clinical care to improve PTSD
treatment, and, subsequently, evaluate a novel PCMHI-based PTSD treatment as part of a stepped care model
for Veterans who report poor social support and are at great risk of PTSD treatment non-response.
Significance/Impact: The proposed research addresses several HSR&D research priorities, including
evaluating the impact of social determinants of health, namely, social support, on the quality and outcomes of
care; testing new models of mental health care to improve outcomes; and intervening with vulnerable Veterans
with PTSD and suicide risk. By measuring and improving social support to enhance PTSD treatment, the
proposed research plan explicitly addresses a key factor that impedes treatment outcomes for a sensitive
population of Veterans. Innovation: Although poor social support is widely recognized as among the strongest
predictors of PTSD development and maintenance, none of the existing PCMHI-based treatments for PTSD
target or measure social support as a primary treatment focus. The proposed CDA-2 research is thus highly
novel. No past or present HSR&D-funded studies have tested methods for monitoring or improving social
support in PCMHI-based treatment among Veterans with PTSD, despite its association with poor clinical
outcomes. Specific Aims: 1) Select an instrument for MBC of social support in clinical settings for Veterans
with PTSD. 2) Iteratively refine and conduct a one-arm pilot test a brief, PCMHI-based behavioral activation
and social engagement intervention for PTSD based on key stakeholder (e.g., Veteran and PCMHI provider)
feedback. 3) Conduct a two-arm pilot randomized clinical trial (RCT) comparing the intervention to usual care
in PCMHI. Methodology: Aim 1 will use quantitative data gathered in an online survey from 210 Veterans to
assess the degree to which four measures of social support (identified via systematic review and clinical utility
ranking) are acceptable, reliabl...

## Key facts

- **NIH application ID:** 10070222
- **Project number:** 1IK2HX002891-01A2
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Sarah Burns Campbell
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10070222

## Citation

> US National Institutes of Health, RePORTER application 10070222, Assessing and Enhancing Social Support to Improve Treatment Outcomes Among Veterans with PTSD (1IK2HX002891-01A2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10070222. Licensed CC0.

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