# Multisite RCT of STEP-Home: A transdiagnostic skill-based community reintegration workshop

> **NIH VA I01** · VA BOSTON HEALTH CARE SYSTEM · 2021 · —

## Abstract

Post-9/11 Veterans from Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) represent a clinically
complex group who require non-stigmatizing and multidisciplinary interventions that effectively target their
many comorbidities associated with mild TBI and posttraumatic stress disorder. Research indicates that a
majority of combat Veterans experience difficulty in readjusting to civilian life after returning from combat
including relationship difficulties, impulsive and dangerous behavior, increased substance use, and increased
anger control problems. Mental health problems are frequently cited as driving these difficulties. Unfortunately,
this group of Veterans has also been demonstrated to be highly resistant to mental health treatment and
difficult to engage, showing high rates of appointment no-shows and scheduling difficulties. We propose this
growing group of Veterans requires integrative, transdiagnostic (across diagnoses) interventions that will be
appropriate for the range of treatment challenges they present while also being palatable and engaging. To
address this treatment gap, we have developed the STEP-Home workshop for returning Veterans and
demonstrated its feasibility and preliminary effectiveness in a recently completed RR&D SPiRE award (2014-
2016). In this Merit Review proposal, we propose to build on those findings and advance the development of
the STEP-Home reintegration workshop to the efficacy stage in a multisite randomized controlled trial. STEP-
Home is a 12-week, 2 hour/week reintegration workshop designed to assist all post-9/11 Veterans (with and
without a history of psychiatric and/or neurologic diagnoses) with developing skills to improve their
anger/impulse control and assist their reintegration to civilian and work life after the military. The core skills and
content of the program are novel in their collective use and have not been applied to a Veteran population prior
to our SPiRE feasibility study. We will conduct a multisite (TRACTS Boston; TRACTS Houston), randomized
controlled trial of STEP-Home (26 workshops; 8 Veterans/workshop; total=208). We have two primary aims in
this proposal. First, we will examine the treatment effects of STEP-Home on primary outcomes relative to an
active control condition (Present Centered Group Therapy). Second, we will assess the maintenance of
treatment effects for our primary outcomes. As an exploratory aim, we will examine treatment effects of STEP-
Home on measures of mental health, functional and vocational status and cognitive secondary outcomes
targeted indirectly in the workshop. Last, in a second exploratory aim, we will determine if the effect of
treatment on the primary outcomes is mediated by the acquisition of core skills/key ingredients (problem
solving, emotional regulation, attention training). The successful completion of the aims proposed has the
potential to significantly improve skills to foster civilian reintegration in post-9/11Veterans. Furthermore, t...

## Key facts

- **NIH application ID:** 10119166
- **Project number:** 5I01RX002907-03
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Catherine Brawn Fortier
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10119166

## Citation

> US National Institutes of Health, RePORTER application 10119166, Multisite RCT of STEP-Home: A transdiagnostic skill-based community reintegration workshop (5I01RX002907-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10119166. Licensed CC0.

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