# PTSD Treatment for Veterans with Serious Mental Illness to Improve Functional Outcomes

> **NIH VA IK2** · BALTIMORE VA MEDICAL CENTER · 2024 · —

## Abstract

Anticipated Impact on Veteran's Healthcare: PTSD is a critical obstacle to the recovery of Veterans with
serious mental illness (SMI; psychotic spectrum and bipolar disorders). The Veterans Health Administration
(VHA) has made treatment of PTSD a high priority and has initiated dissemination of evidence-based practices
(EBPs) for PTSD across the national VHA system. However, EBPs for PTSD have not been tested among, and
are largely not provided to Veterans living with both PTSD and SMI, despite high co-occurrence rates and
profound associated negative functional impact. This study will: [Aim 1) administer the Cultural Formulation
Interview (CFI) during a pre-pilot study of WET with 10 Veterans with SMI and PTSD to inform how best to incorporate
aspects of cultural identity into the WET intervention pilot-testing in Aim 2; Aim 2) conduct a pilot randomized controlled
trial (RCT) with 48 Veterans with SMI and PTSD to examine the feasibility and acceptability of WET, [monitor fidelity],
and preliminarily evaluate clinical and functional outcomes; Aim 3) complete a well-specified process evaluation to
determine what, if any, considerations are needed to optimize WET for Veterans with SMI and regarding
culturally responsive methods. Overall impact will be to move WET towards full evaluation as a potential EBP
for Veterans with PTSD and SMI.
Project Background: PTSD is prevalent among Veterans and others with SMI,3-8contributing to substantial
mental and physical health impairments.7,14-22 Written Exposure Therapy (WET) is a new EBP for PTSD that may
have special clinical utility for Veterans with SMI and PTSD. 31,41-42,44 However, such Veterans have been largely
excluded from PTSD clinical trials, and no WET trials to date have focused on an SMI population.42,45 Further,
there are significant race and ethnicity disparities in PTSD and SMI prevalence and treatment, even in VHA.2,47
For instance, persistence and chronicity of SMI and PTSD are higher for Black, Indigenous, and other people of
color (BIPOC),48,103 underlining the need for PTSD EBPs to be delivered in culturally responsive ways.
Project Objectives: The proposed CDA-2 research will address research and clinical gaps by integrating
culturally responsive assessment methods and testing the feasibility and acceptability of WET among Veterans
with SMI and PTSD. [The first step of this research will focus on administering culturally responsive assessments
and WET to Veterans with PTSD and SMI in a training trial (n = 10), including qualitative interviews exploring
participants' experiences with and views of these instruments and WET.] The second step will involve completing
a small randomized controlled trial of WET to examine feasibility, acceptability, and fidelity of WET, and to
preliminary explore changes to clinical outcomes and functioning among 48 Veterans randomized to WET (n =
32) vs. a PTSD psychoeducation control intervention (n = 16). We will assess rates of recruitment, initial
inter...

## Key facts

- **NIH application ID:** 10811644
- **Project number:** 5IK2RX004272-02
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** Mary Katherine Howell
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2023-04-01 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10811644

## Citation

> US National Institutes of Health, RePORTER application 10811644, PTSD Treatment for Veterans with Serious Mental Illness to Improve Functional Outcomes (5IK2RX004272-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10811644. Licensed CC0.

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