# Empowering Veterans to Self-Manage PTSD Symptoms Following Completion of Trauma-Focused Therapy

> **NIH VA I01** · MINNEAPOLIS VA  MEDICAL CENTER · 2024 · —

## Abstract

Background. Nearly 90% of Veterans who complete trauma-focused therapy (TFT) for PTSD have remaining
treatment needs. In the six-months following TFT, successful completers remain some of the highest utilizers
of VA mental health services despite clinically meaningful symptom improvement. Our prior work demonstrated
that Veterans who benefitted from TFT's primary post-TFT treatment needs were the practice and application
of skills learned during therapy, with the goal of maintaining or building upon treatment gains. Veterans
expressed low self-efficacy for meeting these goals without the support of their therapists and feared
stagnation or relapse without ongoing contact. As such, we developed and feasibility-tested a therapist-
assisted self-management program for TFT completers (EMPOWER) designed as a step down from active
psychotherapy. The feasibility open trial demonstrated that EMPOWER is feasible and highly acceptable to
patients. Further, findings suggest that the intervention was successful in helping Veterans maintain or
enhance PTSD-related gains while reducing their mental health service utilization. These promising findings
warrant a randomized evaluation. Significance. Interventions that meet Veterans' post-TFT treatment needs
are urgently needed. Mental health providers are delivering ongoing treatment to this high priority cohort of
Veterans without evidence to guide their treatment plan. Further, higher than expected levels of post-TFT
mental health care utilization threatens the continued implementation of these highly effective treatments. For
all Veterans to have access to the most effective treatments for PTSD, we must evaluate and implement
interventions that prepare and enable successful TFT completers to step down from active therapy.
Innovation. The proposed study is the first large-scale study of post-TFT care and the first to rigorously
evaluate a self-management program to step-down from active to maintenance mental health services
following a course of active psychotherapy. More broadly, we believe it to be the first intervention to directly
facilitate an episodic model of mental health care. Specific Aims: 1) Estimate posterior probability distributions
of EMPOWER's effects and establish likely ranges for those effects as compared to post-TFT TAU for
Veterans' MH service utilization and self-reported PTSD symptoms. The subsequent Hybrid RCT will be
designed after assessing the likelihood of detecting an effect for EMPOWER across a range of sample sizes
using Go/No Go and Overall Power methods. 2) Explore the impact of EMPOWER compared to post-TFT TAU
on Veterans'(a) self-efficacy for managing PTSD symptoms, (b) satisfaction with post-TFT care, (c) well-being
& functioning (d) depression, and (e) secondary utilization outcomes. 3) Conduct semi-structured interviews
with Veterans and providers to contextualize quantitative findings and identify potential barriers, facilitators,
and strategies to facilitate future imple...

## Key facts

- **NIH application ID:** 10871675
- **Project number:** 5I01HX003301-02
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** Shannon M. Kehle-Forbes
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2023-06-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10871675

## Citation

> US National Institutes of Health, RePORTER application 10871675, Empowering Veterans to Self-Manage PTSD Symptoms Following Completion of Trauma-Focused Therapy (5I01HX003301-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10871675. Licensed CC0.

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