# One-day Life Skills Workshop for Veterans with TBI, pain, and Psychopathology: Evaluating efficacy and mechanism of change

> **NIH VA I01** · MICHAEL E DEBAKEY VA MEDICAL CENTER · 2020 · —

## Abstract

Traumatic brain injury (TBI) is the signature wound of Veterans returning from Operations Iraqi Freedom,
Operation Enduring Freedom and Operation New Dawn (OIF/OEF/OND), with up to 20 percent exposed to a
mild TBI (mTBI) and experiencing persistent post-concussive symptoms. Among those with a mTBI diagnosis,
the majority also suffers from stress-based psychopathology (e.g., depression, post-traumatic stress disorder,
generalized anxiety disorder), as well as chronic pain. To cope with distress, pain, and other difficulties,
Veterans often turn to maladaptive avoidant coping strategies which offer short term relief but
exacerbate/maintain mental health problems and have detrimental long-term effects on social, occupational,
and community reintegration. Unfortunately, Veterans face significant barriers to engaging in mental health
treatment, including stigma, the belief that one should overcome psychological difficulties on his/her own, and
concern that receiving such care would negatively impact their careers. Practical barriers, including time
constraints, distance from a treatment facility, and competing priorities (e.g., work and family demands), are
also barriers to care. Even among Veterans who start mental health treatment, only a small minority complete
a recommended course of evidence-based therapy.
 Acceptance and Commitment Therapy (ACT) is a trans-diagnostic treatment model that helps patients to
overcome avoidance by promoting acceptance-based coping and engagement in meaningful life activities. In
this context, Veterans are asked to think about their “new mission(s)” after leaving the military and the
importance of engaging in actions that fulfill their mission even when it may be difficult. ACT has established
efficacy in the treatment of depression, anxiety, and chronic pain, and has been effectively implemented in
various treatment-delivery formats, including 1-day group workshops. A 1-day ACT workshop addresses
specific needs of Veterans with mTBI, stress-based psychopathology, and chronic pain (polytrauma triad) and
important barriers to treatment. It 1) is trans-diagnostic (i.e., applies to more than one condition); 2) targets
avoidance-based coping; 3) cultivates acceptance-based coping and builds on Veteran’s values and goals to
motivate them to make difficult decisions; 4) is delivered efficiently and thus more accessible; 5) is less
stigmatizing and thus acceptable; and 6) address problems with treatment adherence and completion.
 With the support of an RR&D SPiRE pilot grant, the PIs developed a 1-day ‘ACT on Life’ workshop tailored
specifically for the needs of Veterans with mTBI, stress-based psychopathology, and chronic pain. Veterans
with this polytrauma were then randomly assigned to the ‘ACT on Life’ workshop (N=20) or to Treatment as
Usual (TAU; N=12). All Veterans attending the 1-day ACT workshop completed it, and relative to TAU,
exhibited greater improvements in distress and reintegration at the 3-month follow-up ...

## Key facts

- **NIH application ID:** 9949229
- **Project number:** 1I01RX003117-01A1
- **Recipient organization:** MICHAEL E DEBAKEY VA MEDICAL CENTER
- **Principal Investigator:** Lilian Nazar Dindo
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-02-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9949229

## Citation

> US National Institutes of Health, RePORTER application 9949229, One-day Life Skills Workshop for Veterans with TBI, pain, and Psychopathology: Evaluating efficacy and mechanism of change (1I01RX003117-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9949229. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*