A combination of telehealth coaching and web-based skills training can significantly improve clinical outcomes and social functioning for Veterans who have experienced military sexual trauma (MST), says a VA study published in October 2021 in the “Journal of Rural Health.”

For the small-sample study, funded by VA’s Office of Rural Health, 32 Veterans with a history of MST who also screened positive for either PTSD or depression were offered biweekly telehealth sessions, as well as a web-based skills training program called webSTAIR, for three consecutive months.

The webSTAIR training program included 10 individual web-based modules that patients worked through at a 2:1 ratio, whereby the Veterans would complete two webSTAIR modules followed by a 45-minute telehealth therapy session. The modules focused on learning emotion regulation and relationship skills, while the coaching sessions provided support and help tailoring the skills to the Veteran’s specific needs.

Encouraging results

Immediately following the three-month program, participants were interviewed. They rated the program highly and reported “significant symptom reduction” in PTSD and depression, as well as overall improvement in emotion regulation and interpersonal functioning.

“What we didn’t know prior to the study was how well a blended therapy would work for trauma-exposed Veterans with PTSD or depression,” explains study co-author Dr. Marylène Cloitre. “We knew that integrating self-guided work with regular therapy sessions has been effective for depression and anxiety problems such as social phobia. We’re surprised to see how relatively limited contact with a therapist can provide such positive outcomes, including satisfaction with this type of programming.”

Cloitre is based at the Palo Alto VA. She is a researcher with VA’s National Center for PTSD.

Military sexual trauma impacts 25% of female Veterans

For Veterans who have limited access to care due to lack of providers in their geographic area, the study results are especially encouraging.

“Because of geography and proximity to services, rural Veterans don’t access care as often as those living in urban areas, even though the level of need is the same,” says Cloitre.

The telehealth approach used in the study is also highly relevant for Veterans who have experienced MST. MST impacts an estimated 1 in 4 female Veterans and 1 in 100 male Veterans in the VA health care system.

“Many women Veterans with MST have reported avoiding in-person care at VA facilities because the male-dominated environment can sometimes feel uncomfortable,” says Cloitre. “In addition, providers who specialize in MST are not everywhere.”

Blended therapy works synergistically

In addition to the potential benefits reported above, researchers have found that pairing telehealth coaching with self-paced learning – in lieu of simply offering virtual visits – may increase engagement and follow-through in health care.

“There’s research suggesting that blended therapy may work synergistically to provide better engagement and outcomes than either self-guided or face-to-face therapy sessions alone,” says Cloitre. “The self-guided sessions allow users to work on the program when they want and may be particularly effective in boosting a sense of mastery while the telehealth sessions provide emotional support and expert knowledge as needed.”

The researchers hope to expand on their findings by conducting more studies on blended approaches. Among other studies, they would like to conduct a randomized controlled trial to assess different ratios of telehealth to self-guided work. They say this would help determine which ratio maximizes engagement, retention and outcomes.

More Information

Click here to learn more about VA research.

By Marisa Torrieri is a freelance writer supporting VA's Office of Research and Development

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Published on Feb. 7, 2022

Estimated reading time is 2.8 min.

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  1. Kimberly J Foster February 28, 2022 at 6:41 pm

    I am 63 yrs old. Last graduating class of WACs at Ft. McClelland, thrown into coed. I have suffered for years. It is just recently in the past few years that the Federal Gov’t has openly acknowledged MST. I fought for years for help and compensation from a Gov’t that continued to hide it. It took 43 yrs for the Gov’t to do the right thing, compensate and back pay. I was discharged because of MST/PTSD. I should have carried a medical retirement out in 1978. I’m full of anger at the Federal Gov’t’s lack of accountability! I’d like to be part of your research.

  2. James P. McNichols February 28, 2022 at 6:21 pm

    I’m glad you mentioned that statistic on the female veterans, however you’d be stunned at just how many of us males are victims, in a time when the mere mention of such conduct would have had us locked up for false statements and the good ol’ boy system would have been calling us such names as “f-g” or “queer” and the “you came on to him, you’re lucky be didn’t kick your a– f—-t” sort of crap. I’d honestly wage a guess that there are as many if not more males that endured these assaults due to the VERY low numbers of female veterans at that point in the game. Next time be more inclusive of us female counterparts if you’d be so inclined. Thank you kindly

  3. Michaelle E Strickland February 11, 2022 at 11:49 am

    I live in a rural area, currently struggle with MST/PTSD and do not not to leave my home – much less to travel to a VA clinic/hospital. I have when my husband is able to accompany me and stay with me. I would like to try this method as nothing I have tried works. Is there a way I can join this research group?

  4. A Fitch February 8, 2022 at 11:47 am

    I struggled with MST/PTSD for many years. After a hard deployment was assisted in getting help from the VA. at first it was helpful. But after being assaulted by a male patient at the VA that help quickly vanished. Doors were closed to me and information was hidden. The counselor I had been seeing informed me she could not see me because it was a conflict. The struggle became too much and I quit my job. It led to my divorce, “I’m tired of your military sexual trauma drama”. No job, no family, no counselor. The Oklahoma City VA is just as dangerous to women as the women because they ignore or cover up their poor behavior.

    • Anonymous Source February 11, 2022 at 12:44 pm

      Ma’am, I believe you. Unfortunately I have had traumatic experiences dealing with the VA Health Care System. Harassment from male patients and male staff (Clinician’s, VA Police Officers, and even regular staff members). The women staff members, sometimes whom are jealous of the younger veteran women are nasty towards female veterans as well. Bad attitudes, cover ups of poor behavior from the VA, and outright malicious behavior towards female veterans. I do not trust the VA system at all.

      • Kelly February 28, 2022 at 2:33 pm

        Houston. So sorry you’re experiencing this. It’s not all VAs though. I’m in Northern California, grew up in Oklahoma City. I also received great care in Utah and Oregon too. Back in CA now, and am getting even better care, if that’s possible. Point is, call the hotline, and get information on your options. I’m also MST/PTSD. I’ve filed a claim and am in the appeal process. I’ve received nothing but support, so hang in there. Best wishes, Kelly

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