Benefits Counseling to Preserve Function Among Disability Applicants

NCT ID: NCT00715650

Last Updated: 2016-03-11

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 92 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2008-12-31
• Study Completion Date: 2015-12-31

Brief Summary

This study will address the problem that claimants with psychiatric disabilities who apply for and receive disability benefits go on to work less than those whose claims are denied.

Detailed Description

The objective of this research is to conduct a 6-month randomized clinical trial comparing participants assigned to Benefits Counseling and to those assigned to the control condition, VA Orientation. Benefits Counseling is an adaptation of two counseling approaches to foster veterans' involvement in work and work-related activity compared to the control condition, VA Orientation. The first approach helped recipients of Social Security disability benefits for psychiatric illness return to work in part by alleviating beneficiaries' concerns that they would lose their benefits if they worked. The second approach is a Motivational Interviewing approach that showed great promise in engaging veterans with psychiatric disabilities in compensated work therapy.

Conditions

Veterans' Disability Claims

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Arm 1

This counseling consists of four sessions each approximately 60 minutes each. The four sessions are organized as follows: a) Orientation to Benefits Counseling: Your Benefits and Your Goals b) Work and Claims c) Financial Review: Implications of Your Work Plan and d) Your Plans After the Benefits Notice. The first session focuses on the disability application process as a non-confrontational way to explore attitudes towards work. The second session more directly addresses the claimant's attitudes about work and beliefs about whether work will prevent receipt of disability benefits. The third session addresses the same issue as the second, ambivalence about work and disability, from a financial perspective. The fourth session occurs after the disability determination has been made, and it is possible the veteran may feel differently about a benefit that has been awarded.

Group Type: EXPERIMENTAL

Benefits Counseling

Intervention Type: BEHAVIORAL

Benefits counseling is designed to improve the quality of life of disability applicants by accomplishing two functions: 1) Providing information concerning what vocational rehabilitation services are available and how they will affect receipt of disability payments, 2) Amplifying applicants' existing motivation to engage in work and related-activities, using a Motivational Interviewing approach.

Arm 2

This will consist of four-session orientation with the sessions organized as follows: a) overview of VHA services, b) Primary Care c) Pharmacy and laboratory services and d) specialty services. After the description of each service, participants will be invited to discuss which services they plan to utilize. The counselor will provide telephone numbers and directions to the sites at which these services are provided.

Group Type: ACTIVE_COMPARATOR

VA Orientation

Intervention Type: BEHAVIORAL

VA Orientation is designed to provide the Veteran with information regarding the services available, how to access the services and where the service is located on the VA campus.

Interventions

Benefits Counseling

Benefits counseling is designed to improve the quality of life of disability applicants by accomplishing two functions: 1) Providing information concerning what vocational rehabilitation services are available and how they will affect receipt of disability payments, 2) Amplifying applicants' existing motivation to engage in work and related-activities, using a Motivational Interviewing approach.

Intervention Type: BEHAVIORAL

VA Orientation

VA Orientation is designed to provide the Veteran with information regarding the services available, how to access the services and where the service is located on the VA campus.

Intervention Type: BEHAVIORAL

Other Intervention Names

Motivational Interviewing; New patient orientation

Eligibility Criteria

Inclusion Criteria

• Has never received VBA benefits
• Able to provide valid consent
• Expresses willingness to discuss benefits with a counselor
• Difficulty working as evidenced by a "Yes" to either (a), (b), or (c) of the question below about work-related difficulties: During the past 4 weeks, have you had any of the following problems (such as feeling depressed and anxious):

• Cut down on the amount of time you spent on work or other activities?
• Accomplished less than you would like?
• Didn't do work or other activities as carefully as usual?
• Expresses willingness to try Benefits Counseling if assigned to it
• An evaluation by a psychiatrist or psychologist is scheduled

Exclusion Criteria

• Already receiving VA payments
• Already receiving SSI or SSDI payments
• Has a conservator

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Yale University

OTHER

Sponsor Role: collaborator

VA Office of Research and Development

FED

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Marc I. Rosen, MD

Role: PRINCIPAL_INVESTIGATOR

VA Connecticut Healthcare System West Haven Campus, West Haven, CT

Locations

VA Connecticut Healthcare System West Haven Campus, West Haven, CT

West Haven, Connecticut, United States

Countries

United States

References

Meshberg-Cohen S, Reid-Quinones K, Black AC, Rosen MI. Veterans' attitudes toward work and disability compensation: associations with substance abuse. Addict Behav. 2014 Feb;39(2):445-8. doi: 10.1016/j.addbeh.2013.09.005. Epub 2013 Sep 11.

Reference Type: RESULT

PMID: 24090622 (View on PubMed)

Rosen MI, Ablondi K, Black AC, Mueller L, Serowik KL, Martino S, Mobo BH, Rosenheck RA. Work outcomes after benefits counseling among veterans applying for service connection for a psychiatric condition. Psychiatr Serv. 2014 Dec 1;65(12):1426-32. doi: 10.1176/appi.ps.201300478. Epub 2014 Oct 31.

Reference Type: RESULT

PMID: 25082304 (View on PubMed)

Other Identifiers

D6432-R

Identifier Type: -

Identifier Source: org_study_id