Development of a Family-Based, Post-Deployment Intervention

描述(申请人提供)：随着在伊拉克和阿富汗的持续军事行动，从这些战区返回的军事人员的数量正在增加。部署回国的军事人员在心理社会功能和精神症状方面面临各种损害的重大风险。此外，返回的军事人员的家属，特别是婚姻/恋爱伴侣也经历了严重的痛苦和伤害。相对较少的研究侧重于减少未经挑选的返乡军人样本中的这些损害，以前没有任何研究专门将干预努力集中在返乡军人的家庭制度上。该项目力求通过为回返的军事人员及其伙伴制定一种简短、易于管理、以家庭为基础的干预措施来满足这些需要。更具体地说，本项目提议调整以前开发的家庭干预电话跟踪干预，以便利经历其他类型重大过渡事件的患者和配偶之间的适应，以适应战区部署后士兵和海军陆战队返回家园的过渡。按照目前的构想，这一调整后的干预家庭干预电话跟踪-部署调整(FITT-DR)将包括与这对夫妇举行一次会议，然后给返回人员及其伴侣打一系列电话。这些呼吁将侧重于监测和解决特定领域的问题，这些领域被确定为返回的军事人员及其重要其他人员面临的重要问题。更具体地说，这项建议的总体目标是进一步发展FITT-DR干预措施，并收集关于该干预计划有效性的初步数据。我们建议：1.为FITT-DR干预制定一份全面的和临床相关的手册。2.制定、实施和评估供应商培训计划。3.编制和测试依从性和能力评定量表的信度和效度，以评估提供者对干预手册的遵守情况以及他们提供干预的能力。4.对返回的军事人员及其合作伙伴进行随机对照试点研究，以：(A)评估拟议干预措施的可行性和可接受性，以及(B)估计FITT-DR与常规治疗相比的疗效大小，以减少：a)心理社会功能障碍和b)精神症状。这项先导性研究将为评估这种针对回国军人的新干预措施进行更大规模的临床试验奠定基础。

DESCRIPTION (provided by applicant): With the continuing military engagements in Iraq and Afghanistan, the number of returning military personnel from these war zones is increasing. Military personnel returning home following deployment are at significant risk for a wide variety of impairments in psychosocial functioning and psychiatric symptoms. In addition, family members of returning military personnel, and particularly marital/romantic partners also experience significant levels of distress and impairment. Relatively few studies have focused on reduction of these impairments among unselected samples of returning military personnel, and no previous study has specifically focused intervention efforts on the family system of returning personnel. This project seeks to address these needs by developing a brief, easily administered, family-based intervention for returning military personnel and their partners. More specifically, the current project proposes to adapt the Family Intervention Telephone Tracking (FITT) intervention, previously developed to facilitate adaptation among patients and spouses experiencing other types of major transitional events, to the transition of soldiers and marines returning home following war zone deployment. As currently conceptualized, this adapted intervention Family Intervention Telephone Tracking-Deployment Readjustment (FITT-DR) will consist of 1 meeting with the couple followed by a series of telephone calls to the returning personnel and his/her partner. These calls will focus on monitoring and problem-solving targeted to specific areas identified as important issues facing returning military personnel and their significant others. More specifically, the overall aim of this proposal is to further develop the FITT-DR intervention and to collect preliminary data on the efficacy of this intervention program. We propose to: 1. Develop a comprehensive and clinically relevant manual for the FITT-DR intervention. 2. Develop, implement and evaluate a provider training program. 3. Develop and test the reliability and validity of adherence and competence rating scales to evaluate providers' adherence to the intervention manual and their competence in delivering the intervention. 4. Conduct a randomized controlled pilot study in a sample of returning military personnel and their partners to: a) assess the feasibility and acceptability of the proposed intervention, and b) to provide an estimate of effect size of the efficacy of FITT-DR in comparison to treatment as usual reducing: a) impairments in psychosocial functioning and b) psychiatric symptoms. This pilot study will lay the groundwork for a larger clinical trial evaluating this new intervention for returning military personnel.