Developing an Integrative, Recovery-Based, Post-Acute COVID-19 Syndrome (PACS) Psychotherapeutic Intervention

项目摘要 目前，美国有3460万人，273，232名退伍军人在退伍军人事务部接受检测或治疗 感染COVID-19的设施。虽然急性COVID-19综合征（PACS）的确切患病率， 退伍军人是未知的，使用全球大样本的COVID-19估计精神病学/神经病学PACS 患者（N= 236，379）表明大约11，390，400名美国人和90，311名退伍军人的患病率 VA护理，随着时间的推移，利率可能会增加。此外，大规模研究表明，高达35%的人 在COVID-19后8个月出现功能障碍，感染后精神疾病患病率高 包括焦虑症抑郁症和创伤后应激障碍使用我们的纵向数据 学术分支机构，西奈山新冠肺炎登记处的伊坎医学院（n = 1200）和当地的詹姆斯·J·彼得斯（James J. Peters） VA的临床PACS计划，加上我们在恢复为基础的心理治疗的专业知识，我们是独一无二的 准备为与PACS斗争的退伍军人开发创新治疗方法。 我们的干预旨在改善对PACS症状的心理调整，促进恢复力， 应对，所有这些都可以影响功能状态和生活质量。PACS-CR（PACS-Coping and Recovery） 我们的干预目标是发展心理调整和应对的重点，并加强医疗， 康复和神经治疗。我们的方法是基于CHIME模型， 个人康复包括五个总体过程：1）连通性; 2）希望和乐观 （3）未来;（4）生命的意义;（5）权力。我们将使用 既定的心理治疗技术，如技能培训，基于接受和基于身份 原则 基于对现有基于恢复和COVID-19困境群体干预措施的调整，我们的团队 已经开发和试点，我们提出了一个治疗框架，包括12个90分钟的核心 课程（1x/周x12周），每周额外的专题课程是可选的。我们 提出一项治疗开发NIH 1A期研究，以开发急性后COVID-19综合征 心理治疗干预，“PACS应对和恢复”（PACS-CR）通过迭代开发 同时收集试点数据，以评估其可接受性和可行性。 我们的治疗开发SPiRE将专注于1）确定PACS退伍军人的治疗需求，2） 使用试点定性数据并在利益相关者反馈的帮助下制定治疗方法，3）完善 通过我们小组的三个迭代试点进行干预，在个人和远程保健版本中进行测试。前后 将采取措施跟踪功能改进情况以及这种以恢复为重点的 干预使退伍军人能够参与有意义的生活变化。

Project Abstract At present, 34.6 million people in the United States, and 273,232 Veterans tested or treated in Veteran Affairs facilities contracted COVID-19. While the exact prevalence of Post-Acute COVID-19 Syndrome (PACS) among Veterans is unknown, estimates of psychiatric/neurological PACS using a large global sample of COVID-19 patients (N=236,379) suggest a prevalence of approximately 11,390,400 Americans, and 90,311 Veterans in VA care, with rates likely to increase over time. Moreover, large scale studies suggest up to 35% of individuals experience functional impairment 8 months after COVID-19, and high prevalence of post-infection mental illness including anxiety disorders, depression, and post-traumatic stress disorder. Using longitudinal data from our academic affiliate, Icahn School of Medicine at Mount Sinai’s COVID registry (n≈1200), and local James J. Peters VA’s Clinical PACS program, coupled with our expertise in recovery-based psychotherapy, we are uniquely poised to develop an innovative treatment for Veterans struggling with PACS. Our intervention aims to improve psychological adjustment to PACS symptoms, promote resiliency, and facilitate coping, all of which can impact functional status and quality of life. The PACS-Coping and Recovery (PACS-CR) intervention we aim to develop focuses on psychological adjustment and coping, and augments medical, rehabilitative and neurological treatment for this population. Our approach is based on the CHIME model of personal recovery which includes five overarching processes: 1) Connectedness; 2) Hope and optimism about the future; 3) Identity; 4) Meaning in life; and 5) Empowerment. We will target the CHIME processes using established psychotherapeutic techniques such as skills training, acceptance-based and identity-based principles. Based on adaptations from existing recovery-based and COVID-19 distress group interventions that our team has developed and piloted, we are proposing a treatment framework that consists of a core of twelve 90-minutes sessions (1x/week x 12 weeks) with additional weekly sessions on specialized topics that are optional. We are proposing a treatment development NIH Stage 1A study to develop a Post-Acute COVID-19 Syndrome psychotherapeutic intervention, “PACS Coping and Recovery” (PACS-CR) through an iterative development process while collecting pilot data to assess its acceptability and feasibility. Our treatment development SPiRE will focus on 1) determining the treatment needs of Veterans with PACS, 2) developing the treatment using pilot qualitative data and aided by stakeholder feedback, 3) refining the intervention by three iterative pilots of our groups, testing both in person and telehealth versions. Pre and post measures will be utilized to track functional improvement and the degree to which this recovery-focused intervention has enabled the veterans to engage in meaningful life changes.