Telephone-Based Versus In-Person Delivery of Cognitive Behavioral Treatment for Veterans with Chronic Multisymptom Illness: A Controlled, Randomized Trial

ABSTRACTThe goal of this randomized clinical trial was to examine the efficacy of a cognitive behavioral stress reduction treatment for reducing disability among veterans with chronic multisymptom illness (CMI). Veterans (N = 128) who endorsed symptoms of CMI were randomized to: usual care (n = 43), in-person (n = 42), or telephone-delivered cognitive behavioral stress management (n = 43). Assessments were conducted at baseline, 3 months, and 12 months. The primary outcome was limitation in roles at work and home (i.e., “role physical”). Reductions in catastrophizing cognitions were evaluated as a mechanism of action. Intent-to-treat analyses showed no statistically significant main effect, F(2, 164) = .58, p = .56, or interaction effect, F(4,164) = .94, p = .45, for role physical. Over time, veterans improved in their physical function, F(2,170) = 5.34, p < .01; η2partial = .06, posttraumatic stress disorder (PTSD) symptoms, F(2,170) = 9.39, p < .01; η2partial = .10, depressive symptoms, F(2,170) = 10.81...