Pilot study of internet-based early intervention for combat-related mental distress

Benjamin W. Van Voorhees, Jackie Gollan, Joshua Fogel

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


This article evaluates an Internet-based early intervention combining online cognitive-behavioral therapy (CBT) with electronic peer-to-peer support intended to promote mental health and well-being among combat veterans. We conducted a phase 1 clinical trial of 50 Iraq and Afghanistan veterans using a pre and post single-arm design. We evaluated feasibility and changes in mental health symptoms (depression and posttraumatic stress disorder [PTSD]), functional status, and attitudes toward treatment seeking at baseline and weeks 4, 8, and 12. A diverse group of veterans was enrolled (26% ethnic minority, 90% male, 66% with income <$30,000/year, 88% with no prior treatment for depression). Participants completed a mean of 4 of 6 lessons (standard deviation = 2.54). From baseline to week 12, there were significant declines in the Center for Epidemiologic Studies-Depression scale score (effect size [ES] = 0.41) and PTSD Checklist-Military version score (ES = 0.53). There were significant improvements in willingness to accept diagnosis (ES = 1.08) and perceived social norms and stigma regarding friends (ES = 1.51). Although lack of a control group is a limitation, the Internet-based program combining CBT-based coping skills training and peer-to peer support demonstrated potential feasibility and evidenced benefit in symptom remediation for depression and PTSD.

Original languageEnglish (US)
Pages (from-to)1175-1190
Number of pages16
JournalJournal of Rehabilitation Research and Development
Issue number8
StatePublished - 2012


  • Cognitive therapy
  • Combat disorders
  • Depressive disorder
  • Early intervention (education)
  • Internet
  • Military personnel
  • Posttraumatic
  • Prevention and control
  • Stress disorders
  • Veteran health
  • Veterans

ASJC Scopus subject areas

  • Rehabilitation


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