Exploring the acceptability of behavioral interventions for veterans with persistent “medically unexplained” physical symptoms

• Published in: Journal of psychosomatic research 2023-04, Vol.167, p.111193-111193, Article 111193
• Main Authors: Winograd, Darren M., Hyde, Justeen K., Bloeser, Katharine, Santos, Susan L., Anastasides, Nicole, Petrakis, Beth Ann, Pigeon, Wilfred R., Litke, David R., Helmer, Drew A., McAndrew, Lisa M.
• Format: Article
• Language: English
• Subjects: Behavior Therapy; Behavioral treatment; Chronic illness; Functional somatic disorders; Gulf War; Humans; Medically unexplained; Medically Unexplained Symptoms; Persian Gulf Syndrome - therapy; Persistent physical symptoms; Qualitative; Treatment acceptability; Veterans
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2023.111193

This study evaluated the factors that led to enrollment in, and satisfaction with, behavioral interventions for Veterans living with Gulf War Illness (GWI). One-on-one interviews were conducted pre- and post-intervention with participants randomized to receive either telephone delivered problem-solving treatment (n = 51) or health education (N = 49). A total of 99 Veterans were interviewed pre-intervention and 60 post-intervention. Qualitative data were thematically coded and similarities in themes across the two interventions were examined. Before the study began, participants reported desiring to learn new information about their GWI, learn symptom-management strategies, and support improvements to care for other patients with GWI. After the intervention, Veterans felt positively about both interventions because they built strong therapeutic relationships with providers, their experiences were validated by providers, and they were provided GWI information and symptom-management strategies. Results also suggested that interventions do not have to be designed to meet all of the needs held by patients to be acceptable. A minority of participants described that they did not benefit from the interventions. The results suggest that satisfaction with behavioral interventions for GWI is driven by a strong therapeutic relationship, validating patient's experiences with GWI, and the intervention meeting some of the patient's needs, particularly increasing knowledge of GWI and improving symptom management. •Veterans entered this clinical trial to learn about GWI and to help other Veterans.•Satisfactory behavioral treatments for GWI include a strong therapeutic rapport.•Validating Veteran's symptoms is important for satisfactory behavioral treatments.•Tailoring behavioral treatments to some of patients' treatment needs is important.