Improving Money Management Skills for Veterans With Psychiatric Disabilities

This study has been completed.
Sponsor:
Collaborators:
Duke University
Durham VA Medical Center
Information provided by (Responsible Party):
Eric Elbogen, PhD, University of North Carolina, Chapel Hill
ClinicalTrials.gov Identifier:
NCT01352624
First received: May 10, 2011
Last updated: September 5, 2014
Last verified: September 2014
  Purpose

Veterans with psychiatric disabilities face unique challenges concerning money management. Financial strain, money mismanagement, and homelessness have been well documented among veterans with psychiatric disabilities and linked to poor outcomes. The investigators' long-term goal is to promote recovery among veterans with psychiatric disabilities by addressing an 'unmet need' of developing basic money skills necessary for independent functioning in living, working, and social environments. The investigators' objective in the current application is to rigorously evaluate a pilot-tested, stakeholder-informed intervention grounded in principles of psychiatric rehabilitation designed to help develop money management skills and informed financial judgment among veterans with psychiatric disabilities. $teps for Achieving Financial Empowerment ($AFE) is an individualized, psycho-educational intervention that aims to teach veterans with psychiatric disabilities how to save money, create a viable budget, avoid money scams and financial exploitation, and access vocational and mental health resources. To evaluate the $AFE, the investigators will randomly assign N=200 veterans with psychiatric disabilities to either (a) the $AFE intervention (n=100); or (b) a "usual care" control (n=100). The investigators will interview veterans with psychiatric disabilities at baseline and six months. The investigators' central hypothesis, based on strong preliminary data, is that by fostering financial skills and judgment, the $AFE will concurrently increase employment, boost work motivation, and reduce disablement. If these outcomes are met, the investigators hypothesize the intervention will also lead to reduced psychiatric symptoms and homelessness among veterans with psychiatric disabilities.


Condition Intervention
Psychiatric Problem
Behavioral: $AFE

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Improving Money Management Skills for Veterans With Psychiatric Disabilities

Further study details as provided by University of North Carolina, Chapel Hill:

Primary Outcome Measures:
  • Employment [ Time Frame: Past six months ] [ Designated as safety issue: No ]
    Any part time or full time employment between baseline interview and follow-up interview


Secondary Outcome Measures:
  • Financial savings [ Time Frame: Past Six months ] [ Designated as safety issue: No ]
    Amount of money saved between baseline and follow-up interview

  • Financial Debt [ Time Frame: Past six months ] [ Designated as safety issue: No ]
    Amount of unsecured debt incurred between baseline and follow-up interviews

  • Homelessness [ Time Frame: Past Six Months ] [ Designated as safety issue: No ]
    Homeless and/or living in a homeless shelter for at least one day between baseline and follow-up


Enrollment: 183
Study Start Date: April 2011
Study Completion Date: September 2014
Primary Completion Date: September 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Experimental
$teps for Achieving Financial Empowerment ($AFE)
Behavioral: $AFE
$teps for Achieving Financial Empowerment ($AFE) is an individualized, psycho-educational intervention that aims to teach veterans with psychiatric disabilities how to save money, create a viable budget, avoid money scams and financial exploitation, and access vocational and mental health resources.
No Intervention: Usual Care
Veterans in control arm will receive usual care at VA

Detailed Description:

Veterans with psychiatric disabilities face unique challenges concerning money management. Not only do they encounter problems as do non-veterans with psychiatric disabilities; for example, they may possess limited financial experience due to longstanding dependence on family or have limited money skills related to cognitive deficits. But since veterans can receive disability benefits from both the Veteran's Administration (VA) and the Social Security Administration (SSA), the added income paradoxically exposes veterans to greater risk of severe debt and financial exploitation. To compound this problem, VA and SSA policies for working while disabled differ, often change, and thus can be misunderstood in ways that potentially reduce incentives to seek employment.

Financial strain, money mismanagement, and homelessness have been well documented among veterans with psychiatric disabilities and linked to poor outcomes. Hundreds of thousands of veterans have psychiatric disabilities - a number likely to grow as a substantial proportion of troops return from Iraq and Afghanistan. Yet little systematic research has examined how to help veterans with psychiatric disabilities learn tangible skills needed to maintain financial stability in the community. Our long-term goal is to promote recovery among veterans with psychiatric disabilities by addressing an 'unmet need' of developing basic money skills necessary for independent functioning in living, working, and social environments.

Our objective in the current application is to rigorously evaluate a pilot-tested, stakeholder-informed intervention grounded in principles of psychiatric rehabilitation designed to help develop money management skills and informed financial judgment among veterans with psychiatric disabilities. $teps for Achieving Financial Empowerment ($AFE) is an individualized, psycho-educational intervention that aims to teach veterans with psychiatric disabilities how to save money, create a viable budget, avoid money scams and financial exploitation, and access vocational and mental health resources.

To evaluate the $AFE, the investigators will randomly assign N=200 veterans with psychiatric disabilities to either (a) the $AFE intervention (n=100); or (b) a "usual care" control (n=100). The investigators will interview veterans with psychiatric disabilities at baseline and six months. Our central hypothesis, based on strong preliminary data, is that by fostering financial skills and judgment, the $AFE will concurrently increase employment, boost work motivation, and reduce disablement. If these outcomes are met, the investigators hypothesize the intervention will also lead to reduced psychiatric symptoms and homelessness among veterans with psychiatric disabilities.

The investigators are well prepared to pursue this study because of our peer-reviewed research in this area and success in completing large-scale empirical studies of veterans and non-veterans with psychiatric disabilities. The current research is innovative because it will lead to a brief, targeted, cost-effective, feasible procedure for helping veterans potentially become less reliant on disability funds and more likely to work, gaining independence in the community.

At the end of this project, the investigators expect to show that a systematic, evidence-based approach can greatly bolster self-determination and empowerment for veterans with psychiatric disabilities. The investigators plan to construct a user-friendly, transportable manual so clinicians can readily implement the $AFE intervention. The investigators anticipate the primary impact of this study will be evaluation of a novel and effective method to promote independent living and employment and maximize full society integration among veterans with psychiatric disabilities.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18-65 years
  • Veteran
  • Receives disability for psychiatric or cognitive condition from either the VA or SSA
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01352624

Locations
United States, North Carolina
Duke University
Durham, North Carolina, United States, 27701
Sponsors and Collaborators
University of North Carolina, Chapel Hill
Duke University
Durham VA Medical Center
Investigators
Principal Investigator: Eric Elbogen, Ph.D. UNC-Chapel Hill
Principal Investigator: Eric Elbogen, Ph.D. UNC Chapel Hill
  More Information

Additional Information:
No publications provided

Responsible Party: Eric Elbogen, PhD, Associate Professor, University of North Carolina, Chapel Hill
ClinicalTrials.gov Identifier: NCT01352624     History of Changes
Other Study ID Numbers: H133G100145
Study First Received: May 10, 2011
Last Updated: September 5, 2014
Health Authority: United States: Institutional Review Board

ClinicalTrials.gov processed this record on September 16, 2014