VetChange: Helping Veterans Conquer Alcohol and PTSD

Guest: Monica Roy, Program Manager for Substance Abuse Residential Rehabilitation Treatment Program and Outpatient Alcohol and Drug Treatment Program, VA Boston Healthcare System

Topics Covered:
    •    Overview of the VetChange app and its purpose
    •    How the app addresses barriers to treatment for veterans
    •    Key tools such as the drink log, goal setting, and managing urges
    •    Educational resources on moderate drinking and the effects of trauma
    •    Integration with therapy and ongoing developmentKey

Takeaways:
    •    VetChange is a free, confidential app that provides veterans with the tools to monitor their drinking habits and develop healthier coping mechanisms.
    •    Features include a drink log, goal-setting tools, and strategies to manage urges in real-time.
    •    The app is evidence-based and designed to support veterans who may face barriers to accessing traditional in-person care.
    •    Upcoming developments include enhanced integration with therapy platforms for a more interactive experience.Resources:
    •    Visit VetChange.org to learn more about the app.
    •    Download the VetChange app on iPhone.
    •    Sign up for VA benefits at va.gov.
    •    For immediate support, contact the Vet Center Call Center: 1-877-WAR-VETS (1-877-927-8387).

Episode Transcript

(00:06):
The Department of Veterans Affairs here for a Benefits Breakdown.
This Benefits Breakdown is going to look into a product that VA created called VetChange.
VetChange is a free, confidential, online program to help Veterans cut back or stop
drinking and learn to manage PTSD symptoms without using alcohol.

(00:31):
What's important about this is, I think in the marketing speak there, the cut back or
stop drinking.
This is a way for Veterans and their support group to recognize that maybe alcohol is being
depended on too much for coping.
Someone like me may recognize that, hey, things are fine and life is okay, I'm dealing with

(00:55):
things all right, but I am drinking a little too much for my own physical health.
Any of those that, if you resonate with any of those ideas, VetChange can be a good way
to monitor and take control of your drinking.
We have Monica Roy from the VA Boston Healthcare System at the Jamaica Plain Campus.

(01:17):
She's the Program Manager for Substance Abuse Residential Rehabilitation Treatment Program.
Also the Program Manager for Outpatient Alcohol and Drug Treatment Program, but her role here
in the VetChange app was a subject matter expert.
She helped develop this, she informed on it.
She's going to tell us about the value of it, how it was created, how Veterans can get

(01:41):
the most out of it, the different aspects of it while both monitoring drinking and helping
Veterans manage other urges possibly.
So go to VetChange.org to check it out.
Thank you so much for taking the time to talk to me about VetChange.

(02:01):
Great.
Well, thank you for having me.
Can you briefly explain the conception of VetChange and how it became a product for VA?
Sure.
So we basically wanted to provide a self-help type of platform where Veterans could receive

(02:22):
the same type of treatment they'd receive if they came in and saw a clinician in the VA.
So the skills that are on the app or our website are really the skills that I would use with
a patient who's coming in to see me in person to work on their alcohol use.
So we wanted to make this website an app for Veterans where there may be barriers for coming

(02:46):
in to treatment.
So if someone is far away from a VA or really not quite sure if they want to change so they
could just be curious about their drinking because we have a lot of assessments and feedback
on pieces of the app or if they really are experiencing shame related to the stigma of

(03:06):
substance use and can't bring themselves into the facility.
So we wanted to get to all of those Veterans out there who may not be coming into the VA
and meeting with someone individually.
Can you help explain sort of what goes into assessing a person's alcohol consumption and

(03:28):
how to help them better understand what exactly is going on in their behavior and how to manage
it?
Sure.
So we have a few different ways that we do assessments.
So on the app, when you first open the app, you are asked about how much you're drinking
and how often.

(03:49):
And then immediately given feedback whether this really fits into the kind of the moderate
drinking guidelines.
And these are put forth by NIAAA and if not, what you might be at risk for.
So there is research out there showing that if a person is drinking over a certain amount

(04:12):
that they may be at risk for certain health related consequences or kind of relationship
consequences.
So while someone may not be experiencing that right now, there may be the risk of experiencing
this later down the road.
The other way that the app kind of helps to assess and provide kind of immediate feedback

(04:32):
is that one of the primary interventions that's used right on the home page, so the moment
you open the app is a self-monitoring log or a drink log is what we call it.
So as a person is drinking, they're actually kind of adding in how many drinks they're

(04:54):
having.
So if they have one drink, they put right into the drink log one drink.
And that helps users to be able to start to notice, are there patterns related to my drinking?
Are there certain times of the week I'm drinking more?
Are there certain times of the week I'm drinking more and the next day maybe I'm feeling having
some feelings about that or I had some problems?

(05:16):
So starting to identify those patterns.
Is there any part of the app that helps the veteran maybe recognize or understand alternatives
to drinking or what to do when faced with the strong desire to drink?

(05:37):
Definitely.
So actually, some key components to the app are also skills that can be used in the moment.
So that we have a piece of the app that's called Manage an Urge and under that are
three different sets of skills.
So creating a plan ahead of time of how you, if you know you're going into a situation

(05:59):
where you may be more likely to drink more than the goal that you set, having a plan
ahead of time of how am I going to deal with this?
How am I possibly going to get out of the situation or can I actually drink a soda or
water in between drinks?
So kind of having that written down so that in the moment when a person might want to

(06:22):
drink more, they can take a look at what was the plan.
The other skill that we have is the Distract Yourself skill where you actually set a timer
for 15 minutes and there's a list of distraction ideas.
So the idea is if you want to have that drink, but if you can wait those 15 minutes, find

(06:43):
different ways of distracting yourself, that thought, urge or craving will pass.
So really, and also just kind of pacing the drinking by waiting 15 minutes in between
drinks.
And then we have another skill called Reasons to Change where you kind of identify what
are some of those motivating factors.

(07:05):
You know, you can upload pictures of things or people that keep you motivated.
So you can take a look at that if you feel like you're about to exceed your goal.
And then we also have a whole set of tools to help to cope with some of the feelings
that come up in the aftermath of trauma.
Hopefully that answers your question.
Yeah, it does.

(07:25):
I know that there's a browser version of someone can use like on a laptop or a desktop.
You mentioned that we know there's an app.
I know the app is available for the iPhone and the iOS.
Are there other versions as well for the other platforms?
I think currently we only have it on the iPhone.

(07:48):
I don't think we have the Android yet.
And we do have a website version.
And in fact, the website was the original version.
And we built the app off of the website, kind of identifying the skills we thought would
be most helpful to have in the moment when someone's out and kind of has their phone

(08:08):
in their hand.
So those are the skills that are on the app.
Yeah, I don't know if I primed you for this question.
So feel free to think about it or even defer.
But what like what benefits are there to this exercise of controlling or being aware of
drinking that actually extends beyond just the drinking habit?

(08:29):
So sometimes in therapy, we kind of think of an urge as an urge.
So if it's an urge to drink or an urge to smoke a cigarette, these are tools that probably
can be used in those different areas.
So that idea of logging drinks, having a goal ahead of time, kind of preparing oneself if

(08:52):
they have a goal of kind of knowing what the risk is of exceeding that goal.
I think all of these are skills that can be used in different ways and kind of building
self-awareness.
I think also just starting to notice patterns.
You know, if someone is experiencing trauma symptoms, when are those more likely to come
out and developing coping skills for that?

(09:16):
Because there may be many different ways someone's coping with trauma symptoms.
So this app can actually help to start to hone in on that as well.
You know, when am I experiencing difficulty sleeping or nightmares?
How am I coping?
Are there better ways of coping or more healthy ways of coping?
Is there more that VA is trying to do with this app as far as development or do we feel

(09:38):
like this is polished and where it needs to be?
Sure.
So there's actually a couple of different projects that our group has coming up.
One, I can talk about the website because then that does actually impact the app.
We are currently developing a part of our website that is now going to be used with

(10:03):
therapy and counseling.
So the website will be able to be accessed if someone comes into therapy and they decide
with their therapist that they're going to be using that change.
There will be the therapist and the veteran can interact on the website together.

(10:24):
So kind of assigning different homework assignments, looking at how the drink lock looks
midweek before therapy starts.
And then also, we're going to be building an app that actually interacts directly with
the website.
So right now, I do want to stress that the app that we have does not communicate with
the website we currently have.

(10:44):
So if someone does log drinks in this app, it does not automatically go to the vet change
website.
But one of our projects moving forward is that we are going to be developing a platform
where the app does communicate with the website and vice versa.
Yeah, because I definitely I think anybody who uses an iPhone definitely knows the there's

(11:05):
definitely convenience in being able to log things right away as they're happening on
your phone.
But also when it comes to like reviewing the data, that's almost it's easier on the
computer.
So wonderful.
Well, Monica, thank you so much for your time and telling us about the vet change app and
how veterans can benefit from it.