Financial Incentives for Veteran Therapy Completion

NCT06234371 | Enrolling By Invitation

• 1 other identifier: 21-05-6633
• Study Type: interventional
• Target: 600
• Locations: 1 country
• Sites: 3

Brief Summary

Recovery Resource Council (RRC) is one of the largest and most comprehensive non-profit mental and behavioral healthcare providers in North Texas. Accredited by the Joint Commission in Behavioral Health and licensed by the State of Texas as an Outpatient Treatment Center, RRC strives to promote wellness and recovery through a variety of services and programming. An important component of RRC programming is providing free counseling services to hundreds of U.S. veterans annually. While RRC observes great success for veterans who complete counseling, attendance can be a major obstacle. Veterans who approach RRC for individual counseling services and consent to participate will be randomly assigned to the treatment or control group. The control group will receive counseling as usual. The treatment group will receive $500 gift card payments upon completing their 6th, 12th, and 18th counseling sessions, i.e., $1,500 in gift cards for completing all 18 sessions, the usual prescribed length of therapy. Our primary focus is to examine the impact of the financial incentives on therapy attendance and attrition. In addition, the investigators will estimate the impact on mental health using mental health inventories collected over the course of therapy sessions.

Conditions

Motivation; Stress Disorder; Post Traumatic Stress Disorder; Depression; Depressive Disorder

Keywords

Veterans; Outpatients; Counseling

Outcome Measures

Primary Outcomes (2)

• Number of counseling sessions attended

  Total number of counseling sessions attended

  1 year following randomization

• Completion of therapy

  An indicator variable for completion of therapy will be constructed using discharge codes that RRC assigns to each patient. In particular, there is a discharge code for program completion (regardless of the number of sessions).

  1 year following randomization

Secondary Outcomes (3)

• Completion of every possible number of counseling sessions

  1 year following randomization

• Start-of-Session Mental Health Index and sub-components

  1 year following randomization

• Expected cost and benefit of therapy

  1 year following randomization

Study Arms (2)

Treatment

EXPERIMENTAL

The treatment group will be offered a $500 gift card for completing 6, 12, and 18 counseling sessions; up to $1,500 in total. Because RRC's typical practice involves prescribing and scheduling counseling in 6-session blocks, the financial awards are revealed to veterans in the treatment group in stages. After intake, treatment group individuals are told that they will receive a $500 gift card for completing the first 6 sessions; later sessions and awards are not mentioned. If the counselor decides that another 6-session block should be prescribed, then at the completion of the 5th session (i) the next 6 sessions are scheduled (i.e., sessions 7 through 12) and (ii) the counselor reveals that the participant can earn another $500 for completing the 12th session. The same process takes place during session 11. As part of RRC's typical practice, no veterans are offered more than 18 sessions.

Behavioral: Financial Incentive

Control

NO INTERVENTION

The control group will have access to the normal counseling services provided by RRC staff. Those in the control group will receive "business as usual" services offered by the RRC, which includes the same counseling services and evaluation of how many sessions an individual is recommended to receive.

Interventions

Financial Incentive BEHAVIORAL

The intervention is offering a $500 gift card as an incentive for completing 6 counseling sessions to eligible individuals randomized into the treatment group. Another $500 gift card will be given after completing 12 counseling sessions, and another $500 gift card will be given after completing 18 counseling sessions.

Treatment

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Voluntarily agree to participation requirements outlined in the informed consent form
• years of age or older
• Holds veteran status
• Possesses and is willing to share SSN
• Possesses and is willing to share an active email address
• Individual is not screened out by RRC - i.e., RRC would agree to provide services independent of the research study
• Is participating in individual counseling

You may not qualify if:

• Individuals who are not interested in participating
• Individuals who do not consent
• Individuals posing a significant suicide risk

Sponsors & Collaborators

• Christopher Cronin: lead
• University of Georgia: collaborator

Study Sites (3)

Recovery Resource Council East Campus

Dallas, Texas, 75247, United States

Location

Recovery Resource Council North Campus

Denton, Texas, 76209, United States

Location

Recovery Resource Council West Campus

Fort Worth, Texas, 76111, United States

Location

MeSH Terms

Conditions

Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic; Depression; Depressive Disorder

Condition Hierarchy (Ancestors)

Trauma and Stressor Related Disorders; Mental Disorders; Behavioral Symptoms; Behavior; Mood Disorders

Study Officials

• Christopher Cronin, PhD

  University of Notre Dame

  PRINCIPAL INVESTIGATOR

• Ethan Lieber, PhD

  University of Notre Dame

  PRINCIPAL INVESTIGATOR

• Meghan Skira, PhD

  University of Georgia

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor

Model Details: After participants give consent, they are enrolled in the study. Randomization will be done via the Qualtrics platform. The treatment group will be offered a $500 gift card for completing 6, 12, and 18 counseling sessions; up to $1,500 in total. Because RRC's practice involves prescribing and scheduling counseling in 6-session blocks, the financial awards are revealed to veterans in the treatment group in stages. After intake, treatment group individuals are told that they will receive a $500 gift card for completing the first 6 sessions. If the counselor decides that another 6-session block should be prescribed, then at the completion of the 5th session (i) the next 6 sessions are scheduled and (ii) the counselor reveals that the participant can earn another $500 for completing the 12th session. The same process takes place during session 11. Other than informing individuals in the treatment group of the gift cards, counseling services will not change as a result of this study.

Study Record Dates

• First Submitted: January 2, 2024
• First Posted: January 31, 2024
• Study Start: January 2, 2024
• Primary Completion (Estimated): January 2, 2027
• Study Completion (Estimated): January 2, 2028
• Last Updated: June 18, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (3)