NCT07555275

Brief Summary

Veterans with schizophrenia spectrum disorders who experience psychosis struggle with social integration- e.g., participation in work, housing, and citizenship-due to symptoms, stigma, and psychosocial functioning deficits. Veteran Voices and Visions (VVV) is a psychosocial, peer-led group intervention for Veterans with psychosis based that reduces distress related to psychosis and fosters a sense of belonging for Veterans living with psychosis. VVV destigmatizes psychosis; reframes symptoms; and introduces personalized, meaningful coping strategies enabling social interaction. The investigators will assess VVV's efficacy in a trial comparing recipients of VVV to another peer-led group, Wellness Recovery Action Planning (WRAP), on outcomes of distress from psychosis, sense of belonging, and social functioning while identifying contextual factors regarding implementation at two sites. The investigators hypothesize that proximal reduction in distress and increased sense of belonging results in improvements in social functioning.

Trial Health

63
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
160

participants targeted

Target at P75+ for not_applicable

Timeline
43mo left

Started Apr 2027

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 21, 2026

Completed
8 days until next milestone

First Posted

Study publicly available on registry

April 29, 2026

Completed
11 months until next milestone

Study Start

First participant enrolled

April 1, 2027

Expected
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 29, 2030

6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2030

Last Updated

April 29, 2026

Status Verified

April 1, 2026

Enrollment Period

3 years

First QC Date

April 21, 2026

Last Update Submit

April 21, 2026

Conditions

Keywords

Psychotic Disordershallucinations, auditorysocial isolationVeterans

Outcome Measures

Primary Outcomes (3)

  • Psychotic Symptom Rating Scale for Auditory Hallucinations (PSYRATS-AH)

    PSYRATS-AH is an 11-item subscale assessing frequency, duration, severity, loudness, location, negative content, controllability of voices, intensity of distress, beliefs about origin of voices, and disruption. Items are rated on a five-point ordinal scale (0-4), range is 0 to 44. Higher score means worse distress. PSYRATS has strong inter-rater reliability (r ⩾ 0.9), test-retest reliability (0.55-0.74), and good validity (0.63-0.76). It is the gold standard for assessment of AH and the main finding from the initial VVV pilot study.

    12 and 24 weeks

  • The Sense of Belonging Inventory-Psychological Experiences (SOBI-P)

    The SOBI-P is a reliable measure of belonging that consists of 18 items on a 4-point Likert response scale and it is used widely in SSD.

    12 and 24 weeks

  • The Role Functioning Scale (RFS)

    This is a distal primary outcome. The Role Functioning Scale (RFS) is a broad global integration index across the domains of work, independent living, and family/social networks that ranges from 1 (worst) to 7 (best). It has established reliability and validity in Schizophrenia Spectrum Disorders. The total score for the RFS is calculated by summing the subscales, resulting in a range of 0-28, where higher scores indicate better functioning.

    12 and 24 weeks

Study Arms (2)

Veteran Voices and Visions (VVV)

EXPERIMENTAL

This is a group-based, peer specialist and clinician co-facilitated psychosocial intervention for Veterans with serious mental illness (SMI), called "Veteran Voices and Visions" (VVV). VVV is an adaptation of a community-based support group model called the Hearing Voices (HV) approach. The approach facilitates group cohesion around and normalization of the common psychotic symptoms of hallucinations, delusions, and social isolation.

Behavioral: Veteran Voices and Visions (VVV)

Wellness Recovery Action Planning (WRAP)

ACTIVE COMPARATOR

Wellness Recovery Action Planning (WRAP) is a peer-led, structured self-management and recovery program designed for serious mental illness delivered in weekly group sessions for 8-12 weeks. It covers personalized wellness strategies, identification of warning signs for re-lapse, and crisis plans. It has improved overall distress due to psychiatric symptoms, quality of life, and hope. A systemic review and meta-analysis concluded WRAP reliably improves subjective recovery outcomes but not symptoms. WRAP is not tailored to psychosis.

Behavioral: Wellness Recovery Action Planning (WRAP)

Interventions

This is a group-based, peer specialist and clinician co-facilitated psychosocial intervention for Veterans with SMI, called "Veteran Voices and Visions" (VVV). VVV is an adaptation of a community-based support group model called the Hearing Voices (HV) approach. The approach facilitates group cohesion around and normalization of the common psychotic symptoms of hallucinations, delusions, and social isolation.

Also known as: VVV
Veteran Voices and Visions (VVV)

Wellness Recovery Action Planning (WRAP) is a peer-led, structured self-management and recovery program designed for serious mental illness delivered in weekly group sessions for 8-12 weeks. It covers personalized wellness strategies, identification of warning signs for re-lapse, and crisis plans. It has improved overall distress due to psychiatric symptoms, quality of life, and hope. A systemic review and meta-analysis concluded WRAP reliably improves subjective recovery outcomes but not symptoms. WRAP is not tailored to psychosis.

Also known as: WRAP
Wellness Recovery Action Planning (WRAP)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Has been experiencing auditory hallucinations at least weekly within the past 6 months that are not exclusively due to substance use
  • English fluency sufficient for participating in groups
  • Able to provide consent

You may not qualify if:

  • Psychosis exclusively due to substance use
  • Clinically significant seizure disorder, traumatic brain injury, dementia, developmental disorder/intellectual disability
  • Inability to provide informed consent for any reason, including due to acute psychosis, mania, or dementia, or active guardianship or durable power of attorney
  • Plan to transfer or terminate care in the next 3 months
  • Has previously attended a VVV group

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073-1003, United States

Location

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, 15240, United States

Location

MeSH Terms

Conditions

Psychotic DisordersHallucinationsSocial Isolation

Interventions

Vision, Ocular

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic DisordersMental DisordersPerceptual DisordersNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsSocial BehaviorBehavior

Intervention Hierarchy (Ancestors)

Light Signal TransductionSignal TransductionBiochemical PhenomenaChemical PhenomenaCell Physiological PhenomenaSensationNervous System Physiological PhenomenaMusculoskeletal and Neural Physiological PhenomenaOcular Physiological Phenomena

Study Officials

  • Ippolytos A Kalofonos, MD PhD MPH

    VA Greater Los Angeles Healthcare System, West Los Angeles, CA

    PRINCIPAL INVESTIGATOR
  • Matthew J Chinman, PhD

    VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Ippolytos A Kalofonos, MD PhD MPH

CONTACT

Erica H Fletcher, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Although participants and care providers will know to which condition participants have been assigned, research assistants responsible for all assessments will be blinded to study group assignment.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This is a 4-year hybrid 1 efficacy trial comparing VVV and WRAP across two sites. A hybrid 1 trial is when an intervention is tested for efficacy while collecting implementation data that could inform future delivery in real-world settings.
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 21, 2026

First Posted

April 29, 2026

Study Start (Estimated)

April 1, 2027

Primary Completion (Estimated)

March 29, 2030

Study Completion (Estimated)

September 30, 2030

Last Updated

April 29, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will share

The PI will create de-identified, study-specific datasets that include all variables in a publication. Some loss of information might occur given the need to remove protected health information (PHI). The PI will replace social security and medical station numbers with study-specific numbers. The PI will drop date of birth and replace age with age categories, in accordance with PHI requirements for people 85 years of age and older. Dates of service will be replaced with year dummies.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
Datasets meeting VA standards for disclosure to the public will be made available within 1 year of publication.
Access Criteria
Prior to distribution, a local privacy officer will certify that all datasets contains no PHI. Final data sets will be maintained locally until enterprise level resources become available for long-term storage and access. Guidance on request and distribution processes will be provided by VA Office of Research and Development (ORD). Those requesting data will be asked to sign a Letter of Agreement.

Locations