A Qualitative Study of Veteran and Provider Perspectives on a Novel Acute Care Transitions Intervention for Co-Occurring Mood and Substance Use Disorders

Abstract

The Integrated Treatment Adherence Program (ITAP) is a novel psychosocial intervention designed to strengthen post-acute care transitions for individuals with co-occurring mood and substance use disorders (Mood-SUD). As an adjunctive treatment, ITAP integrates elements of individual therapy, family support, and case management for six months following an acute care transition. This qualitative study explored stakeholder perspectives on ITAP as part of a larger hybrid effectiveness-implementation trial. Semi-structured interviews with veterans (n = 15) and Veterans Health Administration (VHA) mental health providers (n = 15) were analyzed thematically using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to identify determinants of feasibility, effectiveness, and sustainability of implementing ITAP within the VHA in the future. Veterans conveyed that ITAP promoted accountability and motivation and emphasized values-based, recovery-oriented goal setting as central to improvements in mood and substance use. Across both groups, relational continuity, flexible delivery (phone, video, in-person), and coordinated care were viewed as essential for engagement, feasibility, and sustainability. Providers highlighted ITAP’s potential fit within existing VHA services and feasibility for delivery by clinicians or peer specialists, while identifying leadership support, dedicated infrastructure, and opportunities for ongoing follow-up contact after ITAP completion as critical to implementation success. Findings underscore ITAP’s recovery-oriented framework and care coordination as key mechanisms supporting transitional care within the VHA system. Future efforts should focus on refining implementation strategies, evaluating scalability, and examining sustainment across diverse healthcare settings.