USC researchers are studying how to help behavioral health providers effectively treat the growing number of service members and veterans returning to communities.

The Center for Innovation and Research on Veterans & Military Families (CIR) at the USC School of Social Work received a $4.5 million grant from the U.S. Department of Defense to study whether technology — i.e., 3-D avatar animation and mobile apps — are effective at training graduate students and professional clinicians and therapists.

The three-year study will look at multiple ways of rapidly increasing the workforce with culturally competent military social workers.

Anthony Hassan, clinical professor and director of CIR, said the grant is a testament to the trust the department has placed in the ongoing research at the center and school.

CIR and DOD share the same vision that education and training can be and should be advanced.

Anthony Hassan

“CIR and DOD share the same vision that education and training can be and should be advanced, using the most innovative technologies to train clinicians anywhere, anytime to be able to meet the needs of our military and veteran communities,” Hassan said.

The first part of the DOD study will examine the efficacy of graduate student training using current methods in the field, like peer-to-peer role play and standardized patient actors who simulate symptoms.

It will also review a new method being developed that uses a 3-D human avatar — a fictitious Marine who has been exposed to combat stress and now presents with life challenges.

A new game experience

The center has partnered with a game development company to enhance the avatar experience for students, with a future goal of housing it online to increase access.

“There’s really no way you can do true artificial intelligence yet. The ability to have an open-ended, back-and-forth conversation is still years away,” said Dax Berg, CIR’s technology project manager overseeing the new avatar development.

“We’re trying to ‘game-ify’ it in a way where the user can get lost in the conversation,” Berg explained. “We’re trying to take something that’s never been done before, and make it possible and feel real.”

The new avatar will also have features that will help students progress in their conversation. At any particular time, students may access an instructor’s feedback to help them get back on track. If they get stuck, students can also access a pop-up menu with sample questions.

The point of the avatar experience is to prepare students as much as possible for when they meet their first veteran or service member face-to-face. It’s an opportunity to practice counseling skills and learn from mistakes.

Resources at one’s fingertips

The second part of the DOD study explores whether technology can help already-trained clinicians stay faithful to an evidence-based practice that treats post-traumatic stress disorder.

Cognitive processing therapy-cognitive (CPT-C) is a regimented therapy that consists of 12 sessions to treat PTSD. Studies show that sticking to the protocol is associated with positive patient outcomes and fewer PTSD symptoms. An erosion rate of evidence-based practices has also been documented.

“After a while, it slips and then clinicians start adding and deleting items,” said Alice Kim, CIR’s assistant director of operations. “It could impact how effective they are, and it’s hard to see how effective CPT-C is.”

The study will enroll already-trained clinicians in a virtual training lab where they will be able to review multiple parts of the therapy and apply those skills with a standardized patient. In their sessions with clients, they will also be able to use a mobile app, which is currently being developed, to act as a reminder of CPT-C protocol and to access resources.

The study will track their performance over a six-month period, when they will be meeting monthly with experts online, to gauge how effective this approach is at retention.

“We want to help supplement their training with the use of new technological tools,” Kim said.

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