Vietnam Veterans - Real Partners in Health: Does self-management support improve your health?

INTERVENTION: The intervention group will receive "usual care" plus The Flinders Model of Chronic Condition Self‐Management, together with any/all of the interventions listed, but agreed between a health professional and the patient: Treatment options (based on the Alcohol Practice Guidelines) may include • Medical management using naltrexone (50mg tablets, orally, once per day, for an initial period of 3 months but may extend up to 9 months) or acamprosate (330mg x 2 tablets, orally, three times per day for an initial period of 3 months but may extend up to 9 months); • Self‐management of alcohol problems using the web based program ‘the right mix’; www.therightmix.gov.au (duration: ongoing as needed by each individual); • Individual counselling using cognitive behaviour therapy based on motivational interviewing, cue exposure, cognitive restructuring and relapse prevention will be provided in the community through Drug and Alcohol Services SA (DASSA) and Vietnam Veterans Counselling Service (VVCS) (duration 30‐90 minutes per session for as many sessions required by each individual); • Group therapy (Stanford six‐week generic self‐management course ‐ 2 1/2 hours per one session per week). • “Drink Watchers: A self‐monitoring approach” (duration: ongoing per individual, as needed); • Alcoholics Anonymous (duration approx 2 hours per session, once per week, for as many sessions as the Veteran requires). Each group will be offered the same treatment options during a nine month period which will be agreed between the participant, their GP and other health providers. One group will be supported in self‐management techniques with the Flinders Model of self‐management in the first nine months, with nine months follow‐up, and the other group will be supported in self‐management in the second nine months. Total intervention period 18 months. CONDITION: Alcohol‐related disorders in Vietnam Veterans Major Depression in Vietnam Veterans Post Traumatic Stress Disorder in Vietnam Veterans PRIMARY OUTCOME: Improved alcohol‐related disability through the development and testing of a comprehensive integrated management strategy for Vietnam Veterans with alcohol and related disorders which can be be implemented in all other Veteran treatment settings. Improved quality of life through the development and testing of a comprehensive integrated management strategy for Vietnam Veterans with alcohol and related disorders which can be be implemented in all other Veteran treatment settings. SECONDARY OUTCOME: Improved self‐management of alcohol and co‐morbid conditions. INCLUSION CRITERIA: Must have been in the Vietnam Conflict and have an alcohol related chronic condition ‐ Each Vietnam Veteran will need to have an Audit score (Alcohol Usage Disorders Identification Test) of 8 or above.