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Results from the multisite implementation of STAR-VA: a multicomponent psychosocial intervention for managing challenging dementia-related behaviors of veterans


Karlin, Bradley E., Visnic, Stephanie, Shealy McGee, Jocelyn, Teri, Linda


Psychological Services, Volume: 11, No.: 2, Pages.: 200-208

Year of Publication



Dementia is often associated with challenging behaviors that can significantly impact the quality of life of individuals with dementia and pose great difficulty for long-term care staff. Antipsychotic medications, historically the mainstay approach for managing such behaviors, have increasingly been associated with limited efficacy and increased death risk with older dementia patients. In an effort to promote and realize the promise of nonpharmacological management of challenging dementia-related behaviors, the U.S. Department of Veterans Affairs (VA) health care system has developed and implemented STAR-VA, an interdisciplinary behavioral intervention for managing challenging dementia-related behaviors of veterans, in 17 VA nursing homes, as part of a pilot implementation initiative. Sixty-four veterans with challenging behaviors associated with dementia participated in the STAR-VA intervention coordinated by Mental Health Providers completing specialized training. Challenging behaviors clustered into 6 behavior types: resistance to care, agitation, violence/aggression, vocalization, wandering, and other. Results indicate that STAR-VA led to significant reductions in the frequency and severity of challenging dementia-related behaviors, with overall effect sizes of approximately 1. In addition, the intervention led to significant reductions in depression and anxiety. Overall, the results support the feasibility and effectiveness of STAR-VA for managing challenging dementia-related behaviors in veterans in real-world, nursing home settings.; PsycINFO Database Record (c) 2014 APA, all rights reserved.

Bibtex Citation

@article{Karlin_2014, doi = {10.1037/a0033683}, url = {}, year = 2014, publisher = {American Psychological Association ({APA})}, volume = {11}, number = {2}, pages = {200--208}, author = {Bradley E. Karlin and Stephanie Visnic and Jocelyn Shealy McGee and Linda Teri}, title = {Results from the multisite implementation of {STAR}-{VA}: A multicomponent psychosocial intervention for managing challenging dementia-related behaviors of veterans.}, journal = {Psychological Services} }


aged, anxiety, behavioral symptoms, complications, dementia, depression, etiology, humans, methods, outcome assessment (health care), pilot projects, psychology, psychotherapy, rehabilitation, therapy, united states, united states department of veterans affairs, veterans

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Before and After Study

Type of Outcomes

Behaviour, Depression and Anxiety


Nursing Homes

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Behavioural Therapies