Developing a benefits counseling website for Veterans using Motivational Interviewing techniques

Understanding Veterans' narrated experience as they navigate a web-based intervention is important because it can inform the content, layout and format of these therapies. Using the "Think Aloud" method, twenty-five Veterans of military service expressed thoughts and reactions while navigating through a web-based Motivational Interviewing intervention. The intervention encouraged Veterans applying for Compensation for military-related psychiatric conditions to engage in work related activities. They then completed quantitative ratings of the site. Overall, the site was rated highly, and ratings were in the neutral range as to whether internet delivery of the material was preferable to in-person counseling. Comments revealed the complexity of adapting Motivational Interviewing for a web-based intervention. The intervention provided reflections and non-judgmental statements to Veterans accustomed to more directive statements, and receiving reflections from a computer-therapist evoked mixed responses. Veterans answered questions with intuitive formats quickly, and usually did not read directions concerning how to answer questions. Veterans felt frustrated by the lack of support throughout the Compensation process. They advocated for further development of this web-based intervention as a support for people awaiting their claim determination. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/3.0/).