Table 1.

Problems encountered and solutions developed by study phase

Phase of study	Problems	Changes implemented
Screening	Difficulty maintaining contact with po- tentially eligible participants	Interviewed potential participants in the hospital as soon as possible after admission
Informed consent	Unfamiliarity with research; suspi- ciousness	Lengthy discussion of consent, administered brief quiz to check un- derstanding before consent
Randomization	Negative reaction to TAU assignment	Assignment of study case managers to provide support and referrals
Completing baseline interview	Poor concentration	Use of open-ended questions; interviews conducted after medica- tions stabilized
Follow-up	Difficulty maintaining contact	Detailed locator interview at each assessment; community voice- mail; study case managers maintained frequent contact; tokens pro- vided for appointments
Therapy attendance	Poor attendance; inability to attend ses- sions on time	First session conducted while still in hospital; one established week- ly time per patient; full-time therapists available for “walk-in” ses- sions