Psychotherapy in mental health clinics of the Department of Veterans Affairs

Abstract

In this study, Department of Veterans Affairs Fiscal Year 2006 national workload data are analyzed to determine use and intensity of outpatient individual and group psychotherapy and, using multivariate analysis, to identify sociodemographic and diagnostic correlates. Results show that among veterans receiving specialty mental health services (n=934,832), average visits numbered 7.9, 64.7% received at least one psychotherapy visit, 94% received individual therapy, and 24.1% received group. Veterans with the most mental health specialty visits of any kind were most likely to receive psychotherapy. Veterans with affective disorders and post‐traumatic stress disorder diagnosis were more likely to receive psychotherapy than others. Veterans who are older, male, Black, or psychiatrically hospitalized were less likely to receive psychotherapy. Correlates of receipt of group therapy (i.e., older, Black, male, substance abuse diagnosis, urban residence) tend to be inversely related to receiving individual therapy. We conclude that psychotherapy is widely available at modest levels of intensity in Veterans Affairs. © 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1–13, 2011.

Mental Health Treatment for Older Veterans Newly Diagnosed with PTSD: A National Investigation

“…In the general VA population, older age was associated with decreased odds of mental healthcare use 17,18 and reduced likelihood of receiving psychotherapy. 19 Among older veterans recently diagnosed with depression, the odds of receiving mental health (MH) treatment decreased with age. 20 Older veterans are also less likely to initiate MH treatment following a positive PTSD screening.…”

A Prospective Study of Racial and Ethnic Variation in VA Psychotherapy Services for PTSD

“…More than 500,000 veterans receive treatment for posttraumatic stress disorder (PTSD) in the U.S. Department of Veterans Affairs (VA) health care system. Both pharmacotherapy and psychotherapy services are available throughout the VA health care system to meet the clinical needs of this population (1,2). Among veterans newly diagnosed as having PTSD, approximately 40% initiate psychotherapy (3).…”

Are There Racial/Ethnic Disparities in Va PTSD Treatment Retention?

“…Emerging evidence suggests that with appropriate treatment, rates of PTSD remission may be as high as 65%, and that medical sequelae may concomitantly abate. [20][21][22] Lower rates of mental health treatment retention have been observed among racial and ethnic minorities, and evidence suggests this is largely due to disparities in treatment. [20][21][22] Lower rates of mental health treatment retention have been observed among racial and ethnic minorities, and evidence suggests this is largely due to disparities in treatment.…”

“…[16][17][18][19] Unfortunately, many Veterans with PTSD who need mental health care do not receive sufficient treatment to clinically benefit. [20][21][22] Lower rates of mental health treatment retention have been observed among racial and ethnic minorities, and evidence suggests this is largely due to disparities in treatment. [23][24][25][26][27][28][29][30] Among racial/ethnic minority Veterans with PTSD, lower treatment retention rates have been similarly observed [28,31] ; however, whether such variation reflects healthcare disparities depends on whether the factor(s) underlying the variation are "admissible" or not.…”