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Use of Guideline-Recommended Treatments for PTSD Among Community-Based Providers in Texas and Vermont: Implications for the Veterans Choice Program

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Abstract

Implementation of the Veterans Choice Program (VCP) allows Veterans to receive care paid for by the Department of Veterans Affairs (VA) in community settings. However, the quality of that care is unknown, particularly for complex conditions such as posttraumatic stress disorder (PTSD). A cross-sectional survey was conducted of 668 community primary care and mental health providers in Texas and Vermont to describe use of guideline-recommended treatments (GRTs) for PTSD. Relatively, few providers reported using guideline-recommended psychotherapy or prescribing practices. More than half of psychotherapists reported the use of at least one guideline-recommended psychotherapy for PTSD, but fewer reported the use of core treatment components, prior training in the GRT(s) they use, or adherence to a treatment manual. Suboptimal prescribing for PTSD patients was reported more commonly than optimal prescribing. Findings raise critical questions regarding how to ensure veterans seeking PTSD care in community settings receive psychotherapy and/or prescribing consistent with clinical practice guidelines.

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Disclaimer

The views expressed are those of the authors and do not reflect the official views or policy of the Department of Veterans Affairs (VA) or US Government.

Conflict of Interest

The authors declare that they have no conflict of interest.

Funding

We gratefully acknowledge funding received through the VA Quality Enhancement and Research Initiative (QUERI; PEC 15-243), in partnership with the VA Office of Analytics and Business Intelligence. We would like to extend special thanks to Dr. Amy Kilbourne and Dr. Joseph Francis for their support throughout the course of this work. During manuscript preparation, Dr. Finley was also supported by the VA-funded EMPOWER QUERI program (QUE 15-272).

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Authors and Affiliations

  1. South Texas Veterans Health Care System, 7400 Merton Minter Blvd., San Antonio, TX, 78229-4404, USA

    Erin P. Finley PhD MPH, Polly H. Noël PhD, Mary Bollinger PhD MPH & Mary Jo V. Pugh PhD RN

  2. University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA

    Erin P. Finley PhD MPH, Michael Mader MS, Elizabeth K. Haro MPH, Polly H. Noël PhD, Mary Bollinger PhD MPH, Hector A. Garcia PsyD & Mary Jo V. Pugh PhD RN

  3. VA National Center for PTSD, White River Junction, VT, 05009, USA

    Nancy Bernardy PhD & Kathleen Sherrieb DrPH

  4. Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA

    Nancy Bernardy PhD & Kathleen Sherrieb DrPH

  5. National Center for PTSD Dissemination and Training Division, Menlo Park, CA, 94025, USA

    Craig S. Rosen PhD

  6. Stanford University School of Medicine, Stanford, CA, 94305, USA

    Craig S. Rosen PhD

  7. Valley Coastal Bend Veterans Health Care System, Harlingon, 78550, TX, USA

    Hector A. Garcia PsyD

Authors
  1. Erin P. Finley PhD MPH
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  2. Michael Mader MS
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  3. Elizabeth K. Haro MPH
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  4. Polly H. Noël PhD
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  5. Nancy Bernardy PhD
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  6. Craig S. Rosen PhD
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  7. Mary Bollinger PhD MPH
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  8. Hector A. Garcia PsyD
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  9. Kathleen Sherrieb DrPH
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  10. Mary Jo V. Pugh PhD RN
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Corresponding author

Correspondence to Erin P. Finley PhD MPH.

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Finley, E.P., Mader, M., Haro, E.K. et al. Use of Guideline-Recommended Treatments for PTSD Among Community-Based Providers in Texas and Vermont: Implications for the Veterans Choice Program. J Behav Health Serv Res 46, 217–233 (2019). https://doi.org/10.1007/s11414-018-9613-z

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  • DOI: https://doi.org/10.1007/s11414-018-9613-z

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