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

  • Erin P. FinleyEmail author
  • Michael Mader
  • Elizabeth K. Haro
  • Polly H. Noël
  • Nancy Bernardy
  • Craig S. Rosen
  • Mary Bollinger
  • Hector A. Garcia
  • Kathleen Sherrieb
  • Mary Jo V. Pugh


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.



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 Information

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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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection [YEAR]  2018

Authors and Affiliations

  • Erin P. Finley
    • 1
    • 2
    Email author
  • Michael Mader
    • 2
  • Elizabeth K. Haro
    • 2
  • Polly H. Noël
    • 1
    • 2
  • Nancy Bernardy
    • 3
    • 4
  • Craig S. Rosen
    • 5
    • 6
  • Mary Bollinger
    • 1
    • 2
  • Hector A. Garcia
    • 2
    • 7
  • Kathleen Sherrieb
    • 3
    • 4
  • Mary Jo V. Pugh
    • 1
    • 2
  1. 1.South Texas Veterans Health Care SystemSan AntonioUSA
  2. 2.University of Texas Health Science Center at San AntonioSan AntonioUSA
  3. 3.VA National Center for PTSDWhite River JunctionUSA
  4. 4.Department of PsychiatryGeisel School of Medicine at DartmouthHanoverUSA
  5. 5.National Center for PTSD Dissemination and Training DivisionMenlo ParkUSA
  6. 6.Stanford University School of MedicineStanfordUSA
  7. 7.Valley Coastal Bend Veterans Health Care SystemHarlingonUSA

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