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Delivery of Exposure and Response Prevention Among Veterans with Obsessive–Compulsive Disorder

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Abstract

Veterans with obsessive–compulsive disorder (OCD) often face barriers to receiving evidence-based treatments such as exposure and response prevention (ERP). Through retrospective review of electronic medical records, this study examined the rates of ERP delivery in a national sample of 554 veterans newly diagnosed with OCD in the Veterans Health Administration between 2016 and 2017. Results indicated that only 4% of veterans (n = 22) received any ERP treatment; and, of those, 16 veterans received “true ERP.” Veterans who received any ERP were younger than those who did not. ERP was primarily delivered by psychologists in urban facilities along the East and West coasts of the USA. The findings from this study emphasize the need to train more providers to effectively deliver ERP in addition to providing telehealth services to increase access to care for veterans in rural areas.

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Data Availability

De-identified dataset available upon request.

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Funding

This research was partially supported by the use of resources and facilities at the VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety (CIN# 13–413), Michael E. DeBakey VA Medical Center, Houston, TX. The views expressed reflect those of the authors and not necessarily the policy or position of the Department of Veterans Affairs, the U.S. government, or Baylor College of Medicine. None of these bodies played a role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Authors and Affiliations

  1. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA

    Alyssa G. Hertz PsyD, Anthony H. Ecker PhD, Natalie E. Hundt PhD & Terri L. Fletcher PhD

  2. VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA

    Darius B. Dawson PhD, Anthony H. Ecker PhD, Ashley Helm MA, Natalie E. Hundt PhD & Terri L. Fletcher PhD

  3. VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA

    Darius B. Dawson PhD, Anthony H. Ecker PhD, Ashley Helm MA, Natalie E. Hundt PhD & Terri L. Fletcher PhD

  4. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Darius B. Dawson PhD

  5. Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Fenan S. Rassu PhD

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  1. Alyssa G. Hertz PsyD
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  2. Darius B. Dawson PhD
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Contributions

DD, AE, TF, AH, and NH contributed to the study conception and design. Data collection was performed by DD, AE, TF, AH, NH, and FR. Data analysis was performed by TF. The first draft of the manuscript was written by AH, FR, and DD, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Terri L. Fletcher PhD.

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Hertz, A.G., Dawson, D.B., Rassu, F.S. et al. Delivery of Exposure and Response Prevention Among Veterans with Obsessive–Compulsive Disorder. J Behav Health Serv Res 50, 514–523 (2023). https://doi.org/10.1007/s11414-023-09838-3

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