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Addressing Barriers in Access to Mental Health Care Within the Veterans Health Administration: Evidence-Based Psychotherapies for Anxiety and Related Disorders

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References

  • Adler, D. A., Possemato, K., Mavandadi, S., Lerner, D., Chang, H., Klaus, J., & Oslin, D. W. (2011). Psychiatric status and work performance of veterans of Operations Enduring Freedom and Iraqi Freedom. Psychiatric Services, 62(1), 39–46.

    Article  PubMed  Google Scholar 

  • Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Latin, H. M., Ellard, K. K., Bullis, J. R., & Cassiello-Robbins, C. (2017). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide (2 ed.). Oxford University Press.

  • Barrera, T. L., Mott, J. M., Hundt, N. E., Mignogna, J., Yu, H. J., Stanley, M. A., & Cully, J. A. (2014). Diagnostic specificity and mental health service utilization among veterans with newly diagnosed anxiety disorders. General hospital psychiatry, 36(2), 192–198.

    Article  PubMed  Google Scholar 

  • Black, D. W., Carney, C. P., Peloso, P. M., Woolson, R. F., Schwartz, D. A., Voelker, M. D., & Doebbeling, B. N. (2004). Gulf War veterans with anxiety: prevalence, comorbidity, and risk factors.Epidemiology,135–142.

  • Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo‐controlled trials. Depression and anxiety, 35(6), 502–514.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52(1), 685–716.

    Article  CAS  PubMed  Google Scholar 

  • Ecker, A. H., O’Leary, K., Fletcher, T., Hundt, N. E., York-Ward, K., Kauth, M. R., & Cully, J. A. (in press). Training and supporting mental health providers to implement evidence-based psychotherapies in frontline practice. Translational Behavioral Medicine.

  • First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015). Structured Clincial Interview for DSM-5 Disorders-Research Version (SCID-5 for DSM-5, Research Version; SCID-5-RV). American Psychiatric Association.

  • Fletcher, T. L., Helm, A., Vaghani, V., Kunik, M. E., Stanley, M. A., & Singh, H. (2020). Identifying psychiatric diagnostic errors with the Safer Dx Instrument. International Journal for Quality in Health Care, 32(6), 405–411.

    Article  PubMed  Google Scholar 

  • Frank, H. E., Becker-Haimes, E. M., & Kendall, P. C. (2020). Therapist training in evidence‐based interventions for mental health: a systematic review of training approaches and outcomes.Clinical Psychology: Science and Practice, 27(3), e12330.

  • Gros, D. F. (2014). Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. Psychiatry research, 220(1), 275–282.

    Article  PubMed  Google Scholar 

  • Gunter, R. W., & Whittal, M. L. (2010). Dissemination of cognitive-behavioral treatments for anxiety disorders: Overcoming barriers and improving patient access. Clinical psychology review, 30(2), 194–202.

    Article  PubMed  Google Scholar 

  • Hofmann, S. G., Wu, J. Q., & Boettcher, H. (2014). Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: a meta-analysis. Journal of consulting and clinical psychology, 82(3), 375.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22.

    Article  CAS  PubMed  Google Scholar 

  • Jordan, B. K., Schlenger, W. E., Hough, R., Kulka, R. A., Weiss, D., Fairbank, J. A., & Marmar, C. R. (1991). Lifetime and current prevalence of specific psychiatric disorders among Vietnam veterans and controls. Archives of General Psychiatry, 48(3), 207–215.

    Article  CAS  PubMed  Google Scholar 

  • Karlin, B. E., Brown, G. K., Trockel, M., Cunning, D., Zeiss, A. M., & Taylor, C. B. (2012). National dissemination of cognitive behavioral therapy for depression in the Department of Veterans Affairs health care system: therapist and patient-level outcomes. Journal of consulting and clinical psychology, 80(5), 707.

    Article  PubMed  Google Scholar 

  • Karlin, B. E., & Cross, G. (2014). From the laboratory to the therapy room: national dissemination and implementation of evidence-based psychotherapies in the US Department of Veterans Affairs Health Care System. American Psychologist, 69(1), 19.

    Article  PubMed  Google Scholar 

  • Karlin, B. E., Ruzek, J. I., Chard, K. M., Eftekhari, A., Monson, C. M., Hembree, E. A., & Foa, E. B. (2010). Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration. Journal of Traumatic Stress, 23(6), 663–673.

    Article  PubMed  Google Scholar 

  • Lippa, S. M., Fonda, J. R., Fortier, C. B., Amick, M. A., Kenna, A., Milberg, W. P., & McGlinchey, R. E. (2015). Deployment-related psychiatric and behavioral conditions and their association with functional disability in OEF/OIF/OND veterans. Journal of Traumatic Stress, 28(1), 25–33.

    Article  PubMed  PubMed Central  Google Scholar 

  • McIngvale, E., Van Kirk, N., & Stanley, M. (2015). OCD and active duty members/veterans: A review. Poster presented at the 22nd Annual Conference of the International OCD Foundation, Boston, MA

  • Milanak, M. E., Gros, D. F., Magruder, K. M., Brawman-Mintzer, O., & Frueh, B. C. (2013). Prevalence and features of generalized anxiety disorder in Department of Veteran Affairs primary care settings. Psychiatry research, 209(2), 173–179.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pfeiffer, P. N., Ganoczy, D., Ilgen, M., Zivin, K., & Valenstein, M. (2009). Comorbid anxiety as a suicide risk factor among depressed veterans. Depression and anxiety, 26(8), 752–757.

    Article  PubMed  PubMed Central  Google Scholar 

  • Phillips, A. C., Batty, G. D., Gale, C. R., Deary, I. J., Osborn, D., MacIntyre, K., & Carroll, D. (2009). Generalized anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: the Vietnam experience study. Psychosomatic Medicine, 71(4), 395–403.

    Article  CAS  PubMed  Google Scholar 

  • Raines, A. M., Boffa, J. W., Goodson, J. T., Franklin, C. L., & Schmidt, N. B. (2021). An All-Encompasing Approach to Treating Anxiety and Related Disorders: A Safety Aid Reduction Treatment Manual. South Central MIRECC.

  • Seal, K. H., Bertenthal, D., Miner, C. R., Sen, S., & Marmar, C. (2007). Bringing the war back home: Mental health disorders among 103 788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs Facilities. Archives of internal medicine, 167(5), 476–482.

    Article  PubMed  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine, 166(10), 1092–1097.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., McIngvale, E., Barrera, T. L., Amspoker, A. B., Lindsay, J. A., Kauth, M. R., & Teng, E. (2017). VHA providers’ knowledge and perceptions about the diagnosis and treatment of obsessive-compulsive disorder and related symptoms. Journal of Obsessive-Compulsive and Related Disorders, 12, 58–63.

    Article  Google Scholar 

  • Trivedi, R. B., Post, E. P., Sun, H., Pomerantz, A., Saxon, A. J., Piette, J. D., & Fihn, S. D. (2015). Prevalence, comorbidity, and prognosis of mental health among US veterans. American journal of public health, 105(12), 2564–2569.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). Clinician-administered PTSD scale for DSM-5. Boston: National Center for Posttraumatic Stress Disorder.

    Google Scholar 

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Acknowledgements

This material is the result of work supported with resources and the use of facilities at the Southeast Louisiana Veterans Health Care System in New Orleans, LA. Amanda M. Raines is supported by the United States Department of Veterans Affairs (Clinical Science Research and Development Service) under Career Development Award-2 IK2CX001978-02. The contents of this article do not represent the views of the Department of Veterans Affairs or the United States Government.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Southeast Louisiana Veterans Health Care System, New Orleans, LA 70119, USA

    Chelsea R. Ennis Ph.D., Amanda M. Raines Ph.D., Mary O. Shapiro Ph.D. & C. Laurel Franklin Ph.D.

  2. South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119, USA

    Chelsea R. Ennis Ph.D., Amanda M. Raines Ph.D., Mary O. Shapiro Ph.D. & C. Laurel Franklin Ph.D.

  3. Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112, USA

    Chelsea R. Ennis Ph.D., Mary O. Shapiro Ph.D. & C. Laurel Franklin Ph.D.

  4. School of Medicine, Louisiana State University, New Orleans, LA 70112, USA

    Amanda M. Raines Ph.D.

  5. Bay Pines VA Healthcare System, Saint Petersburg, FL 33744, USA

    Mirela A. Aldea Ph.D.

  6. U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention, Washington DC, USA

    Chris M. Crowe Ph.D.

Authors
  1. Chelsea R. Ennis Ph.D.
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  2. Amanda M. Raines Ph.D.
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  3. Mirela A. Aldea Ph.D.
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  4. Mary O. Shapiro Ph.D.
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  5. Chris M. Crowe Ph.D.
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  6. C. Laurel Franklin Ph.D.
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Contributions

Chelsea Ennis conceptualized the manuscript. Chelsea Ennis and Amanda Raines prepared the initial draft of the manuscript. All other authors (i.e., Mirela Aldea, Mary Shapiro, Chris Crowe, and Laurel Franklin) reviewed and edited the manuscript. All authors approved the final version of the paper for submission.

Corresponding author

Correspondence to Chelsea R. Ennis Ph.D..

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R. Ennis, C., M. Raines, A., A. Aldea, M. et al. Addressing Barriers in Access to Mental Health Care Within the Veterans Health Administration: Evidence-Based Psychotherapies for Anxiety and Related Disorders. Adm Policy Ment Health 50, 173–176 (2023). https://doi.org/10.1007/s10488-022-01241-y

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  • DOI: https://doi.org/10.1007/s10488-022-01241-y

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