Mental Health Providers’ Decision-Making Around the Implementation of Evidence-Based Treatment for PTSD

Princess E. Osei-Bonsu, Rendelle E. Bolton, Shannon Wiltsey Stirman, Susan V. Eisen, Lawrence Herz, Maura E. Pellowe

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


It is estimated that <15% of veterans with posttraumatic stress disorder (PTSD) have engaged in two evidence-based psychotherapies highly recommended by VA—cognitive processing therapy (CPT) and prolonged exposure (PE). CPT and PE guidelines specify which patients are appropriate, but research suggests that providers may be more selective than the guidelines. In addition, PTSD clinical guidelines encourage “shared decision-making,” but there is little research on what processes providers use to make decisions about CPT/PE. Sixteen licensed psychologists and social workers from two VA medical centers working with ≥1 patient with PTSD were interviewed about patient factors considered and decision-making processes for CPT/PE use. Qualitative analyses revealed that patient readiness and comorbid conditions influenced decisions to use or refer patients with PTSD for CPT/PE. Providers reported mentally derived and instances of patient-involved decision-making around CPT/PE use. Continued efforts to assist providers in making informed and collaborative decisions about CPT/PE use are discussed.

Original languageEnglish (US)
Pages (from-to)213-223
Number of pages11
JournalJournal of Behavioral Health Services and Research
Issue number2
StatePublished - Apr 1 2017

Bibliographical note

Funding Information:
This study was funded by VA HSR&D/QUERI (Grant #: RRP 12–239). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government.

Publisher Copyright:
© 2016, National Council for Behavioral Health (outside the USA).


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