Psychotherapy in the Veterans Health Administration: Missed Opportunities?

Jeffrey A. Cully, Laura Tolpin, Louise Henderson, Daniel Jimenez, Mark E. Kunik, Laura A. Petersen

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Informed by data on the dose-response effect, the authors assessed use of psychotherapy in the Veterans Health Administration (VA). The authors identified 410,923 patients with newly diagnosed depression, anxiety, or posttraumatic stress disorder using VA databases (October 2003 through September 2004). Psychotherapy encounters were identified by Current Procedural Terminology codes for the 12 months following patients' initial diagnosis. Psychotherapy was examined for session exposure received within the 12-month follow-up period and time (in days) between diagnosis and treatment. Of the cohort, 22% received at least one session of psychotherapy; 7.9% received four or more sessions; 4.2% received eight or more sessions; and 2.4% received 13 or more sessions. Delays between initial mental health diagnosis and initiation of care averaged 57 days. Patient variables including age, marital status, income, travel distance, psychiatric diagnosis, and medical-illness burden were significantly related to receipt of psychotherapy. Treatment delays and general underuse of psychotherapy services are potential missed opportunities for higher-quality psychotherapeutic care in integrated health care settings.

Original languageEnglish (US)
Pages (from-to)320-331
Number of pages12
JournalPsychological Services
Issue number4
StatePublished - Nov 2008
Externally publishedYes


  • anxiety
  • depression
  • mental health
  • posttraumatic stress disorder
  • psychotherapy

ASJC Scopus subject areas

  • Clinical Psychology
  • Applied Psychology


Dive into the research topics of 'Psychotherapy in the Veterans Health Administration: Missed Opportunities?'. Together they form a unique fingerprint.

Cite this