Brief CBT Training Yields Decreases in Depression Among Veterans

Veterans are at risk for many psychological problems, including depression. One of the approaches most commonly used to address the increase in cases of depression through the Veterans Health Administration (VHA) is the use of antidepressant medication. Treatment options also include therapy, specifically cognitive behavioral therapy for depression (CBT-D). Although both methods have been shown to be effective when used alone or together, CBT-D often is preferred because it can also alleviate symptoms of comorbid problems and does not carry the risk of side effects. However, many therapists in the VA are not adequately trained in evidence based psychotherapies (EBP) such as CBT. The majority of training required for EBP is cost- and time-prohibitive, a challenge for organizations like the VHA. Therefore, if VA therapists could receive abbreviated training that provides a fundamental framework for effective delivery of CBT, it could decrease depression rates for thousands of veterans.

Bradley E. Karlin, of the Office of Mental Health Services at the Veterans Affairs Central Office in Washington, D.C., recently conducted a study that assessed the depression scores of 356 veterans seeking help for depression after they received CBT-D from therapists who underwent brief training through the VHA. Karlin evaluated the competency of the therapists before and after training, and measured depression and quality-of-life scores of all participants after they completed therapy. He found that nearly all the therapists completed the training and scored in the competent level. Additionally, 70% of participants completed most of the therapy sessions and saw decreases in symptom severity upward of 40%.

The findings of this study show that the training provided by the VHA results in significant reductions in depression and increases overall quality of life for veterans. The retention rates achieved in this study also support the efficacy of brief training and suggest that veterans who receive CBT-D from adequately trained therapists are likely to adhere to treatment and thus have better outcomes than those who drop out early. Karlin believes the findings might need further exploration because the therapists recruited for this study expressed an interest in learning more about CBT, which could have influenced the outcome. Future work should address this and also look at how comorbid conditions, such as posttraumatic stress, affect the reductions in depression. Despite these shortcomings, this study emphasizes the dynamic impact that brief training can have on the veteran population. “These findings, yielded far outside of the laboratory environment, suggest that CBT may indeed be transportable to and flourish in complex, real-world settings,” Karlin said.

Karlin, Bradley E., Gregory K. Brown, Mickey Trockel, Darby Cunning, and Antonette M. Zeiss. 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 (2012): 707-18. Print.

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  • Bright


    October 17th, 2012 at 3:20 PM

    Easy solution: find more therapists willing to work with the VA who are trained to offer effective CBT, then you have the answer. But they will have to be compensated for their work, so that means VA has to learn that to get lasting and current treatment for their vets that works they might have to shell out a little more money in reimbursement than what they have been willing to do in the past.

  • blaine


    October 18th, 2012 at 4:04 AM

    so all you really need is a brief intervention to make a real difference to so many who need it- let’s do it and help out these veterans who have sacrificed so much for all of the rest of us



    October 18th, 2012 at 8:42 AM

    This is a good thing no doubt.Now we only need to sustain and improve on this by having more trained professionals.There may be better treatment methods out there but they need to be taken advantage of.As long as we have adequately trained professionals we can do that and that will continue to benefit the veterans,which is a great thing indeed.

  • Andrew


    October 18th, 2012 at 11:21 AM

    You would think that counselors working with this demographic would have learned by now that even a brief shining moment of positive cognitive behavioral therapy could go a long way toward making a difference in one of these guys lives, instead of always insisting that treatment as usual is the path to stay on. I mean, isn’t it obvious that if one thing isn’t working, then it might be time to shake things up and try something a little different, or maybe even a combo of two things? I don’t know., I think that sometimes we all get just a little too bogged down in all the red tape to really be able to see more clearly what exactly is going to be the best steps to take to move forward with a patient.

  • Brayden


    October 19th, 2012 at 12:08 PM

    As long as you actually have therapists who are interested in contuing their education and learning about new ways to treat old problems, then you have a win-win situation.

    They are learning new ways to help their patients while the patients are receiving a type of care at a level that they may have neevr had before. It might make overcoming something that used to feel impossible to overcome feel like it is possible once again.

  • Cole


    October 20th, 2012 at 5:40 AM

    Unfortunately it is going to take more than just this one study to convince many providers that there is more to treatment of depression that a magic little pill.

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