Dissemination of cognitive behavioral therapy for substance use disorders in the Department of Veterans Affairs Health Care System: Description and evaluation of Veteran outcomes

Subst Abus. 2021;42(2):168-174. doi: 10.1080/08897077.2019.1674238. Epub 2019 Oct 23.

Abstract

As part of the nation's largest dissemination and implementation of evidence-based psychotherapies (EBPs) and the promotion of EBPs for substance use disorders (SUDs), the Veterans Health Administration (VHA) is working to nationally implement Cognitive Behavioral Therapy for SUD (CBT-SUD). The current manuscript describes the approach to system-wide training and reports Veteran outcomes associated with CBT-SUD implementation. Methods: Four-hundred fifty-eight Veterans with a range of treatment goals received treatment through the Department of Veterans Affairs (VA) CBT-SUD Training Program. Veteran outcomes related to substance use, substance use-related problems, and quality of life were assessed with the Brief Addiction Monitor, the Short Inventory of Problems, and the World Health Organization Quality of Life-BREF. Results: Statistically significant reductions in alcohol use, heavy alcohol use, other drug use, and substance use-related problems, as well as significant improvements in quality of life, were observed over the course of treatment. Conclusions: Program evaluation findings suggest that large-scale training in and implementation of EBPs for SUDs is associated with improvements in substance use and other functional outcomes. Limitations from this real-world implementation project, including the lack of a control group and missing post-treatment data, are discussed.

Keywords: Cognitive behavioral therapy; Veterans; dissemination; evidence-based psychotherapy; implementation; substance use disorders.

MeSH terms

  • Cognitive Behavioral Therapy*
  • Delivery of Health Care
  • Humans
  • Quality of Life
  • Substance-Related Disorders* / therapy
  • United States
  • United States Department of Veterans Affairs
  • Veterans*