Providers' and administrators' perspectives of massed posttraumatic stress disorder (PTSD) treatment in Veterans Affairs (VA) PTSD outpatient clinics.

Posttraumatic stress disorder (PTSD) treatments delivered in a massed format (i.e., therapy sessions at least 3 days per week) can significantly reduce dropout rates and result in similar PTSD symptom reduction as standard delivery (i.e., once or twice a week). The VA Health Care System is the largest integrated delivery system in the United States and is uniquely positioned to provide mass treatment to veterans with PTSD. Understanding providers' and administrators' perceived barriers and facilitators to massed treatment can inform implementation. This study conducted semistructured interviews with VA PTSD Clinic providers (n = 17) from five sites and VA mental health administrators (n = 14) from seven VA sites of varying facility complexities and geographic regions. The consolidated framework for implementation research and social cognitive theory informed the interview guide and the thematic analysis. Providers and administrators identified barriers to implementation, including presumed negative veteran and provider attitudes to massed treatment, increased pressure on providers, lack of staff time and other resources, and limits created by current systems and performance metrics. Providers and administrators also identified implementation facilitators, including high expectations for effectiveness, engagement, and acceptability; increased resources, time, and flexibility over scheduling; access to knowledge and training; a heightened need for adjunctive and coordinated care; and thoughtful planning, communication, and support from leadership. Findings suggest that VA providers and administrators are largely supportive of massed treatment and believe it can improve retention rates. They also believe there would be several barriers to implementation, but that many may be overcome with strategic and purposeful planning. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Duke Scholars

Author Patrick Shields Calhoun Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...

Author George Lee Jackson Population Health Sciences