Evidence-Based Treatment
Evidence-Based Therapy
Therapy at VA
Evidence-based therapies (EBTs) are treatments that have been shown to improve a variety of mental health conditions and overall well-being. These treatments are tailored to each Veteran’s priorities, values, preferences, and goals for therapy. EBTs often work quickly and effectively, sometimes within a few weeks or months, depending on the nature or severity of your symptoms. Work with your VA provider to choose the treatment options that work best for you. To learn more about EBTs offered at VA and the mental health conditions they are used to treat, explore the information below.
Acceptance and Commitment Therapy (ACT)
ACT is a therapy that can help transform and improve the lives of people experiencing depression. ACT aims to help you live in a way that’s more closely aligned with your values, improving your relationships with yourself, others, and the world.
Through this therapy, you’ll learn to accept your thoughts and emotions, choose and commit to actions that align with your values, and take action to achieve what matters most to you. ACT typically requires 10 to 16 individual sessions, but it can be tailored to your treatment preferences and priorities. Through this therapy, you may experience:
- A decrease in negative thoughts and feelings.
- Increased awareness and focus that helps you to fully connect with others and live in the moment.
- The ability to clarify your values and take action to achieve what means the most to you in life.
If you choose ACT, you may be asked to:
- Commit to attending sessions regularly.
- Set treatment goals with your therapist at the onset of therapy.
- Speak openly about your depression, the challenges you’re facing, and your values.
To determine whether ACT may be right for you, speak honestly with your mental health provider about your symptoms so you can work together to create the most effective treatment plan.
Behavioral Activation (BA)
BA is a therapy that has been shown to relieve or resolve symptoms of depression. This therapy will help you become more engaged with activities that can improve your mood.
BA will teach you how your behaviors are connected to your feelings, ways to monitor your daily activities, and ways to identify and achieve the things you value and enjoy in life. Sessions of BA are action-oriented, focused on problem-solving, and typically provided in 20 to 24 individual sessions. After participating in this treatment, you may experience:
- An increase in healthy behaviors and positive experiences, thoughts, and mood.
- The ability to turn overwhelming tasks into attainable achievements.
- Increased participation in hobbies and social events, including some that you may have enjoyed before your depression.
If you choose BA, you may be asked to:
- Work with your provider to set goals for treatment and a plan for reaching those goals.
- Engage with activities that may feel uncomfortable at first but will help you become more socially active.
- Determine what are your values in life and how you can live in ways that are more closely aligned with them.
To learn more about this therapy, speak with your mental health provider about your symptoms and treatment goals. Together, you can determine the treatment that best fits your needs.
Behavioral Family Therapy (BFT)
BFT is a therapy for Veterans with a severe disability or a psychiatric disorder such as schizophrenia, bipolar disorder, and severe depression. This treatment involves their families as well.
Typically lasting from 20 to 25 sessions of 50 minutes each, BFT emphasizes the importance of a strong family support system, and it can help motivate your loved ones to participate in this journey with you. BFT has five components: engagement, assessment, illness education, communication skills training, and problem-solving instruction. These components may be presented through:
- Role-playing and skill practice in an out-of-session setting.
- Review of written materials.
- Family education about mental health and your specific condition.
- Development of communication and problem-solving skills to help you and your family cope with mental health stressors together.
If you choose this therapy, you may be asked to:
- Commit to attending regular weekly sessions.
- Practice role-playing and skill development in and out of therapy sessions.
- Be open and honest with your therapist and family throughout the process.
To learn more about this therapy, speak with your mental health provider about your symptoms and treatment goals. Together, you can determine the treatment that best fits your needs.
Cognitive Behavioral Conjoint Therapy (CBCT)
CBCT is a therapy that is shown to help treat PTSD in Veterans. This treatment is meant to be delivered together with a Veteran’s family member or another loved one. Some Veterans desire family involvement in their treatment plans because of the impact that PTSD has had on the quality of their relationships and social life.
CBCT typically consists of a 15-session treatment plan over three phases, which can be tailored to each couple. After engaging with this therapy, you may experience:
- A decrease in PTSD symptoms and their severity.
- Improved relationships with family members and others in your life.
- A decrease in comorbid symptoms that may be linked to your PTSD and their severity.
- An increase in your partner’s mood and engagement.
If you choose CBCT, you may be asked to:
- Learn about PTSD and its impact on how relationships function.
- Practice new communication skills with your partner, both in and outside of sessions.
- Develop skills to help you and your partner overcome avoidance.
- Change problematic beliefs about trust, power, and emotional and physical intimacy.
To learn more about CBCT, speak with your mental health provider about how you’re feeling and discuss your goals and preferences for treatment.
Cognitive Behavioral Therapy (CBT)
CBT is a type of therapy that is shown to treat a variety of mental health conditions, including anxiety, bipolar disorder, depression, PTSD, schizophrenia, and substance use disorder. CBT treatments often focus on identifying and neutralizing unhelpful thought patterns and behaviors that worsen your mental health condition.
Typically lasting from 12 to 16 sessions, CBT can help you reach your defined goals for treatment. Through this therapy, you may:
- Develop more balanced and helpful thoughts about yourself, others, and the future.
- Spend more time engaging in pleasurable or productive activities.
- Achieve personal goals and solve problems by learning new skills.
- Improve your quality of life and overall level of functioning.
If you choose CBT, you will be asked to:
- Commit to attending sessions regularly.
- Work with your therapist to set treatment goals.
- Address important personal issues during each session.
- Practice the new skills you learn outside of therapy sessions.
No matter what is causing your mental health condition, proven treatments and resources are available. To learn more about CBT, speak openly with your mental health provider about your symptoms so you can work together to determine the best treatment plan for you.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
CBT-I is a talk therapy that research has shown to be the best way to treat insomnia disorder. Veterans with insomnia disorder experience frequent sleep disruption, usually over more than three months, including trouble getting to sleep or staying asleep, as well as waking up too early.
CBT-I therapy typically involves about four to seven weekly sessions of 30 to 60 minutes each. During CBT-I talk therapy, you may:
- Learn how much sleep you need to feel rested and how to achieve it.
- Spend less time in bed trying to sleep.
- Learn how to turn your bed back into a place for sleep, not wakefulness.
- Learn strategies that help your mind and body relax and prepare for sleep.
- Adjust thoughts that get in the way of sleep.
If you choose CBT-I treatment you will be asked to:
- Commit to attending weekly sessions.
- Maintain a daily sleep diary so that you and your therapist can track your sleep challenges and improvements.
- Practice new skills, such as relaxation strategies or wind-down routines.
No matter what caused your insomnia or how long you have experienced it, CBT-I is a treatment proven to help, even if you have other medical or mental health conditions. To learn more about CBT-I, speak with your mental health provider or ask your primary care provider for a screening for insomnia disorder and referral to care.
Cognitive Processing Therapy (CPT)
CPT is a therapy that can teach you ways to identify, evaluate, and ultimately relieve the unpleasant thoughts you may have following a traumatic experience. Trauma can change the way you think about yourself, others, and the world, and it may leave you feeling stuck. Through CPT, you can learn skills that help you recognize more helpful ways to think about your trauma and create a new perspective on the world.
CPT typically lasts for 12 weekly sessions, either in an individual or a group setting, depending on your preference. Through this therapy, you may:
- Develop healthier, balanced beliefs about yourself and others.
- Return to the activities and moments you enjoy in life.
- Practice new skills that provide more helpful ways to think about your trauma.
If you choose CPT, you will be asked to:
- Commit to attending weekly sessions.
- Speak and write openly about the trauma you’ve experienced — but not right away.
- Complete your writing and worksheets between sessions.
- Practice the skills you’ve learned with your therapist in real-life settings.
Speak openly with your mental health provider about your symptoms and priorities so you can work together to determine whether this therapy is best for you.
Dialectical Behavioral Therapy (DBT)
DBT is a therapy that can help Veterans relieve or resolve the effects of military sexual trauma, suicidal ideation, and borderline personality disorder. This treatment simultaneously combines acceptance and change strategies to help Veterans fully accept themselves and understand that undergoing change can help improve their overall quality of life.
Typically lasting from 20 to 24 sessions, DBT has four main components: Individual therapy, skills training classes, one-on-one telephone consultation, and an intensive group track. DBT can be adjusted for each participant, depending on the nature and severity of their mental health symptoms. Through this therapy, you may:
- Develop a more balanced view of your reality.
- Find increased motivation to participate in new or former activities and hobbies.
- Advance your skills related to mindfulness, addressing interpersonal relationships, regulating your emotions, and tolerating distress.
- Experience a decrease in impulsive behaviors.
If you choose DBT, you may be asked to:
- Attend weekly sessions with your provider to discuss therapy goals, progress, and any challenges encountered since your last check-in.
- Participate in a weekly skills group to learn and practice new tactics.
- Apply new skills to specific events and challenges in your life.
- Complete homework between sessions that will monitor and promote your progress in adopting valuable skills.
No matter what is causing your mental health condition, proven treatments and resources are available. To learn more about DBT, speak openly with your mental health provider about your symptoms so you can work together to determine the best treatment plan for you.
Integrative Behavioral Couples Therapy (IBCT)
IBCT is a therapy for couples that focuses on reducing marital distress and improving relationship satisfaction. This therapy develops increased emotional understanding, effective communication strategies, and improved behavioral responses between loved ones. By accepting your personal differences and understanding your partner’s sensitivities and stressors, you can work together to overcome the challenges you’re facing.
IBCT typically ranges from 11 to 26 sessions, but your treatment plan will be tailored to your needs and has no fixed number of sessions. The therapy may teach you how to negotiate and set goals together with your partner, friend, or family member in two phases: evaluation and treatment.
- The evaluation phase usually consists of a joint session, an individual session with each partner, and a feedback session for the therapist to explain their understanding of the couple’s problems and outline next steps for treatment.
- The treatment phase consists of the therapist’s work with the couple to alter and improve the way they interact with and understand each other.
Through this therapy, you may:
- Experience increasing relationship satisfaction.
- See an improvement in your communication skills and emotional closeness with your partner.
- Recognize and change problematic patterns of interaction.
- Increase your positive interactions and connection.
To learn more about IBCT, speak with your mental health provider about how you’re feeling and discuss your goals and preferences for treatment.
Interpersonal Psychotherapy (IPT)
IPT is a therapy that focuses on healing relationship problems that may be the cause or result of depression. By understanding the connection between interpersonal issues and your depression, you can create social skills to help deal with these problems and improve the way you feel.
IPT typically involves 12 to 16 weekly sessions of 50 minutes each over three phases:
- Initial sessions provide information about depression and how it may be affecting your daily life.
- Intermediate sessions focus on one or two specific areas that are most concerning to you and that you believe contribute to your depression. In these sessions, you will also begin developing new skills to improve your response to certain life stressors.
- In the termination phase, your mental health provider will review your progress with you, explore your possible stressors, discuss the new skills you’ve learned, and evaluate whether further treatment is needed. After this phase, many Veterans notice an increase in overall life satisfaction.
If you choose IPT, you will be asked to:
- Commit to attending regular weekly sessions.
- Set treatment goals with your therapist.
- Discuss personal issues that you’re experiencing in each session.
- Practice new skills inside and outside of the sessions.
To learn more about this therapy and its treatment phases, speak with your mental health provider about your symptoms and treatment goals.
Motivational Enhancement Therapy (MET)
MET is a therapy that is mainly for Veterans who are thinking about changing their use of alcohol or drugs. MET is a more structured version of the motivational interviewing that is offered at VA substance use treatment clinics.
Typically lasting from two to four sessions, MET can be used on its own or in combination with other treatments — sometimes at the start of a lengthier treatment plan. Through this therapy, you may:
- Develop healthier habits related to substance use, diet, exercise, and chronic health problems.
- Feel less inclined to pursue risky activities, like having unprotected sex, gambling, or taking drugs with unsafe needles.
- Feel more independent and more aligned with your identity.
If you choose this therapy, you may be asked to:
- Commit to attending sessions regularly.
- Complete an assessment to guide your treatment plan.
- Review the assessment results with your therapist and come to conclusions about what your results mean.
By speaking openly and honestly with your mental health provider, you can work together to find the treatment that is best for you.
Motivational Interviewing (MI)
MI is a therapy that can help you develop healthier habits related to substance use, diet, exercise, chronic health problems, and risky behaviors. An MI therapist can work with you to explore your values and goals for treatment and offer acceptance and compassion as you consider making changes in your life.
Typically lasting from one to four sessions, MI is goal-oriented and tailored to your life and preferences. This therapy can work on its own or in combination with other treatments. Through this therapy, you may:
- Develop healthier habits related to substance use, diet, exercise, and chronic health problems.
- Feel less inclined to pursue risky activities, like having unprotected sex, gambling, or taking drugs with unsafe needles.
- Notice an increase in your engagement with and response to treatment for other health conditions.
If you choose MI, you may be asked to:
- Commit to attending sessions regularly.
- Set goals with your therapist at the onset of treatment.
- Speak openly about your mental health challenges.
By speaking openly and honestly with your mental health provider, you can work together to find the treatment that is best for you.
Problem-Solving Therapy (PST)
PST is a therapy for Veterans who are experiencing depression or suicidal thoughts. PST can help you recover from going through difficult situations and learn skills for coping with challenging life circumstances and chronic daily stressors.
PST is a goal-oriented treatment that teaches Veterans how to identify, understand, and evaluate problems. Then Veterans learn to find creative solutions to those problems and pursue the best course of action. The number of sessions varies depending on your needs. Through this treatment, you may experience:
- Decreased feelings associated with suicide and depression.
- Increased confidence in confronting situations rather than avoiding them.
- Heightened feelings of optimism and a clearer view of reality.
- The ability to address difficult situations like finding a job or working through a serious health issue.
If you choose PST, you may be asked to:
- Complete written assignments in and outside of sessions, sometimes as homework.
- Learn new problem-solving skills to overcome obstacles and address challenges.
- Identify a problem and practice your new skills to find a solution.
- Meet regularly with your therapist to discuss and establish goals for treatment.
Speak openly with your mental health provider about your symptoms and priorities so you can work together to determine whether this therapy is best for you.
Prolonged Exposure Therapy (PE)
PE is a therapy that can teach you to gradually approach and address traumatic memories, feelings, and situations that you may be avoiding. By talking about these difficult moments and confronting these challenges directly, you may see symptoms of PTSD begin to decrease so that you can start living your life more fully again.
PE typically lasts from eight to 15 sessions and can be tailored to your treatment preferences, values, and priorities. Through this therapy, you may:
- Learn new breathing techniques to help address your anxiety.
- Feel more comfortable in situations and settings that you would have previously avoided due to trauma.
- Have fewer unwanted memories and thoughts.
If you choose this therapy, you may be asked to:
- Commit to attending regular weekly sessions.
- Talk about the details of your trauma.
- Make a list of the people, places, or activities that you’ve avoided since your trauma and gradually confront them over time.
- Complete homework and practice new skills outside of the sessions.
Speak openly with your provider about your mental health symptoms so that you can work together to determine the treatment plan that is best for you.
Safety Planning Intervention (SPI)
SPI is a treatment for Veterans experiencing or displaying suicidal thoughts and behaviors. By working with your provider to create a safety plan, you can discover healthy ways to cope with these thoughts, curb these behaviors, and improve your quality of life.
SPI can be a single session or incorporated into ongoing treatment for those who wish to continue meeting with their therapist. Sessions are typically one-on-one and range from 20 to 40 minutes long. After attending one or a series of sessions, you may:
- Feel a heightened sense of control over yourself and your environment.
- Experience a more optimistic attitude when it comes to feelings related to suicidal thoughts.
- Notice a decrease in unhelpful thoughts and an increase in helpful thoughts.
If you choose SPI, you may be asked to:
- Work with your provider to create a written list of coping strategies and resources to use during a suicidal episode.
- Identify warning signs that signal when to use your coping strategies.
- Assess the overall safety plan and remove barriers to using it during a crisis.
- Review the plan periodically with your provider when your circumstances or needs shift.
Speak openly with your provider about your feelings and mental health symptoms so that you can work together to determine the safety plan that best meets your needs and situation.
Social Skills Training (SST)
SST is a therapy for serious mental health conditions, such as schizophrenia, bipolar disorder, and severe depression, that have not responded to other treatments. Typically, SST is provided in a group setting and can teach you ways to better express yourself and respond to others’ thoughts, feelings, and needs.
SST strives to improve your social skills and increase your ability to function in everyday settings. Through this therapy, you may:
- Learn to start and maintain better conversations.
- Become more comfortable asking for help from others.
- Feel safer in expressing your feelings, resolving conflicts, making friends, and asserting yourself when necessary.
- Notice increased satisfaction in your personal relationships.
- Become more independent.
If you choose SST, you may be asked to:
- Commit to attending sessions regularly.
- Learn about the importance of various social skills.
- Demonstrate your ability to use various skills in a role-play.
- Accept feedback and notes for improvement from peers.
- Practice outside of the therapy group between sessions.
To determine whether SST may be right for you, speak with your mental health provider openly about your challenges.
