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<p>Nightmares, which are associated with various biopsychosocial issues, are common and often undertreated among veterans. To address the demand for Cognitive Behavioral Therapy for Nightmares (CBT-N) in the Veterans Health Administration (VHA), experts have trained mental health clinicians in its delivery. Program evaluation data show positive clinician perceptions of CBT-N but reveal implementation barriers, including the incompatibility between CBT-N and certain practice settings. One such setting is Primary Care Mental Health Integration (PCMHI), where brief episodes of care may limit CBT-N feasibility. Survey results suggest PCMHI clinicians (<i>n</i>=13) perceive greater CBT-N benefits than clinicians in other settings (<i>n</i>=64) but face barriers such as scheduling constraints. A subanalysis showed that PCMHI clinicians (<i>n</i>=3) find CBT-N to be significantly less appropriate and feasible than clinicians in other settings (<i>n</i>=12). These preliminary findings support adapting CBT-N for PCMHI as a pathway to increased uptake and improved access to nightmare treatment within the VHA.</p>

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Delivering Cognitive Behavioral Therapy for Nightmares (CBT-N) in primary care within the Veterans Health Administration: A preliminary report on clinician-perceived barriers and benefits

  • 期刊论文

  • 发表日期：

    2026年5月22日

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  • Courtney J. Bolstad,
  • Constance H. Fung,
  • Lori Davis,
  • Lisa Zubkoff,
  • Adam D. Bramoweth,
  • Audrey L. Austin,
  • Gerald McGwin,
  • Christina Krieg,
  • Katherine E. Miller

摘要

Nightmares, which are associated with various biopsychosocial issues, are common and often undertreated among veterans. To address the demand for Cognitive Behavioral Therapy for Nightmares (CBT-N) in the Veterans Health Administration (VHA), experts have trained mental health clinicians in its delivery. Program evaluation data show positive clinician perceptions of CBT-N but reveal implementation barriers, including the incompatibility between CBT-N and certain practice settings. One such setting is Primary Care Mental Health Integration (PCMHI), where brief episodes of care may limit CBT-N feasibility. Survey results suggest PCMHI clinicians (n=13) perceive greater CBT-N benefits than clinicians in other settings (n=64) but face barriers such as scheduling constraints. A subanalysis showed that PCMHI clinicians (n=3) find CBT-N to be significantly less appropriate and feasible than clinicians in other settings (n=12). These preliminary findings support adapting CBT-N for PCMHI as a pathway to increased uptake and improved access to nightmare treatment within the VHA.