Implementing brief Dynamic Interpersonal Therapy (DIT) in a VA Medical Center

Area of Science:

• Mental Health Services Research
• Psychotherapy Implementation Science
• Veterans Health Administration (VA) Healthcare

Background:

• Rising mental health demands within the VA necessitate innovative service delivery strategies.
• Challenges in provider, patient, and system-level factors can impede the expansion of psychotherapy options.
• Enhancing choice, access, and quality of care is a key objective for VA mental health services.

Purpose of the Study:

• To describe the implementation process of a new psychotherapy model within the VA.
• To identify and address barriers encountered during the integration of an evidence-based psychodynamic therapy.
• To evaluate the impact of the initiative on Veteran access and utilization of psychodynamic psychotherapy.

Main Methods:

• Brief Dynamic Interpersonal Therapy (DIT), an evidence-based short-term psychodynamic psychotherapy, was selected for implementation.
• Data collection focused on the implementation process, identified barriers, patient demographics, and access metrics.
• Qualitative and quantitative data were gathered to assess the feasibility and outcomes of DIT integration.

Main Results:

• DIT was delivered by 9 psychologists and 22 master's level externs to 73 Veterans.
• Annual referrals for psychodynamic psychotherapy saw a 360% increase post-implementation.
• DIT constituted 70.1% of all psychodynamic psychotherapy referrals, becoming the predominant modality.

Conclusions:

• Integrating evidence-based short-term psychodynamic psychotherapy into the VA system is achievable.
• VA mental health providers can be effectively trained in and implement brief psychodynamic psychotherapy.
• Psychodynamic treatment approaches present a viable and promising alternative to existing VA mental health services.