Assessment and treatment of obsessive compulsive disorder in veterans with PTSD: A qualitative descriptive study

The comorbidity of obsessive compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) is common and leads to worse clinical and psychosocial outcomes than PTSD alone. Yet, OCD remains underdiagnosed and undertreated among veterans, a population with high rates of PTSD. This qualitative descriptive study aimed to understand Veterans Affairs providers' current practices for assessing and treating OCD in veterans with PTSD, as well as barriers to and needs for assessment and treatment. Twelve clinical psychologists were recruited to participate in semistructured interviews. The qualitative interview guide and analysis were informed by the consolidated framework for implementation research. Rapid, matrix, and team-based qualitative techniques were used to facilitate analysis. Psychologists across general mental health clinics (n = 7) and a trauma-focused specialty clinic (n = 5) were interviewed. Findings revealed most psychologists in general mental health clinics had assessed for and treated OCD in veterans with PTSD. Yet, across clinics, providers held misconceptions about OCD diagnosis and treatment. Providers reported barriers to assessment and treatment including a perceived lack of knowledge and training, access to consultation and resources, and time. Trauma-focused specialty clinic providers also noted national mandates as a barrier to OCD assessment and treatment in veterans with PTSD. Providers identified needs including time for and access to education, training, consultation, and resources. Findings from this study detail current practices and strategies to facilitate assessment and treatment of OCD in PTSD. Addressing current barriers and needs would increase accessibility of services and potentially improve the lives of thousands of veterans at Veterans Affairs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).