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Implementing evidence-based group psychotherapy in Veterans Health Administration (VHA): Implications for burnout and
Thorayya Said Giovannelli1, Kristin Mattocks2, Frances M Aunon3
1James A. Haley Veterans Hospital.
Abstract:
Among behavioral health care providers, use of evidence-based psychotherapies has been associated with lower burnout when there is perceived institutional support, specialty clinical training, and high-quality clinical supervision. Mental health care providers implementing dialectical behavior therapy (DBT) have reported reduced burnout, with some evidence that the DBT consultation team may prevent burnout. Within the Veterans Health Administration, we examined provider experiences of burnout before and during implementation of an adjunctive outpatient DBT skills group and provider consultation team for veterans at high risk for suicide attempt. We conducted individual qualitative interviews with Veterans Health Administration staff (study therapists, referring providers, and administrative leaders), analyzed interviews with rapid qualitative analysis, and identified a subset of quotes related to burnout (N = 16 quotes provided by 14 respondents). We triangulated this data with process note data gathered at our site meetings to provide further context. Before DBT Skills Group implementation, providers anticipated high rates of burnout when treating veterans at high risk for suicide attempts and that the consultation team could attenuate burnout. During implementation, providers noted limited prior experience with evidence-based psychotherapies, little time to prepare for group, and staff turnover as factors related to higher burnout. Veterans Health Administration staff also noted the value of the consultation team for reducing provider burnout and ensuring staff were proficient in treating high-risk veterans. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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