Staff perspectives on implementing dialectical behavior therapy skills groups in the Veterans Health Administration.
Year: 2025
Type: article
Abstract: Reducing veteran suicide is a high priority for the Veterans Health Administration (VHA). While dialectical behavior therapy skills groups (DBT-SG) may be as effective as comprehensive DBT in reducing suicide attempt, barriers and facilitators to this innovation in VHA are not well known. In preparation for a hybrid Type 1 effectiveness-implementation trial, we conducted individual semistructured qualitative interviews with 35 VHA staff (therapists, suicide prevention coordinators, local and national leaders) and identified themes using rapid qualitative analysis (Hamilton, 2013). Five themes emerged: (a) While leadership noted wanting innovative suicide prevention, (b) knowledge of DBT varied widely across respondents. (c) Implementation challenges, especially after COVID-19, included staff shortage and burnout. (d) DBT-SG may require adaptation to fit the diversity of the veteran population, including Indigenous, homeless, and urban veterans, and (e) virtual DBT-SG options hold promise for expanding reach and access and must be implemented with appropriate risk management. Enthusiasm for DBT-SG was high, and implementation challenges in a stressed health care system were noted. DBT-SG, especially delivered virtually, holds promise for VHA and will need to be implemented with attention to staffing, provider needs, and veteran diversity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Source: Psychological Services
DOI: 10.1037/ser0000960
Authors: Suzanne E. Decker, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Frances M. Aunon, Lorrie Walker, Elizabeth Galliford, Neal Doran, Scarlett Baird, Jennifer K. Rielage, Joseph Sadek, Josephine Ridley, Jenny Bannister, Thorayya S. Giovannelli, Sara J. Landes, Marianne Goodman, Eric DeRycke, Chris Shriver, Ethan Spana, Mark Honsberger, Stacey A. Demirelli, Elena Shest, Steve Martino
Institutions: VA Connecticut Healthcare System, VA Central Western Massachusetts Healthcare System, VA San Diego Healthcare System, New Mexico VA Health Care System, VA Northeast Ohio Healthcare System, James A. Haley Veterans' Hospital, Central Arkansas Veterans Healthcare System, Quality Enhancement Research Initiative, Veterans Health Administration, James J. Peters VA Medical Center, Mental Illness Research, Education and Clinical Centers
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
OpenAlex ID: W4411346901