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Dissemination & Implementation Science

Barriers and facilitators to adjunctive DBT Skills Groups in Veterans Health Administration for Veterans at high-risk for suicide attempt: Mixed-methods progress-focused formative evaluation

(PS5-4) Barriers and Facilitators to Adjunctive DBT Skills Groups in Veterans Health Administration for Veterans at High-risk for Suicide Attempt: Mixed-methods Progress-focused Formative Evaluation

Saturday, November 22, 2025

10:00 AM - 11:00 AM CST

Location: Elite Hall A, Level 1

Author(s)

Suzanne E. Decker, Ph.D. (she/her/hers)

Psychologist; Associate Professor
VA Connecticut Healthcare System; Yale School of Medicine
West Haven, Connecticut, United States

Co-Author(s)

AK

Aimee Kroll-Desrosiers, Ph.D.

Research Health Scientist; Assistant Professor
VA Central Western Massachusetts Healthcare System; University of Massachusetts Chan Medical School, Dept of Population and Quantitative Health Sciences; UMass Amherst, Dept of Health Promotion and Policy
Leeds, Massachusetts, United States
KM

Kristin Mattocks, M.P.H., Ph.D.

Associate Chief of Staff, Research; Professor
VA Central Western Massachusetts Healthcare System; University of Massachusetts Chan Medical School, Dept of Population and Quantitative Health Sciences; UMass Amherst, Dept of Health Promotion and Policy
Leeds, Massachusetts, United States
Scarlett Baird, Ph.D.

Psychologist; Assistant Professor
VA San Diego Healthcare System; University of California San Diego School of Medicine, Department of Psychiatry
San Diego, California, United States
ND

Neal Doran, Ph.D.

Chief of Psychology; Professor
VA San Diego Healthcare System; University of California San Diego School of Medicine, Department of Psychiatry
San Diego, California, United States
JR

Jennifer K. Rielage, Ph.D.

Psychology Section Chief; Associate Professor
VA New Mexico Healthcare System; University of New Mexico School of Medicine, Department of Psychiatry and Behavioral Sciences
Albuquerque, New Mexico, United States
JR

Josephine Ridley, Ph.D.

Assistant Chief of Psychology; Adjunct Associate Professor
VA Northeast Ohio Healthcare System; Case Western Reserve University
Cleveland, Ohio, United States
JB

Jenny Bannister, Ph.D.

Psychologist
James A. Haley Veterans Hospital
Tampa, Florida, United States
TG

Thorayya Giovannelli, Psy.D. (she/her/hers)

Psychologist
James A. Haley Veterans Hospital
Tampa, Florida, United States
FA

Frances M. Aunon, Ph.D. (she/her/hers)

Psychologist; Associate Research Scientist
VA Connecticut Healthcare System; Yale School of Medicine, Department of Psychiatry
West Haven, Connecticut, United States
SL

Sara J. Landes, Ph.D.

Director; Associate Professor
Behavioral Health Quality Enhancement Research Initiative (QUERI), Central Arkansas Veterans Healthcare System; Department of Psychiatry, University of Arkansas for Medical Sciences
North Little Rock, Arkansas, United States
MG

Marianne Goodman, M.D.

Director; Professor
Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 2, James J. Peters Department of Veterans Affairs Medical Center; Icahn School of Medicine at Mount Sinai, Dept of Psychiatry
The Bronx, New York, United States
EG

Elizabeth Galliford, M.P.H.

Health Science Specialist
VA Connecticut Healthcare System
West Haven, Connecticut, United States
LW

Lorrie Walker, M.P.H.

Health Science Specialist
VA Central Western Massachusetts Healthcare System
Leeds, Massachusetts, United States
ED

Eric C. DeRycke, M.P.H.

Health Science Specialist
VA Connecticut Healthcare System
West Haven, Connecticut, United States
CS

Chris L. Shriver, M.A.

Health Science Specialist
VA San Diego Healthcare System
San Diego, California, United States
LM

Lyanette Martinez, M.S.

Health Science Specialist
VA New Mexico Healthcare System
Albuquerque, New Mexico, United States
HB

Hannah Brown, B.A.

Health Science Specialist
VA Northeast Ohio Healthcare System
Cleveland, Ohio, United States
ES

Elena Shest, B.A.

Health Science Specialist
James A. Haley Veterans Hospital
Tampa, Florida, United States
SM

Steve Martino, Ph.D.

Chief of Psychology; Professor
VA Connecticut Healthcare System; Yale School of Medicine, Dept of Psychiatry
West Haven, Connecticut, United States

Abstract Text: Suicide prevention is the highest clinical priority at Veterans Health Administration (VHA), and requires effective implementation of evidence-based treatments for those at high risk. In a hybrid type 1 effectiveness-implementation trial, guided by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS), our team assessed barriers and facilitators to an adaptation of Dialectical Behavior Therapy Skills Groups, supported by therapist consultation team (DBT-SG), as an adjunct to treatment as usual. Prior to launching a clinical trial of DBT-SG to reduce Veteran emotion dysregulation and suicide attempt at four VHA medical centers, VHA administrators and clinical providers expressed enthusiasm and high confidence in the innovation, and caution about the healthcare system’s ability to deliver the intervention given staffing levels (citation redacted). This poster presents new mixed-methods data from a progress-focused formative evaluation, conducted during the clinical trial and collecting data from VHA clinicians, referring providers, and administrative leaders (n=27 quantitative, n = 35 qualitative; data are still accruing). Organizational Readiness for Change (ORCA) mean scores indicate that while confidence in the innovation and its evidence is high (on a 5-point Likert-type scale, M = 4.4, SD = 0.5), confidence in the context to support implementation is mixed (M = 3.8, SD = 0.7). Facilitation scores were positive (M = 4.2, SD = 0.5). Qualitative interviews expand on these findings to show that staff’s high enthusiasm for the treatment is tempered somewhat by difficulty carving out time to prepare for group, staff turnover, and administrative responsibilities. Findings have implications for the impact of staffing levels on providers’ ability to deliver suicide prevention care at VHA, consistent with literature (Feyman et al., 2023).