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Symposia

Couples / Close Relationships

Innovations in Relationship Care for Veterans and their Loved Ones

4 - (SYM 51) Provider and Patient Outcomes from a National VA Training Initiative in Cognitive-behavioral Conjoint Therapy for PTSD

Sunday, November 23, 2025
10:56 AM - 11:13 AM CST
Location: Foster 2, Level 2
Keywords: Couples / Close Relationships, Veterans, Treatment
Recommended Readings: Liebman, R. E., Whitfield, K. M., Sijercic, I., Ennis, N., & Monson, C. M. (2020). Harnessing the healing power of relationships in trauma recovery: A systematic review of cognitive-behavioral conjoint therapy for PTSD. Current Treatment Options in Psychiatry, 7, 203-220.,   Landes, S. D., Wilmoth, J. M., London, A. S., & Landes, A. T. (2023). Risk factors explaining military deaths from suicide, 2008–2017: A latent class analysis. Armed Forces & Society, 49(1), 115–137. https://doi.org/10.1177%2F0095327X211046976,   Monson, C. M., Wagner, A. C., Mithoefer, A. T., Liebman, R. E., Feduccia, A. A., Jerome, L., ... & Mithoefer, M. C. (2020). MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial. European Journal of Psychotraumatology, 11(1), 1840123.,   ,  
Abstract Body
Posttraumatic stress disorder (PTSD) and intimate relationship functioning are reciprocally related. Couple-based PTSD treatments, such as Cognitive Behavioral Conjoint Therapy (CBCT) for PTSD, show promise in clinical trials for treating both PTSD symptoms and enhancing intimate relationship functioning. The Veterans Affairs (VA) healthcare system is invested in training mental health providers in evidence-based PTSD treatments, including CBCT for PTSD. This presentation describes the process and outcome of a large national VA dissemination & training initiative for CBCT for PTSD. Four-hundred and four frontline VA licensed mental health providers were selected to participate in a comprehensive 6-month training program, involving both an intensive multiday training workshop and subsequent cohort-based consultation on at least two training cases. As part of this training initiative, 569 couples began CBCT for PTSD. Data were collected on predictors of provider training completion, attrition rates of both providers and couples, and couples’ clinical outcomes. Sixty-four percent of the providers completed the 6-month training program successfully; predictors of successful provider completion included being a psychologist rather than a clinician from another mental health discipline; working in a specialty PTSD clinic rather than other mental health setting; having completed prior similar training programs; and having adequate time for CBCT for PTSD cases in their schedules. Overall, veterans and their partners reported significant improvements in veterans’ PTSD symptoms, relationship satisfaction, and partners’ accommodating behaviors during CBCT for PTSD. Approximately one-third of couples completed the full 15-session treatment; engaging in a less than adequate dose (< 12 sessions; 43%) was associated with significant improvement in PTSD outcomes, but not veterans’ relationship satisfaction or partners’ accommodation. Results from this training program suggest that VA mental health providers can be trained to successfully implement CBCT for PTSD, particularly when they are able to accommodate training in a new modality into their work schedules. These results also echo prior clinical trial data showing that CBCT for PTSD is effective, but that completing the full 15-session protocol may not be feasible for the majority of couples.