# From Training to Practice: Understanding the Integration of Evidence-Based Psychotherapies for Depression (INTEGRATE)

> **NIH VA I01** · MINNEAPOLIS VA  MEDICAL CENTER · 2024 · —

## Abstract

Background. Depression is a highly prevalent mental health disorder that carries a heavy disease burden and
is the 2nd leading risk factor for suicide among Veterans. VA has disseminated three effective psychotherapies
for depression to VA clinics but therapist use of these treatments is <12%. Surprisingly, no studies have
examined the provision of evidence-based psychotherapies for depression (D-EBPs) in VA and reasons
underlying infrequent delivery, leaving a critical gap in depression care delivery in VA. System factors are a
known driver of EBP use, and early signs from OMHSP's efforts and unique factors related to how depression
care is organized in VA warrant an empirical investigation. Significance. Low utilization of D-EBPs and the
lack of empirical evidence on barriers is a significant problem for several reasons. First, suicide prevention is a
top priority in VA and across the nation and untreated depression is a major risk factor for suicide. Second,
effectiveness of existing interventions that target provider-level barriers cannot be maximized without data
about system barriers. Increasing the reach of other EBPs (e.g., PTSD) has required intervention at all levels
(patient, provider, and system) and the same is undoubtably true for D-EBPs. Identifying and targeting system
factors and exploring therapist factors and conducting the first exploration of patient perceptions of D-EBPs will
bolster these early provider-focused interventions. Furthermore, this proposal is timely in that it comes on the
heels of OMHSP's shift from assessing anticipated barriers to D-EBP delivery during trainings to developing
partnerships to understand barriers experienced in the field. Finally, since this proposal is examining D-EBP
delivery in specialty mental health clinics where other mental health conditions are treated, findings have
implications of EBPs for those other conditions. Innovation/Impact. The proposed 3.5-year study will be the
first study to examine reasons for low utilization of depression EBPs by therapists in VA. Our mixed-methods
approach will yield a robust understanding of how the policies, resources and culture within specialty mental
health clinics contribute to low D-EBP use by therapists. Our aims are directly aligned with OMHSP's goal to
increase the implementation of clinical practice guideline-concordant care in VA mental health clinics. Our
proposed classification of all VA medical centers on system-level factors that are associated with D-EBP
delivery, strategic qualitative analysis, intervention mapping and stakeholder engagement provides invaluable
data to OMHSP and the field quickly. Aims. 1) Quantitatively examine the association between health system
factors and D-EBP delivery; 2) Qualitatively examine how contextual and system factors impact therapist
decisions around the provision of D-EBPs; 3) Develop a framework of intervention targets and potential
solutions to reduce barriers to D-EBP use; 4) Secondary/Exploratory...

## Key facts

- **NIH application ID:** 10680433
- **Project number:** 5I01HX003323-02
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** Princess E. Ackland
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2022-08-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10680433

## Citation

> US National Institutes of Health, RePORTER application 10680433, From Training to Practice: Understanding the Integration of Evidence-Based Psychotherapies for Depression (INTEGRATE) (5I01HX003323-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10680433. Licensed CC0.

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