# A pragmatic trial of brief CBT for anxiety in VA primary care

> **NIH VA I01** · MICHAEL E DEBAKEY VA MEDICAL CENTER · 2020 · —

## Abstract

Anticipated Impacts on Veteran's Healthcare VA has established strategic goals related to “Access” and
"Timely and Integrated Care". The proposed pragmatic trial targets these goals by addressing a significant gap
in VA mental health care - namely the treatment of anxiety in the primary care setting using innovative delivery
options. Using a partnership approach, the project will examine the effectiveness and implementation potential
of a brief psychotherapy program for Veterans with anxiety in primary care. Psychotherapy services will be
delivered either in-person or through VA Video Connect-Home (VVC-H). Clinical and implementation outcomes
will inform future dissemination efforts to improve access and delivery of high quality anxiety care in VA
primary care settings.
Background Anxiety disorders are common in VA primary care settings and are associated with substantial
functional impairment, poor health-related quality of life, suicide, and high rates of comorbid psychiatric and
medical disorders. No brief psychotherapy interventions for anxiety currently exist for VA primary care settings
- where many Veterans seek care. Cognitive Behavioral Therapy (CBT) is a first line treatment for anxiety but
Primary Care Mental Health Integration (PCMHI) providers need an intervention approach for anxiety disorders
that is brief, problem-focused, and fits into their system of care.
Objectives The proposed 4-year, multisite trial will use a pragmatic randomized trial design to examine the
effectiveness and implementation potential of a brief CBT intervention for anxiety delivered either in-person or
via VVC-H, according to patient preference. CBT will be delivered by existing PCMHI providers at three large
VAMCs. Aim 1 will examine the clinical effectiveness of the bCBT intervention vs. EUC for anxiety and quality
of life at 4-, 8-, and 12-month follow-ups. Aim 2 will determine factors associated with bCBT response and
explore Veteran demographic and clinical factors associated with VVC-H engagement. An exploratory aim will
use mixed, qualitative and quantitative methods to better understand implementation successes and
challenges related to delivery and impact of bCBT anxiety and VVC-H use in the PCMHI setting.
Methods The proposed project seeks to embed bCBT into PCMHI programs using existing VHA providers. A
total of 225 Veterans diagnosed with an anxiety disorder will be recruited from three VAMCs. Eligible Veteran
participants will be randomized to a bCBT or to an Enhanced Usual Care (EUC) condition. A professionally
diverse set of PCMHI providers will be invited to deliver bCBT. Providers will receive bCBT training and
support to embed treatment into their existing practice setting. Veterans randomized to bCBT will receive 4 – 9
sessions based upon treatment response (50% reduction in GAD-7) by session 4. Veterans will also be offered
the choice of receiving bCBT in-person or through VVC-H. EUC participants will receive 4 brief monthly check-
in cal...

## Key facts

- **NIH application ID:** 9950743
- **Project number:** 1I01HX002796-01A1
- **Recipient organization:** MICHAEL E DEBAKEY VA MEDICAL CENTER
- **Principal Investigator:** Jeffrey Alexander Cully
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9950743

## Citation

> US National Institutes of Health, RePORTER application 9950743, A pragmatic trial of brief CBT for anxiety in VA primary care (1I01HX002796-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9950743. Licensed CC0.

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