Experiences of providers delivering evidence-based psychotherapy for PTSD to black Veterans: A qualitative study

Abstract: Previous research has found that Black veterans (vs. White veterans) evidence less symptom improvement following trauma-focused evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD). Black veterans’ experiences of racism and discrimination, as well as how providers respond to these experiences during PTSD EBPs, may help to explain these racial disparities in outcomes. However, there is a lack of qualitative research exploring providers’ experiences delivering PTSD EBPs to Black veterans. This study aimed to fill this gap in the literature by interviewing 15 mental health providers with experience delivering PTSD EBPs working at a West Coast Veterans Affairs Medical Center about (a) their comfort in discussing racism and discrimination with veterans, (b) the role of their identity in these discussions, (c) the extent to which racism and discrimination are presenting problems in PTSD EBPs, (d) Black veterans’ response to PTSD EBPs, and (e) ways PTSD EBPs may be improved for Black veterans. Rapid analysis procedures were used to identify prominent and relevant themes, which are summarized and discussed with a focus on informing clinical recommendations and the development of provider training that may improve experiences and outcomes for Black veterans engaging in PTSD EBPs. In this study, 15 VA mental health providers with experience delivering evidence-based psychotherapy for posttraumatic stress disorder were interviewed about their experiences treating Black veterans. While providers reported they were comfortable discussing discrimination/racism with veterans, some providers seemed less comfortable discussing these topics; some White providers expressed concerns that these discussions may damage rapport with Black veterans. This research can aid in designing training/support for providers to better serve Black veterans.