TY - JOUR
AU - C. J. Bolstad
AU - C. H. Fung
AU - L. Davis
AU - L. Zubkoff
AU - A. D. Bramoweth
AU - A. L. Austin
AU - G. McGwin
AU - C. Krieg
AU - K. E. Miller
A1 - 
AB - Nightmares, which are associated with various biopsychosocial issues, are common and often undertreated among veterans. To address the demand for Cognitive Behavioral Therapy for Nightmares (CBT-N) in the Veterans Health Administration (VHA), experts have trained mental health clinicians in its delivery. Program evaluation data show positive clinician perceptions of CBT-N but reveal implementation barriers, including the incompatibility between CBT-N and certain practice settings. One such setting is Primary Care Mental Health Integration (PCMHI), where brief episodes of care may limit CBT-N feasibility. Survey results suggest PCMHI clinicians (n=13) perceive greater CBT-N benefits than clinicians in other settings (n=64) but face barriers such as scheduling constraints. A subanalysis showed that PCMHI clinicians (n=3) find CBT-N to be significantly less appropriate and feasible than clinicians in other settings (n=12). These preliminary findings support adapting CBT-N for PCMHI as a pathway to increased uptake and improved access to nightmare treatment within the VHA.
AD - Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Health Care System, Birmingham, AL, USA. courtney.bolstad@va.gov.; Division of Gerontology, Geriatrics, and Palliative Care, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. courtney.bolstad@va.gov.; VA Greater Los Angeles Geriatric Research, Education, and Clinical Center, Los Angeles, CA, USA.; Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.; Birmingham VA Health Care System, Birmingham, AL, USA.; Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Health Care System, Birmingham, AL, USA.; Division of General Internal Medicine and Population Science, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.; Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.; Center for Healthcare Evaluation, Research, and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.; Primary Care Mental Health, VISN 22 Clinical Resource Hub, VA Phoenix Health Care System, Phoenix, AZ, USA.; Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.; Department of Psychiatry and Behavioral Sciences, University of Minnesota-Twin Cities, Minneapolis, MN, USA.
AN - 42171872
BT - J Clin Sleep Med
C5 - Healthcare Disparities; Education & Workforce
CP - 1
DA - 05/2026
DO - 10.1007/s44470-026-00073-z
DP - NLM
ET - 20260522
IS - 1
JF - J Clin Sleep Med
LA - eng
N2 - Nightmares, which are associated with various biopsychosocial issues, are common and often undertreated among veterans. To address the demand for Cognitive Behavioral Therapy for Nightmares (CBT-N) in the Veterans Health Administration (VHA), experts have trained mental health clinicians in its delivery. Program evaluation data show positive clinician perceptions of CBT-N but reveal implementation barriers, including the incompatibility between CBT-N and certain practice settings. One such setting is Primary Care Mental Health Integration (PCMHI), where brief episodes of care may limit CBT-N feasibility. Survey results suggest PCMHI clinicians (n=13) perceive greater CBT-N benefits than clinicians in other settings (n=64) but face barriers such as scheduling constraints. A subanalysis showed that PCMHI clinicians (n=3) find CBT-N to be significantly less appropriate and feasible than clinicians in other settings (n=12). These preliminary findings support adapting CBT-N for PCMHI as a pathway to increased uptake and improved access to nightmare treatment within the VHA.
PY - 2026
SN - 1550-9389 (Print); 1550-9389
ST - Delivering Cognitive Behavioral Therapy for Nightmares (CBT-N) in primary care within the Veterans Health Administration: A preliminary report on clinician-perceived barriers and benefits
T1 - Delivering Cognitive Behavioral Therapy for Nightmares (CBT-N) in primary care within the Veterans Health Administration: A preliminary report on clinician-perceived barriers and benefits
T2 - J Clin Sleep Med
TI - Delivering Cognitive Behavioral Therapy for Nightmares (CBT-N) in primary care within the Veterans Health Administration: A preliminary report on clinician-perceived barriers and benefits
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1007/s44470-026-00073-z
VL - 22
VO - 1550-9389 (Print); 1550-9389
Y1 - 2026
ER -