One-size-fits-all approach to PTSD in the VA not supported by the evidence

Comments on the article by B. E. Karlin and G. Cross (see record 2013-31043-001). Karlin and Cross described innovations in disseminating evidence-based psychotherapies in the Veterans Health Administration (VHA), including therapies for posttraumatic stress disorder (PTSD). The multidimensional model they presented aims to promote the delivery of evidence-based psychotherapies nationally in order to redress the research-to-practice gap reflected in the infrequent use of evidence-based psychotherapies for PTSD in the VHA (Shiner et al., 2013). In the present authors' view, however, the validity of this otherwise worthy strategic goal is built upon the questionable assumption that there is strong and sufficient evidence to support the use of the therapies being disseminated.