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Concerns about the dissemination and implementation of evidence-based psychotherapies in the Veterans Affairs health care system.

Comments on the article by B. E. Karlin and G. Cross (see record 2013-31043-001). The present authors have concerns stemming primarily from how the Department of Veterans Affairs (VA) defines evidence-based psychotherapies (EBPs). The article by Karlin and Cross alluded to some of the controversies surrounding EBPs and why they have not been broadly implemented in many settings. For example, EBP guidelines often are perceived as mechanistic and only appropriate for certain patient populations; and, indeed, for many troubled individuals, EBPs do not work or require adjustment. A group of 19 current and recent past presidents of three APA divisions (12, 29, and 50) and the North American and International Societies for Psychotherapy Research has identified several questions, the answers to which may be important to increase the optimization of such guidelines.