Improving engagement in evidence-based psychological treatments among Veterans: Direct-to-consumer outreach and pretreatment shared decision-making

Despite growing empirical support over the past half-century, evidence-based psychotherapies (EBPs) remain infrequently delivered. Organized efforts within large public and private systems, including the Veterans Health Administration, have brought significant optimism to closing the research-to-practice gap. Notwithstanding robust improvements, few Veterans and non-Veterans receive EBPs. The current article expands implementation knowledge and practice by extending focus of EBP implementation from provider, system, and policy-level requirements to key patient-level barriers and associated "pull strategies" for promoting interest, demand, and engagement. Specifically, the article presents a public health and clinical engagement strategy and innovations developed by the authors leveraging strategic actions for increasing EBP uptake and engagement in two key areas: (a) direct-to-consumer outreach and education, and (b) pretreatment shared decision-making. Public Health Significance The present article advances a public health and clinical engagement model to address key patient factors that have limited the delivery of evidence-based psychotherapies (EBPs). Key strategies, including direct-to-consumer outreach and education and pretreatment shared decision-making, are presented and examined for promoting treatment uptake and engagement.