The short answer
The 2023 VA/DoD PTSD guideline strongly recommends three psychotherapies: Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Eye Movement Desensitization and Reprocessing (EMDR). It also suggests Ehlers' Cognitive Therapy, Present-Centered Therapy, and Written Exposure Therapy. VA offers free courses on the guideline for community providers.
What does the VA/DoD guideline recommend for PTSD?
The current guideline, published by VA and the Department of Defense in 2023, gives its strongest psychotherapy recommendation to three manualized, trauma-focused treatments. See the provider summary.
| Strength | Psychotherapies |
|---|---|
| Recommended (strong) | Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR) |
| Suggested (weak) | Ehlers' Cognitive Therapy for PTSD, Present-Centered Therapy, Written Exposure Therapy (WET) |
The guideline also covers medications, other treatments, and assessment. This page sticks to psychotherapy.
What does a "strong" recommendation mean?
It means the guideline's panel judged the evidence and the balance of benefits and harms strong enough that most patients should be offered that treatment. A "weak" recommendation means the panel found a treatment reasonable to offer, with less confidence. Neither label means other approaches are banned or useless.
Do community therapists have to use these treatments?
No law requires a community therapist to use a guideline treatment. The guideline is a reference, not a rule. Some VA programs or contracts may ask about evidence-based treatment, and Veterans who've been in VA care may already know these names.
What the guideline does give you is a shared language. If a Veteran says "I did PE at the VA and it didn't help," knowing what PE involves helps you plan next steps with them.
Where can you train?
- Free overview courses. VA's National Center for PTSD offers a free online course, Psychotherapy for PTSD: Recommendations from the VA/DoD Clinical Practice Guideline, with continuing education credit through TRAIN. See VA's community care training page.
- Full certification. Becoming competent in CPT, PE, or EMDR takes formal workshop training plus consultation on real cases. Those trainings are offered by treatment developers and professional organizations, usually for a fee.
- Case questions. The free PTSD Consultation Program can help you think through a case or find training.
How ValorWell handles this
ValorWell doesn't dictate which treatment you use. Treatment approach is your clinical decision, made within your training, your scope, and the client's goals. If you're trained in CPT, PE, or EMDR, you use them when they fit. If you aren't, you can decline referrals that call for a specialty you don't offer.
ValorWell may support continuing education case by case, which can include trauma training.
Important limits
- Guidelines change. VA and DoD update them every few years. Check the current version before citing it.
- Recommendations don't replace clinical judgment. Client preference, co-occurring conditions, and readiness all matter.
- Don't practice a manualized treatment without training. Reading a manual isn't the same as being trained and consulted on cases.
- This page isn't a treatment protocol. It's an orientation for therapists who are new to Veteran care.