{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:37:00Z","timestamp":1786113420834,"version":"build-2736575974"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Behav Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Military-affiliated adults including veterans, active-duty service members, and their families experience elevated rates of mental health conditions such as PTSD, depression, and anxiety. Addressing these needs requires accessible, high-quality, and evidence-based care delivered at scale. Cohen Veterans Network (CVN), a national network of community-based military family clinics, was established in 2015 to provide rapid access to mental healthcare, emphasizing evidence-based psychotherapies, measurement-based care, and standardized clinical and operational practices. This retrospective study examined ten years of outpatient mental health care (2016\u20132025) across CVN clinics (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200945,947 clients). Analyses focused on symptom change, clinically significant improvement, and trends over time, with stratification by client type and gender. Results indicate that across more than a decade of care, clients demonstrated consistent, meaningful symptom reductions. Among clients who screened positive at intake, mean PHQ-9 improvements ranged from 6.05 to 7.10 points, GAD-7 improvements from 5.67 to 6.24 points, and PCL-5 improvements from 16.50 to 18.37 points, with 55\u201368% of clients achieving clinically significant change. Outcomes remained stable despite network expansion, shifts in client composition, and external stressors such as the COVID-19 pandemic. Outcomes are also described by client type and gender, with all subgroups demonstrating symptom reductions. These findings demonstrate that using a social franchise model combining centralized infrastructure, local clinic management, standardized training requirements, and rigorous quality control can sustainably deliver high-quality, effective psychotherapy at scale. The CVN experience provides a replicable framework for addressing mental health disparities among military-affiliated populations and other underserved groups.\n                  <\/jats:p>","DOI":"10.1007\/s11414-026-10014-6","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T18:57:05Z","timestamp":1785956225000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ten Years of Outcomes in a National Mental Health Network for Veterans, Service Members, and Military Families"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2411-228X","authenticated-orcid":false,"given":"Steven L.","family":"Lancaster","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Chiarello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Linkh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy A.","family":"Neal-Walden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony M.","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"10014_CR1","doi-asserted-by":"publisher","unstructured":"Crockett JL, Yu-Lefler HF, Shumate ED, et al. 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