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However, research suggests that CBT\u2010CP is underused. The current study used national Veterans Health Administration data to examine the use of CBT\u2010CP by CBT\u2010CP\u2010trained therapists to treat patients with pain over a five\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Multilevel modeling was used to evaluate clinic, therapist, and patient\u2010level factors as predictors of CBT\u2010CP receipt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection<\/jats:title><jats:p>Administrative data on 37,514 patients seen at a national sample of Veterans Health Administration locations for pain were collected from the U.S. Veterans Health Administration central data repository.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>Results indicated 38.4% of patients with pain seen by a CBT\u2010CP\u2010trained therapist received CBT\u2010CP during the observation period. Patients were more likely to receive CBT\u2010CP if more time elapsed since their therapist received CBT\u2010CP training and if their therapist had a master's degree (vs. a doctorate). Patients with somatic symptom disorder and depressive disorders were more likely to receive CBT\u2010CP, while patients with comorbid personality disorders or substance use disorders were less likely to receive CBT\u2010CP. Patients seen in pain specialty, PTSD, biomedical, and mental health clinics were more likely to receive CBT\u2010CP than those not seen in these clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings suggest that the reach of CBT\u2010CP is substantively related to factors at each level. Future research is needed to better understand the therapy treatment decision\u2010making processes and to address education gaps and other factors that impede the implementation of evidence\u2010based practices.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14604","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T13:14:41Z","timestamp":1744290881000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of Cognitive\u2010Behavioral Therapy in a Nation\u2010Wide Veterans Health Administration Sample: The Role of Clinic, Therapist, and Patient Factors"],"prefix":"10.1111","volume":"60","author":[{"given":"Alan","family":"McGuire","sequence":"first","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"},{"name":"Department of Psychology Indiana University Purdue University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindy","family":"Flanagan","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"},{"name":"Department of Psychology Indiana University Purdue University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison E.","family":"Stout","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Coffing","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Kukla","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"},{"name":"Department of Psychology Indiana University Purdue University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Traylor","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Myers","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Henry","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3549-3840","authenticated-orcid":false,"given":"Jessica","family":"Carter","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Matthias","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Health Information and Communication Roudebush VA Medical Center  Indianapolis Indiana USA"},{"name":"Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Regenstrief Institute  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001839"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4276175"},{"key":"e_1_2_9_4_1","unstructured":"V.D.C.P. 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