Department of Veterans Affairs

The Department of Veterans Affairs (VA) operates the largest integrated healthcare delivery system in the United States. Counseling has had an important and increasingly prominent role in the VA healthcare system since its establishment over 60 years ago. Administered by the Veterans Health Administration (VHA), the VA healthcare delivery system contains the nation's largest mental healthcare system. The VA is the largest provider of mental health services in the country and is among the nation's largest employers [Page 154]of psychiatrists, psychologists, social workers, and mental health nurses.

To meet the diverse psychosocial needs of veterans, the VHA provides a full spectrum of counseling services, including individual, group, and family psychotherapy; intensive case management; vocational rehabilitation; medication management; psychoeducation; skills training; psychological, cognitive, and neuropsychological assessment services; and psychosocial rehabilitation (PSR) for veterans with serious mental illness. Counseling services (and related psychological services) provided by VHA emphasize evidence-based approaches to a variety of mental health and substance use disorders (including comorbid conditions) and behavioral medicine conditions (e.g., smoking cessation, sleep disturbance, weight management, medical adherence) and to facilitate readjustment to and maximum functioning in the community.

Counseling services are provided to veterans in both VA medical centers (VAMCs) and in VA community-based outpatient clinics (CBOCs). As of January 1, 2007, there were 155 VAMCs and over 700 CBOCs. In addition, a range of readjustment counseling and outreach services (e.g., bereavement counseling, military sexual trauma counseling, vocational counseling, referral services) are provided to veterans and eligible family members in 209 VA Vet Centers located in all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.