Department of Veterans’ Affairs
Guidelines for Clinical Mental Health Day Programmes
DVA is committed to ensuring that the treatment being provided in the group mental health treatment
programmes that it purchases on behalf of DVA clients is evidence based.
All veterans prior to inclusion in an outpatient day programme must have a comprehensive clinical
assessment by a qualified clinician and include a comprehensive treatment plan in consultation with the
veteran.
The table below provides a guide to the types of programmes that DVA is interested in purchasing. For
each type of programme (excluding Trauma Recovery Programmes – PTSD), the broad content that
DVA would expect to see and sample outcome measures are specified.
The suggested content is based on best practice evidence. Therapies without a strong evidence base may
be included in group programmes as adjunct therapy, but will not be purchased as a stand-alone group
treatment programme.
Consistent with the Primary Mental Health Alliance Guidelines for Determining Benefits for Private
Health Insurance Purposes for Private Mental Health Care 2015, programmes should operate on the
following basis:
Half day programmes:
These programmes should have a minimum of 2.5 hours of structured therapeutic contact each treatment
day. DVA requires that at least 1 - 1.5 of these minimum hours should use evidenced based core content.
The remaining hours may use additional adjunct therapy to support the treatment goals of the
programme.
Clinical disorders half-day programmes would be expected to run for 8-16 treatment days. Half-day
programmes for associated problems would be expected to run for 8-12 treatment days
Full day programmes:
These programmes should have a minimum of 4.5 hours of structured therapeutic contact each treatment
day. DVA requires that at least 2 - 3 hours of these minimum hours should use evidenced based core
content. The remaining hours may use additional adjunct therapy to support the treatment goals of the
programme.
Full day programmes for clinical disorders would be expected to run for 4-8 treatment days. Half-day
programmes for associated problems would be expected to run for 4-6 treatment days.
Table 1: Types, Content and Outcome Measures for Mental Health Programmes
Type of Program
Expected Core Content
Sample outcome
measures
Clinical disorders and sub-clinical presentations
These groups are intended for clients with a range of anxiety, mood, alcohol and drug use disorders
respectively, including sub-clinical presentations. They are intended to address shared features across
disorders within each cluster, rather than targeting each disorder separately (e.g., specific anxiety
disorders). Individual treatment should be provided for clients with acute and/or severe presentations of
these clinical disorders, targeted to the specific disorder.
Cognitive behavioural therapy (CBT) including structured
problem solving, anxiety management (including
cognitive, physiological and behavioural anxiety reduction
strategies ) and cognitive therapy
Anxiety disorders
Targeted interventions: e.g.
 Social skills training if relevant
 In vivo exposure if relevant
 Reducing substance use if relevant
Hours of core content: 12 - 16
Cognitive behavioural therapy (CBT), including structured
problem solving, activity scheduling/ behavioural
activation and cognitive therapy
OR
Mood disorders
Interpersonal therapy (IPT)
OR
Mindfulness (if individual has not responded to CBT/IPT)
Beck Anxiety
Inventory (BAI)*
Depression, Anxiety
and Stress Scale
(DASS-21)
Hospital Anxiety and
Depression Scale
(HADS)
Condition specific
measures where
relevant
DASS-21
Beck Depression
Inventory (BDI)*
Hospital Anxiety and
Depression Scale
(HADS)
Hamilton Depression
Scale (HAM-D)
Reducing substance use if relevant
Hours of core content : 12 – 16
Alcohol use
disorders
Motivational interviewing (MI) if relevant
Psycho-education, including risks, health impacts,
managing cravings, cycle of change
Cognitive behavioural therapy (CBT), including
behavioural self-management, coping skills training, cue
exposure, relapse prevention
Alcohol Unit
Disorders
Identification Test
(AUDIT)
DASS-21 if relevant
Hours of core content : 12 – 16
Substance use
disorders
Motivational interviewing (MI) if relevant
Motivational enhancement therapy (MET)
Cognitive behavioural therapy (CBT) including
behavioural self-management, coping skills training, cue
exposure, relapse prevention
Hours of core content : 12 – 16
Drug Abuse
Screening Test
(DAST-20)
DASS-21 if relevant
Type of Program
Expected Core Content
Sample outcome
measures
Associated problems
These groups are intended for clients with mild to severe problems in each of these domains. However in
the context of severe presentations, individual targeted interventions should also be offered.
Sleep
Psycho-education, including sleep hygiene, the effects of
substances, exercise, and appropriate sleep environments
Cognitive behavioural therapy for insomnia (CBT-i),
including sleep hygiene and stimulus control strategies
and cognitive therapy
Sleep diary
Pittsburgh Sleep
Quality Index (PSQI)
Hours of core content : 10 – 12
Pain management
Anger management
Cognitive behavioural therapy (CBT), including cognitive
therapy and behavioural techniques; arousal management
and relaxation; gentle exercise
Patient Health
Questionnaire-15
(PHQ-15)
Hours of core content : 10 – 12
8-item PHQ Somatic
Symptom Short Form
(PHQ-SSS)
Developing a therapeutic alliance
Dimensions of Anger
Reactions 5 (DAR5)
Psycho-education, including anger monitoring,
motivational interviewing (pros /cons of anger),
identifying cues and contextual factors, physiological,
cognitive and behavioural aspects of anger, role of
military training in anger responses, impacts on others
State Trait Anger
Expression Inventory
(STAXI)*
DASS-21 if relevant
Cognitive behavioural therapy (CBT), including arousal
management, cognitive therapy, self-instruction training,
exposure for anger, and behavioural techniques
Hours of core content : 10 – 12
Communication
Psycho-education
and relationship
Communication skills training, e.g.:
skills
 verbal and non-verbal communication,
 active listening skills,
 barriers to communication,
 assertive communication,
 giving and receiving feedback,
 effective communication strategies,
 building positive relationships
Should include partner/significant other involvement
where possible
Hours of core content : 10 – 12
Issues of Ageing
Psycho-education covering topics such as Grief and Loss,
Cognition and Ageing, Memory Boosters, Healthy
Ageing, Staying active, Managing Anxiety, Sleep
CBT, including activity scheduling, helpful thinking,
arousal management techniques, cognitive therapy and
mindfulness techniques
Hours of core content : 10 – 12
*These instruments are not in the public domain.
Dyadic Adjustment
Scale (DAS)
Family Assessment
Device (FAD)