A growing chorus of veterans and their therapists are sounding the alarm over the Department of Veterans Affairs (VA) implementing stricter limits on one-on-one mental health therapy sessions, a move that patients describe as “abandonment” and providers fear is clinically inappropriate, particularly for those grappling with severe post-traumatic stress disorder, addiction, and other chronic conditions.
The Department of Veterans Affairs (VA), long considered a pillar of support for those who served, is now facing intense scrutiny over its mental health care policies. A recent report from CNN reveals a concerning trend: VA hospitals are reportedly enforcing stricter limits on individual therapy sessions, leaving many veterans feeling abandoned and therapists frustrated by what they deem clinically inappropriate directives.
This situation comes to light through the powerful testimony of veterans like Michael, a hardened Marine veteran who served in Afghanistan and struggles with severe post-traumatic stress disorder (PTSD). Michael, who spoke under a pseudonym to discuss sensitive health issues, recounts harrowing experiences of conflict, from exploding vehicles to child exploitation, which continue to manifest as flashbacks and nightmares.
After years of battling addiction and multiple suicide attempts, Michael finally found a trusted VA therapist who provided a lifeline. However, his lifeline was abruptly cut when his one-on-one sessions were suddenly terminated. “It feels like they took the training wheels off before I’m ready,” he said, describing the feeling of being “thrown away like yesterday’s trash.”
The Heart of the Matter: Policy Enforcement and Its Impact
According to mental health providers and VA patients across the country, some VA hospitals are intensifying the enforcement of a policy that limits the number of long-term therapy sessions. This policy, which has been in place under earlier administrations, typically allocates between four and 24 sessions per patient, depending on the treatment type.
However, what has changed is the discretion previously afforded to therapists. Mental health care providers from four facilities confirmed to CNN that they are now being pressured to halt one-on-one sessions once the allotted number is reached, irrespective of clinical assessments. This intensified enforcement, a dynamic first reported by The War Horse, also aims to reduce the overall number of patients receiving long-term care.
The consequences for providers who push back are severe, with reports of disciplinary actions, including potential removal of their privileges to practice. Some therapists now face the added burden of justifying extensions in writing, a significant departure from previous practices.
“It’s re-traumatizing for the veteran. It almost feels like I’m a perpetrator of that, having to carry out those orders,” one provider lamented, highlighting the ethical dilemma and emotional toll on mental health professionals.
The VA’s Stance vs. Reality on the Ground
When contacted by CNN, the VA denied that veterans are being denied necessary care. Peter Kasperowicz, a VA spokesperson, stated, “There are no limits on the number of VA appointments a Veteran can have in mental health or any other areas.” He clarified that the VA “works with Veterans over an initial eight to 15 mental health sessions and collaboratively plans any needed follow-on care,” emphasizing a goal of recovery and greater independence.
Despite the official denial, therapists uniformly describe a “draconian effort” to expedite patients out of individual therapy since President Donald Trump took office in January 2025 and installed Doug Collins as VA Secretary.
Rationale and Debate: Balancing Access with Sustained Care
Providers report being told that the push to limit sessions is intended to make room for more veterans to enter the VA system and accelerate patient flow. Indeed, some studies suggest that shorter-term, limited sessions can be effective for certain veterans with PTSD, as highlighted by a report from the National Institute of Mental Health (NIMH).
The practice of limiting longer-term mental health care is also common in the private sector, where insurance companies often impose utilization reviews. However, VA providers argue that the forced imposition of limits, rather than a collaborative decision between patient and therapist, is the critical flaw. “It should be agreed upon between the patient and the therapist regarding when treatment should end,” one provider insisted.
The Human Cost: Staff Exodus and Veteran Abandonment
The intensified pressure to limit sessions has led to a significant loss of experienced staff. A mental health care provider in the western US noted, “we have been hemorrhaging staff” as many quit in frustration. This exodus exacerbates an already critical situation, as the VA faces a severe shortage of psychologists, according to a recent VA Inspector General report.
Former VA psychologist Stephen Long retired in 2024, partly due to the mandate to limit one-on-one sessions. He emphasized that longer-term, open-ended therapy is crucial for building trust, which is often essential for veterans to process complex trauma. Long likened mental health care to physical health: “If you need insulin for your diabetes, you don’t stop it,” he stated, arguing that chronic mental illnesses require similar continuous care.
Mark Jorges, a former psychotherapist at the VA hospital in Temple, Texas, resigned in May, citing frustrations over the session limits. He stressed that a set number of sessions is “not appropriate clinically, because veterans have different pathologies.” Conditions like PTSD, depression, anxiety, and acute stress disorder, which represent the majority of patients he saw, cannot be arbitrarily capped.
Alternative Treatments and the Fight for Individualized Care
When one-on-one sessions are curtailed, veterans are often offered alternatives like group therapy or the option to re-apply for individual treatment. However, for many, these are not viable solutions. Michael, for instance, finds it impossible to discuss his deeply personal issues in a group setting. Even re-applying for individual therapy can involve months of waiting, with no guarantee of seeing the same trusted therapist – a significant barrier for veterans who have invested years in building rapport.
Jake Pannell, an Army veteran receiving PTSD and anxiety treatment at a VA facility in Washington state, confirmed that providers are now limiting visits to 8-12 sessions, reserving “check-in” visits only for active crises. Pannell, who previously worked as a VA behavioral health counselor, expressed grave concern: “We have to wait ’till veterans threaten to kill themselves before they get care? I’m scared to death for my veterans.”
The American Psychological Association (APA), the largest scientific and professional organization for psychologists in the US, is aware of these reports. Katherine McGuire, the APA’s chief advocacy officer, emphasized that “Veterans deserve individualized, recovery-oriented care based in shared decision-making between the provider and the Veteran.”
The Broader Implications and Call for Trust
The alleged limitations on therapy sessions underscore a broader, ongoing challenge within VA mental health services. While not directly linked to session limits, a December 2024 VA Office of Inspector General (OIG) report on the Hinesville VA Clinic in Georgia found issues of “suboptimal” therapist utilization rates and “delayed access” to mental health care, with patients experiencing median wait times of at least three weeks between subsequent individual psychotherapy sessions. These systemic issues highlight the complex environment in which veterans seek care.
For veterans like Michael, who await re-approval for care, the fear is palpable: “just lettin’ everything take back over.” The current situation raises profound questions about the VA’s commitment to providing the long-term, trusting relationships essential for veterans to heal and thrive. The call from veterans and mental health professionals alike is clear: uphold the promise of care that is individualized, clinically appropriate, and sustained for as long as needed.
