Indeed. Having worked exclusively in a VA SUD/PCT clinic for a year, I can attest that the primary EBPs we used were CPT, PE, and EMDR. Alternatively, I also use STAIR Narrative Therapy.
I've also had some vets that went through a course of EMDR swear by it, yet, they come to me even more distressed because EMDR "unearthed" challenging emotions EMDR didn't address with them, so then I run them through a course of CPT typically. I am not personally a fan of EMDR and do not regard it as really helpful; I think much of the cognitive reframing aspect tends to be the moderating variable in this therapy, and thus, can be better applied and executed under another therapy such as CPT.
Yeah, I've had vets who swore PE was the devil, and were very apprehensive in doing PE when I described the approach to them. Also, depending on the nature of their trauma(s), previous treatment experiences for PTSD, I may not even recommend PE as a first-line treatment, but rather, may begin with CPT to address underlying cognitions, re-evaluate and may recommend a course of PE, especially when there are significant criterion E symptoms still prevalent. Having folks start out in PE and then drop out can be very counter-productive and potentially harmful because they end up believing they've failed at therapy, and then become dissuaded from re-engaging in the future (I came across this sentiment several times).
Indeed - I really like CPT and also am "VA-trained" in it; I think it can be incredibly useful for folks who are new to PTSD treatment. I like to do a good orientation session and lay out the therapies I offer, and describe them in-depth so they have a clear understanding of how each therapy will be used to target the symptoms that have impacted their quality of life. Also, PE can be very beneficial and have robust and long-term effects, based on the right "inclusion criteria" IMO.
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