Implementing cognitive behavioral therapy in the real world: a case study of two mental health centers.
Journal Article (Journal Article)
BACKGROUND: Behavioral health services for children and adolescents in the U.S. are lacking in accessibility, availability and quality. Evidence-based interventions for emotional and behavioral disorders can improve quality, yet few studies have systematically examined their implementation in routine care settings. METHODS: Using quantitative and qualitative data, we evaluated a multi-faceted implementation strategy to implement cognitive-behavioral therapy (CBT) for depressed adolescents into two publicly-funded mental healthcare centers. Extent of implementation during the study's duration and variables influencing implementation were explored. RESULTS: Of the 35 clinicians eligible to participate, 25 (71%) were randomized into intervention (n = 11) or usual care (n = 14). Nine intervention clinicians completed the CBT training. Sixteen adolescents were enrolled in CBT with six of the intervention clinicians; half of these received at least six CBT manually-based sessions. Multiple barriers to CBT adoption and sustained use were identified by clinicians in qualitative interviews. CONCLUSION: Strategies to implement evidence-based interventions into routine clinical settings should include multi-method, pre-implementation assessments of the clinical environment and address multiple barriers to initial uptake as well as long-term sustainability.
Full Text
Duke Authors
Cited Authors
- Kramer, TL; Burns, BJ
Published Date
- February 29, 2008
Published In
Volume / Issue
- 3 /
Start / End Page
- 14 -
PubMed ID
- 18312677
Pubmed Central ID
- PMC2294138
Electronic International Standard Serial Number (EISSN)
- 1748-5908
Digital Object Identifier (DOI)
- 10.1186/1748-5908-3-14
Language
- eng
Conference Location
- England