title: Disseminating evidence-based treatments for PTSD in organizational settings: A high priority focus area.
abstract: Dissemination of evidence-based treatments for PTSD has become an important focus of activity in the aftermath of recent terrorist attacks (e.g., London underground and U.S. 9/11 attacks), natural disasters (e.g., Indian Ocean tsunami and Hurricane Katrina), and wars (e.g., in Iraq and Afghanistan). This has become a high priority need for all mental health training and service delivery organizations. Researchers and educators have begun to examine clinician and client perceptions and preferences regarding PTSD treatment processes, and health care systems are organizing more comprehensive efforts at training and system change. As this evolution of services moves forward, effective dissemination should be a major focus of health policy research for the next decade or more. This review critically evaluates the PTSD-related research and emerging theory related to four major sets of variables that affect dissemination: (1) Practitioner factors, (2) Training methods, (3) The practice innovation(s) being disseminated; and (4) Organization or system factors. We evaluate findings from recent studies in light of emerging models of dissemination, and in the final section of the paper, we consider five broad topics with particular implications for dissemination of PTSD-specific treatments. They are: (1) The content of dissemination (i.e., which treatment protocols or intervention methods should be prioritized); (2) Strict adherence versus flexibility in the use of treatment manuals and the role of fidelity assessment; (3) The need for collaboration with user audiences; (4) The potential role of web-based technologies in increasing the effectiveness and efficiency of dissemination; and (5) Development of dissemination infrastructures within organizations.
authors.affiliation: National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025, USA. josef.ruzek@va.gov
authors.forename: Josef I
authors.initials: JI
authors.lastname: Ruzek
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Rosen
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice; D006291:Health Policy; D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*