title: Clinicians' perspectives on cognitive therapy in community mental health settings: implications for training and implementation.
abstract: Policymakers are investing significant resources in large-scale training and implementation programs for evidence-based psychological treatments (EBPTs) in public mental health systems. However, relatively little research has been conducted to understand factors that may influence the success of efforts to implement EBPTs for adult consumers of mental health services. In a formative investigation during the development of a program to implement cognitive therapy (CT) in a community mental health system, we surveyed and interviewed clinicians and clinical administrators to identify potential influences on CT implementation within their agencies. Four primary themes were identified. Two related to attitudes towards CT: (1) ability to address client needs and issues that are perceived as most central to their presenting problems, and (2) reluctance to fully implement CT. Two themes were relevant to context: (1) agency-level barriers, specifically workload and productivity concerns and reactions to change, and (2) agency-level facilitators, specifically, treatment planning requirements and openness to training. These findings provide information that can be used to develop strategies to facilitate the implementation of CT interventions for clients being treated in public-sector settings.
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 S. Huntington Ave (116B3), Boston, MA 02130, USA. sws@bu.edu
authors.forename: Shannon Wiltsey
authors.initials: SW
authors.lastname: Stirman
authors.forename: Ana
authors.initials: A
authors.lastname: Gutiérrez-Colina
authors.forename: Katherine
authors.initials: K
authors.lastname: Toder
authors.forename: Gregory
authors.initials: G
authors.lastname: Esposito
authors.forename: Frances
authors.initials: F
authors.lastname: Barg
authors.forename: Frank
authors.initials: F
authors.lastname: Castro
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Beck
authors.forename: Paul
authors.initials: P
authors.lastname: Crits-Christoph
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy; D003155:Community Mental Health Centers; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D014481:United States