title: Barriers to and Facilitators in the Implementation of Cognitive-Behavioral Therapy for Youth Anxiety in the Community.
abstract: OBJECTIVE
  The study examined, from the perspective of therapists, the barriers to and facilitators in implementing cognitive-behavioral therapy (CBT) for anxious youths in community settings.
  
  
  METHODS
  Fifty therapists (43% of the original training sample of 115 providers) participated in a follow-up interview two years after training and consultation. They reported on barriers to and facilitators in implementation of CBT for youths with anxiety.
  
  
  RESULTS
  Qualitative analyses identified numerous barriers and facilitators, including client factors (for example, motivated clients facilitated the use of CBT, whereas clients with complex issues and numerous psychosocial stressors hindered its use), intervention factors (the structure of CBT helped facilitate its use for some providers, whereas others reported feeling constrained by such structure), and organizational factors (for example, the absence of support within one's institution served as a barrier, whereas supervision supporting the use of CBT facilitated implementation).
  
  
  CONCLUSIONS
  Findings of this implementation trial align with conceptual implementation frameworks and may guide the tailoring of future implementation efforts in order to overcome barriers and maximize facilitators.
authors.affiliation: Ms. Ringle is with the Department of Psychology, University of Miami, Coral Gables, Florida (e-mail: vanesa.ringle@gmail.com ). Ms. Read, Mr. Brodman, and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Edmunds is with Judge Baker Children's Center, Boston. Dr. Barg is with the Department of Family Medicine and Community Health and Dr. Beidas is with the Department of Psychiatry, both at the University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Vanesa A
authors.initials: VA
authors.lastname: Ringle
authors.affiliation: Ms. Ringle is with the Department of Psychology, University of Miami, Coral Gables, Florida (e-mail: vanesa.ringle@gmail.com ). Ms. Read, Mr. Brodman, and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Edmunds is with Judge Baker Children's Center, Boston. Dr. Barg is with the Department of Family Medicine and Community Health and Dr. Beidas is with the Department of Psychiatry, both at the University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Kendra L
authors.initials: KL
authors.lastname: Read
authors.affiliation: Ms. Ringle is with the Department of Psychology, University of Miami, Coral Gables, Florida (e-mail: vanesa.ringle@gmail.com ). Ms. Read, Mr. Brodman, and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Edmunds is with Judge Baker Children's Center, Boston. Dr. Barg is with the Department of Family Medicine and Community Health and Dr. Beidas is with the Department of Psychiatry, both at the University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Edmunds
authors.affiliation: Ms. Ringle is with the Department of Psychology, University of Miami, Coral Gables, Florida (e-mail: vanesa.ringle@gmail.com ). Ms. Read, Mr. Brodman, and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Edmunds is with Judge Baker Children's Center, Boston. Dr. Barg is with the Department of Family Medicine and Community Health and Dr. Beidas is with the Department of Psychiatry, both at the University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Brodman
authors.affiliation: Ms. Ringle is with the Department of Psychology, University of Miami, Coral Gables, Florida (e-mail: vanesa.ringle@gmail.com ). Ms. Read, Mr. Brodman, and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Edmunds is with Judge Baker Children's Center, Boston. Dr. Barg is with the Department of Family Medicine and Community Health and Dr. Beidas is with the Department of Psychiatry, both at the University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
authors.affiliation: Ms. Ringle is with the Department of Psychology, University of Miami, Coral Gables, Florida (e-mail: vanesa.ringle@gmail.com ). Ms. Read, Mr. Brodman, and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Edmunds is with Judge Baker Children's Center, Boston. Dr. Barg is with the Department of Family Medicine and Community Health and Dr. Beidas is with the Department of Psychiatry, both at the University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Frances
authors.initials: F
authors.lastname: Barg
authors.affiliation: Ms. Ringle is with the Department of Psychology, University of Miami, Coral Gables, Florida (e-mail: vanesa.ringle@gmail.com ). Ms. Read, Mr. Brodman, and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Edmunds is with Judge Baker Children's Center, Boston. Dr. Barg is with the Department of Family Medicine and Community Health and Dr. Beidas is with the Department of Psychiatry, both at the University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy*; D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult