title: Implementation of transdiagnostic cognitive therapy in community behavioral health: The Beck Community Initiative.
abstract: OBJECTIVE
  Progress bringing evidence-based practice (EBP) to community behavioral health (CBH) has been slow. This study investigated feasibility, acceptability, and fidelity outcomes of a program to implement transdiagnostic cognitive therapy (CT) across diverse CBH settings, in response to a policy shift toward EBP.
  
  
  METHODS
  Clinicians (n = 348) from 30 CBH programs participated in workshops and 6 months of consultation. Clinician retention was examined to assess feasibility, and clinician feedback and attitudes were evaluated to assess implementation acceptability. Experts rated clinicians' work samples at baseline, mid-, and end-of-consultation with the Cognitive Therapy Rating Scale (CTRS) to assess fidelity.
  
  
  RESULTS
  Feasibility was demonstrated through high program retention (i.e., only 4.9% of clinicians withdrew). Turnover of clinicians who participated was low (13.5%) compared to typical CBH turnover rates, even during the high-demand training period. Clinicians reported high acceptability of EBP and CT, and self-reported comfort using CT improved significantly over time. Most clinicians (79.6%) reached established benchmarks of CT competency by the final assessment point. Mixed-effects hierarchical linear models indicated that CTRS scores increased significantly from baseline to the competency assessment (p < .001), on average by 18.65 points. Outcomes did not vary significantly between settings (i.e., outpatient vs. other).
  
  
  CONCLUSIONS
  Even clinicians motivated by policy-change rather than self-nomination may feasibly be trained to deliver a case-conceptualization driven EBP with high levels of competency and acceptability. (PsycINFO Database Record
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Torrey A
authors.initials: TA
authors.lastname: Creed
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Frankel
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Ramaris E
authors.initials: RE
authors.lastname: German
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Green
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Shari
authors.initials: S
authors.lastname: Jager-Hyman
authors.affiliation: Corporal Michael J. Crescenz Veteran's Administration Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104.
authors.forename: Kristin P
authors.initials: KP
authors.lastname: Taylor
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Abby D
authors.initials: AD
authors.lastname: Adler
authors.affiliation: Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania. 3535 Market Street, Floor 3, Philadelphia, PA 19104.
authors.forename: Courtney B
authors.initials: CB
authors.lastname: Wolk
authors.affiliation: Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, (116B-3), 150 South Huntington Avenue, Boston, 02130.
authors.forename: Shannon W
authors.initials: SW
authors.lastname: Stirman
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Waltman
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Williston
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Rachel
authors.initials: R
authors.lastname: Sherrill
authors.affiliation: Philadelphia Department of Behavioral Health and Intellectual disAbility Services, 801 Market Street, Philadelphia, PA 19107.
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Evans
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street Floor 2, Philadelphia, PA 19104.
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Beck
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015928:Cognitive Behavioral Therapy / Q000193:education / Q000379:methods*; D003156:Community Mental Health Services / Q000379:methods* / Q000592:standards; D055317:Evidence-Based Practice / Q000193:education / Q000379:methods*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care