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Brief Reports   |    
Facilitators and Barriers Associated With Implementation of Evidence-Based Psychotherapy in Community Settings
Bradley D. Stein, M.D., Ph.D.; Karen L. Celedonia, M.P.H.; Jane N. Kogan, Ph.D.; Holly A. Swartz, M.D.; Ellen Frank, Ph.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200508
View Author and Article Information

Dr. Stein and Ms. Celedonia are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, where Dr. Swartz and Dr. Frank are affiliated. Dr. Kogan is with the Center for High-Value Health Care, University of Pittsburgh Medical Center, Pittsburgh.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  Despite widespread use of individual outpatient psychotherapies among community mental health centers (CMHCs), few studies have examined implementation of these psychotherapies. This exploratory qualitative study identified key themes associated with the implementation of an empirically supported psychotherapy in CMHCs.

Methods  The authors conducted semistructured interviews with 12 key informants from four CMHCs that had implemented interpersonal and social rhythm therapy (IPSRT). Their responses were categorized into key themes.

Results  Five major themes were identified: pretraining familiarity with IPSRT, administrative support for implementation, IPSRT fit with usual practice and clinic culture, implementation team and plan, and supervision and consultation. Discussion of these themes varied among participants from clinics considered successful or unsuccessful implementers.

Conclusions  Participants identified both key themes and several strategies for facilitating implementation. The findings suggest that when these key factors are present, outcome-enhancing treatments can be implemented and sustained, even in clinics with limited resources.

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