A Pilot Study Disseminating Cognitive Behavioral Therapy for Depression: Therapist Factors and Perceptions of Barriers to Implementation

Abstract

This preliminary report on dissemination of Cognitive Behavioral Therapy (CBT) for depression assessed numerous therapist factors thought to influence implementation in a community setting. Participants were 24 therapists, aged 26-61 who participated in three, 1-day workshops and 8 months of ongoing group consultation. Attitudes toward empirically supported treatments (ESTs) and readiness to change were positively correlated whereas attitudes toward ESTs were negatively correlated with perceived client barriers to implementation. Therapists' report of client and setting factors were negatively associated with therapists' reports of implementation of CBT. Results are discussed in terms of implications and recommendations for dissemination and implementation of ESTs.

Translation of a comprehensive health behavior intervention for women living with HIV: the SMART/EST Women's Program

“…Despite the variety of challenges to implementation that have been documented at the organization, provider, and intervention levels [41][42][43][44][45], this translation was effective in achieving health behavior change at the community health center level. By providing services targeting multiple chronic health conditions in the settings where persons living with HIV receive their primary medical care, they can take full advantage of the increased longevity associated with improved medication and treatment.…”

Training Substance Use Disorder Counselors in Cognitive Behavioral Therapy for Depression: Development and Initial Exploration of an Online Training Program

“…Like their administrative counterparts, busy practitioners also have concerns about the time and expense associated with EBP training (Lewis & Simons, 2011;Riley et al, 2007;R. E. Stewart, Stirman, & Chambless, 2012).…”

“…Clinicians are often wary of EBPs (especially manualized treatments) out of concern they will detract from client-therapist rapport, will be less effective with clients seen in real-world settings, and will remove therapist experience from clinical decision making (Lewis & Simons, 2011;Shafran, et al, 2009;R. E. Stewart, et al, 2012).…”

Therapists’ Self-Efficacy for CBT Dissemination: is Supervision the Key?

“…However, therapists often have reservations about the implementation process, such as concerns about the validity of new treatments, overloaded work schedules, and limited time for training [5,6]. Even with training, clinicians may struggle to incorporate new skills into their therapeutic repertoire and may lack confidence in their ability to do so [7,8].…”

“…The effective implementation of EBPs in community mental health requires cognitive and behavioral changes in newly trained therapists [5][6][7]. This includes learning to re-conceptualize clients' problems, understand and apply the underlying theoretical model, and act in a manner consistent with the treatment methods.…”