Factors that predict dissemination of evidence-based practice in one local authority in England: An assessment of introducing node-link mapping into substance misuse practice

Abstract

Aims: Node-link mapping (NLM) has been strongly advocated as a cognitive tool that aims to enhance the treatment process and is supported by a large evidence-base. In one local authority area in England, NLM was systematically introduced and embedded into staff daily practice across five main services including non-statutory, NHS and young people's services. The study aimed to assess training and adoption of NLM prior to implementation into daily practice. Methods/Results: In total, 123 staff members were trained in NLM concepts across a number of workshops. Staff responses were recorded in a Workshop Evaluation Survey that suggested a high degree of satisfaction with the training provided although ''time'' was identified as a pre-requisite to prepare for implementation. A random sample of staff (n = 44) were followed-up at 6 months and were asked to complete a Workshop Assessment Follow-up schedule alongside participation in focus group interviews. Despite a commitment to NLM, there were mixed perceptions into the efficacy of node-link mapping. Staff concerns focused on lack of perceived ownership of the implementation process and a lack of confidence in using mapping on a regular basis. Managers also reflected reservations with ''traditional'' training methods and how to incorporate new practices into supervision processes. Implications for the dissemination of evidence-base practices are discussed.

Response to commentaries: Neither optimism or nihilism… but reasons for hope

“…Insufficient attention is paid to the training of individuals in evidence‐based treatments, and standalone individual‐level workshop training is often ineffective at changing practice . Training needs to be adapted to clinicians’ pre‐existing experience, clinical skill, theoretical orientation and motivation levels, and greater consideration should be given to organizational levers and barriers to implementation as well as the provision of ongoing supervision and support .…”