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.
Similar content being viewed by others
References
Aarons, G. A. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The evidence-based practice attitude scale (EBPAS). Mental Health Services Research, 6(2), 61–74.
Barton, J. M., Montemarano, J. A., Persky, M., Simons, A. D., & Padesky, C. (2010, June). In the trenches: A qualitative analysis of community therapists’ experience of a structured treatment dissemination project. Paper presented at the meeting of the World Congress of Behavioral and Cognitive Therapies, Boston, MA.
Bohart, A. C., O’Hara, M., & Leitner, L. M. (1998). Empirically violated treatments: Disenfranchisement of humanistic and other psychotherapies. Psychotherapy Research, 8, 141–157.
Borntrager, C. F., Chorpita, B. F., Higa-McMillan, C., & Weisz, J. R. (2009). Provider attitudes toward evidence-based practices: Are the concerns with the evidence or with the manuals? Psychiatric Services, 60, 677–681.
Bryant, M. J., Simons, A. D., & Thase, M. E. (1999). Therapist skill and patient variables in homework compliance: Controlling an uncontrolled variable in cognitive therapy outcome research. Cognitive Therapy and Research, 23(4), 381–399.
Chorpita, B. F. (2007). Modular cognitive-behavioral therapy for childhood anxiety disorders. New York: Guilford.
Cukrowicz, K. C., White, B. A., Reitzel, L. R., Burns, A. B., Driscoll, K. A., Kemper, T. S., et al. (2005). Improved treatment outcome associated with the shift to empirically supported treatments in a graduate training clinic. Professional Psychology: Research and Practice, 36(3), 330–337.
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4, 50–65.
Dreesen, L., & Arntz, A. (1998). The impact of personality disorders on treatment outcome of anxiety disorders: Best-evidence synthesis. Behaviour Research and Therapy, 36, 265–274.
Dunn, V., Crichton, N., Roe, B., Seers, K., & Williams, K. (1998). Using research for practice: A UK experience of the BARRIERS scale. Journal of Advanced Nursing, 27, 1203–1210.
Ford, J. D. (1979). Research on training counselors and clinicians. Review of Educational Research, 69, 87–130.
Ford, J. D., & Weissbein, D. A. (1997). Training of transfer: An updated review. Performance Improvement Quarterly, 10, 22–41.
Funk, S. G., Champagne, M. T., Wiese, R. A., & Tornquist, E. M. (1991). BARRIERS: The barriers to research utilization scale. Applied Nursing Research, 4(1), 39–45.
Gotham, H. J. (2004). Diffusion of mental health and substance abuse treatments: Development, dissemination, and implementation. Clinical Psychology: Science and Practice, 11, 160–176.
Henry, W. P. (1998). Science, politics, and the politics of science: The use and misuse of empirically validated treatment research. Psychotherapy Research, 8, 126–140.
Hulburt, M. S., Garland, A. F., Nguyen, K., & Brookman-Frazee, L. (2010). Child and family therapy process: Concordance of therapist and observational Perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 37(3), 230–244.
Jensen-Doss, A., Cusack, K. J., & Arellano, M. A. (2008). Workshop-based training in trauma- focused CBT: An in-depth analysis of impact on provider practices. Community Mental Health Journal, 44(4), 227–244.
Kramer, T. L., & Burns, B. J. (2008). Implementing Cognitive Behavioral Therapy in the real world: A case study of two mental health centers. Implementation Science, 3, 14–24.
Mahrer, A. R. (2005). Empirically supported therapies and therapy relationships: What are the serious problems and plausible alternatives? Journal of Contemporary Psychotherapy, 35, 3–25.
Milne, D. L., Baker, C., Blackburn, I., James, I., & Reichelt, K. (1999). Effectiveness of cognitive therapy training. Journal of Behavior Therapy and Experimental Psychiatry, 30, 81–92.
Moulding, N. T., Silagy, C. A., & Weller, D. P. (1999). A framework for effective management of change in clinical practice: Dissemination and implementation of clinical practice guidelines. Quality in Health Care, 8, 177–183.
Nelson, T. D., & Steele, R. G. (2007). Predictors of practitioner self-reported use of evidence- based practices: Practitioner training, clinical setting, and attitudes toward research. Administration and Policy in Mental Health and Mental Health Service Review, 34, 319–330.
Pagoto, S. L., Spring, B., Coups, E. J., Mulvaney, S., Coutu, M. F., & Ozakinci, G. (2007). Barriers and facilitators of evidence-based practice perceived by behavioral science health professionals. Journal of Clinical Psychology, 63(7), 695–705.
Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training strategies. Administration and Policy in Mental Health, 36, 24–34.
Rees, C. S., McEvoy, P., & Nathan, P. R. (2005). Relationship between homework completion and outcome in cognitive behavior therapy. Cognitive Behavior Therapy, 34, 242–247.
Saldana, L., Chapman, J. E., Henggeler, S. W., & Rowland, M. D. (2007). Organizational readiness for change in adolescent programs. Journal of Substance Abuse Treatment, 33(2), 159–169.
Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., et al. (2009). Mind the gap: Improving the dissemination of CBT. Behaviour Research and Therapy, 47, 902–909.
Shaw, B. F., Elkin, E., Yamaguchi, J., Olmsted, M., Vallis, T. M., & Dobson, K. S. (1999). Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression. Journal of Consulting and Clinical Psychology, 67(6), 837–846.
Sholomskas, D. E., Syracuse-Siewert, G., Rounsaville, B. J., Ball, S. A., Nuro, K. F., & Carroll, K. M. (2005). We don’t train in vain: A dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 73(1), 106–115.
Simons, A. D., Marti, N., Lewis, C. C., Rohde, P., Curry, J., & March, J. (under review). What “matters” in cognitive behavior therapy for adolescent depression? A test of homework as an active ingredient of CBT.
Simons, A. D., Padesky, C., Montemarano, J., Lewis, C. C., Murakami, J., Reid, M., et al. (2010). Training and dissemination of Cognitive Behavioral Therapy for depression: A preliminary examination of therapist competence and client outcomes. Journal of Consulting and Clinical Psychology, 78(5), 751–756.
The Hill Group (2011). Retrieved from http://conferences.thehillgroup.com/obssr/DI2011/abstracts.html
Weisz, J., Donenburg, G., Han, S., & Weiss, B. (1995). Bridging the gap between laboratory and clinic in child and adolescent psychology. Journal of Consulting and Clinical Psychology, 63, 688–701.
Wiltsey Stirman, S., Crits-Christoph, P., & DeRubeis, R. J. (2004). Achieving successful dissemination of empirically supported psychotherapies: A synthesis of dissemination theory. Clinical Psychology: Science and Practice, 11(4), 343–359.
Young, J., & Beck, A. T. (1980). Cognitive Therapy Scale: Rating manual. Unpublished manuscript, Center for Cognitive Therapy, University of Pennsylvania, Philadelphia, PA
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lewis, C.C., Simons, A.D. A Pilot Study Disseminating Cognitive Behavioral Therapy for Depression: Therapist Factors and Perceptions of Barriers to Implementation. Adm Policy Ment Health 38, 324–334 (2011). https://doi.org/10.1007/s10488-011-0348-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10488-011-0348-x