Mental health clinician perspectives regarding factors impacting implementation of evidence-based psychotherapies in Veterans Health Administration community-based outpatient clinics.

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  • Additional Information
    • Source:
      Publisher: Elsevier/North-Holland Country of Publication: United States NLM ID: 7905527 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-7714 (Electronic) Linking ISSN: 01638343 NLM ISO Abbreviation: Gen Hosp Psychiatry Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, Elsevier/North-Holland.
    • Subject Terms:
      Veterans*/psychology ; Veterans Health*; Ambulatory Care Facilities ; Humans ; Mental Health ; Pilot Projects ; Psychotherapy ; United States ; United States Department of Veterans Affairs
    • Abstract:
      Objective: Uptake of Evidence-Based Psychotherapies (EBPs) by mental health (MH) clinicians, especially in community settings, remains highly variable. This formative pilot study aimed to understand the attitudes and practices of Veterans Health Administration community-based MH clinicians regarding EBPs and to identify multi-level factors that enable and hinder EBP implementation in this unique context.
      Methods: Semi-structured interviews were conducted with MH clinicians (N = 40) working in community-based outpatient clinics (CBOCs) in metro/urban (n = 20) and non-metro/rural (n = 20) locations. Interviews were guided by the Consolidated Framework for Implementation Research and were analyzed using rapid content analysis. Results were organized by system-, clinician-, patient-, and innovation-levels.
      Results: EBPs were consistently perceived as important to delivering quality MH care, with most clinicians having received training in at least one VHA EBP. However, limited EBP training and consultation opportunities, inadequate autonomy to schedule EBP sessions, high and complex caseloads, and feelings of isolation at CBOCs decreased EPB use. Social workers perceived disparities in EBP training access relative to psychologists. Some barriers were more salient in non-metro/rural settings (e.g., patient-level privacy concerns).
      Conclusions: Increased EBP training opportunities- particularly for social workers-, greater flexibility over schedules and caseloads, and more mechanisms for consultation and professional development may increase EBP uptake in community-based clinics.
      (Published by Elsevier Inc.)
    • Grant Information:
      R25 MH080916 United States MH NIMH NIH HHS
    • Contributed Indexing:
      Keywords: Community-based clinics; Consolidated framework for implementation research (CFIR); Evidence based psychotherapies; Qualitative methods
    • Publication Date:
      Date Created: 20220219 Date Completed: 20220317 Latest Revision: 20220317
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.genhosppsych.2022.01.001
    • Accession Number:
      35182907