Therapist and Organizational Factors Associated with Participation in Evidence-Based Practice Initiatives in a Large Urban Publicly-Funded Mental Health System

Excerpt

In recent years, there has been an emphasis on the implementation of evidence-based practices (EBPs) in practice settings. This focus is due to a growing understanding that EBPs are not reaching the most vulnerable, particularly those served by the public health and mental health systems.^[ 1 ^, 2 ^] For example, despite there being over 1200 evidence-based treatments for childhood psychiatric disorders,^[ 3 ^] these treatments are rarely found in public mental health settings.^[ 3 ^, 4 ^] Implementation science, the study of methods to promote the systematic uptake of research,^[ 5 ^] was developed to understand how to more effectively implement EBP in community settings. Conceptual frameworks,^[ 6 ^, 7 ^] corroborated by empirical evidence,^[ 8 ^– 10 ^] suggest that EBP implementation necessitates an understanding of the individuals (e.g., provider knowledge and attitudes),^[ 11 ^– 13 ^] organizations (e.g., organizational culture and climate),^[ 14 ^, 15 ^] and systems (e.g., financing)^[ 16 ^, 17 ^] involved, as well as the particular stage of implementation (i.e., exploration, preparation, implementation, and sustainment; EPIS framework).^[ 6 ^, 7 ^] However, despite the growing body of literature on characteristics of implementation success, there has been less attention paid to understanding which individuals and organizations choose to implement (i.e., adopt) EBP in the community, particularly within the context of systems who do not mandate EBP implementation. …