Improving and sustaining delivery of CPT for PTSD in mental health systems: a cluster randomized trial

Shannon Wiltsey Stirman, Erin P Finley, Norman Shields, Joan Cook, Rachel Haine-Schlagel, James F Burgess Jr, Linda Dimeff, Kelly Koerner, Michael Suvak, Cassidy A Gutner, David Gagnon, Tasoula Masina, Matthew Beristianos, Kera Mallard, Vanessa Ramirez, Candice Monson, Shannon Wiltsey Stirman, Erin P Finley, Norman Shields, Joan Cook, Rachel Haine-Schlagel, James F Burgess Jr, Linda Dimeff, Kelly Koerner, Michael Suvak, Cassidy A Gutner, David Gagnon, Tasoula Masina, Matthew Beristianos, Kera Mallard, Vanessa Ramirez, Candice Monson

Abstract

Background: Large-scale implementation of evidence-based psychotherapies (EBPs) such as cognitive processing therapy (CPT) for posttraumatic stress disorder can have a tremendous impact on mental and physical health, healthcare utilization, and quality of life. While many mental health systems (MHS) have invested heavily in programs to implement EBPs, few eligible patients receive EBPs in routine care settings, and clinicians do not appear to deliver the full treatment protocol to many of their patients. Emerging evidence suggests that when CPT and other EBPs are delivered at low levels of fidelity, clinical outcomes are negatively impacted. Thus, identifying strategies to improve and sustain the delivery of CPT and other EBPs is critical. Existing literature has suggested two competing strategies to promote sustainability. One emphasizes fidelity to the treatment protocol through ongoing consultation and fidelity monitoring. The other focuses on improving the fit and effectiveness of these treatments through appropriate adaptations to the treatment or the clinical setting through a process of data-driven, continuous quality improvement. Neither has been evaluated in terms of impact on sustained implementation.

Methods: To compare these approaches on the key sustainability outcomes and provide initial guidance on sustainability strategies, we propose a cluster randomized trial with mental health clinics (n = 32) in three diverse MHSs that have implemented CPT. Cohorts of clinicians and clinical managers will participate in 1 year of a fidelity oriented learning collaborative or 1 year of a continuous quality improvement-oriented learning collaborative. Patient-level PTSD symptom change, CPT fidelity and adaptation, penetration, and clinics' capacity to deliver EBP will be examined. Survey and interview data will also be collected to investigate multilevel influences on the success of the two learning collaborative strategies. This research will be conducted by a team of investigators with expertise in CPT implementation, mixed method research strategies, quality improvement, and implementation science, with input from stakeholders in each participating MHS.

Discussion: It will have broad implications for supporting ongoing delivery of EBPs in mental health and healthcare systems and settings. The resulting products have the potential to significantly improve efforts to ensure ongoing high quality implementation and consumer access to EBPs.

Trial registration: NCT02449421 . Registered 02/09/2015.

Keywords: CPT; Delivery; EBPs; Fidelity; Implementation; Learning collaborative; Sustainability.

References

    1. McHugh RK, Barlow DH. The dissemination and implementation of evidence-based psychological treatments: a review of current efforts. Am Psychol. 2010;65:73–84. doi: 10.1037/a0018121.
    1. Karlin BE, Cross G. From the laboratory to the therapy room: national dissemination and implementation of evidence-based psychotherapies in the US Department of Veterans Affairs Health Care System. Am Psychol. 2014;69(1):19–33. doi: 10.1037/a0033888.
    1. Karlin BE, Brown GK, Trockel M, Cunning D, Zeiss AM, Taylor CB. National dissemination of cognitive behavioral therapy for depression in the Department of Veterans Affairs Health Care System: therapist and patient level outcomes. J Consult Clin Psychol. 2012;80(5):707. doi: 10.1037/a0029328.
    1. Chard KM, Ricksecker EG, Healy ET, Karlin BE, Resick PA. Dissemination and experience with cognitive processing therapy. J Rehabil Res Dev. 2012;49(5):667–678. doi: 10.1682/JRRD.2011.10.0198.
    1. Eftekhari A, Ruzek JI, Crowley JJ, Rosen CS, Greenbaum MA, Karlin BE. Effectiveness of national implementation of prolonged exposure therapy in Veterans Affairs care. JAMA Psychiatry. 2013;70(9):949–955. doi: 10.1001/jamapsychiatry.2013.36.
    1. Shiner B, D’Avolio LW, Nguyen TM, Zayed MH, Young-Xu Y, Desai RA, Schnurr PP, Fiore LD, Watts BV. Measuring use of evidence based psychotherapy for posttraumatic stress disorder. Adm Policy Ment Health Ment Health Serv Res. 2013;40(4):311–318. doi: 10.1007/s10488-012-0421-0.
    1. Lu MW, Plagge JM, Marsiglio MC, Dobscha SK. Clinician documentation on receipt of trauma-focused evidence-based psychotherapies in a VA PTSD clinic. J Behav Health Serv Res. 2016;43(1):71–87. doi: 10.1007/s11414-013-9372-9.
    1. Osei-Bonsu PE, Bolton RE, Stirman SW, Eisen SV, Herz L, Pellowe ME. Mental health providers’ decision-making around the implementation of evidence-based treatment for PTSD. J Behav Health Serv Res. 2016;7:1–1. doi: 10.1111/jphs.12107.
    1. Cook JM, Dinnen S, Simiola V, Thompson R, Schnurr PP. VA residential provider perceptions of dissuading factors to the use of two evidence-based PTSD treatments. Prof Psychol: Res Pract. 2014;45(2):136–142. doi: 10.1037/a0036183.
    1. Cook JM, Dinnen S, Simiola V, Thompson R, Schnurr PP. VA residential provider perceptions of dissuading factors to use of two evidence-based PTSD treatments. Clin Psychol. In press.
    1. Osei-Bonsu PE, Bokhour BG, Glickman ME, Rodrigues S, Mueller NM, Dell NS, Zhao S, Eisen SV, Elwy AR. The role of coping in depression treatment utilization for VA primary care patients. Patient Educ Couns. 2014;94(3):396–402. doi: 10.1016/j.pec.2013.10.021.
    1. Dusenbury L, Brannigan R, Falco M, Lake A. A review of research on fidelity of implementation: implications for drug abuse prevention in school settings. Health Educ Res. 2003;18(2):237–256. doi: 10.1093/her/18.2.237.
    1. Wilk JE, West JC, Duffy FF, Herrell RK, Rae DS, Hoge CW. Use of evidence-based treatment for posttraumatic stress disorder in Army behavioral healthcare. Psychiatry. 2013;76(4):336–348. doi: 10.1521/psyc.2013.76.4.336.
    1. Waller G, Stringer H, Meyer C. What cognitive behavioral techniques do therapists report using when delivering cognitive behavioral therapy for the eating disorders? J Consult Clin Psychol. 2012;80(1):171. doi: 10.1037/a0026559.
    1. Stirman SW, Calloway A, Toder K, Miller CJ, DeVito AK, Meisel SN, Xhezo R, Evans AC, Beck AT, Crits-Christoph P. Community mental health provider modifications to cognitive therapy: implications for sustainability. Psychiatr Serv. 2013;64(10):1056–1059. doi: 10.1176/appi.ps.201200456.
    1. Aarons GA, Miller EA, Green AE, Perrott JA, Bradway R. Adaptation happens: a qualitative case study of implementation of the incredible years evidence-based parent training program in a residential substance abuse treatment program. J Children’s Serv. 2012;7(4):233–245. doi: 10.1108/17466661211286463.
    1. Castro FG, Barrera M, Jr, Martinez CR., Jr The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004;5(1):41–45. doi: 10.1023/B:.
    1. Griner D, Smith TB. Culturally adapted mental health intervention: a meta-analytic review. Psychother Theory Res Pract Train. 2006;43(4):531–548. doi: 10.1037/0033-3204.43.4.531.
    1. Bass JK, Annan J, McIvor Murray S, Kaysen D, Griffiths S, Cetinoglu T, Wachter K, Murray LK, Bolton PA. Controlled trial of psychotherapy for Congolese survivors of sexual violence. N Engl J Med. 2013;368(23):2182–2191. doi: 10.1056/NEJMoa1211853.
    1. Schulz PM, Resick PA, Huber LC, Griffin MG. The effectiveness of cognitive processing therapy for PTSD with refugees in a community setting. Cogn Behav Pract. 2006;13(4):322. doi: 10.1016/j.cbpra.2006.04.011.
    1. Galovski TE, Blain LM, Mott JM, Elwood L, Houle T. Manualized therapy for PTSD: flexing the structure of cognitive processing therapy. J Consult Clin Psychol. 2012;80(6):968–981. doi: 10.1037/a0030600.
    1. Weisz JR, Chorpita BF, Palinkas LA, Schoenwald SK, Miranda J, Bearman SK, Daleiden EL, Ugueto AM, Ho A, Martin J, et al. Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial. Arch Gen Psychiatry. 2012;69(3):274–282. doi: 10.1001/archgenpsychiatry.2011.147.
    1. Von Ranson KM, Wallace LM, Stevenson A. Psychotherapies provided for eating disorders by community clinicians: infrequent use of evidence-based treatment. Psychother Res. 2013;23(3):333–343. doi: 10.1080/10503307.2012.735377.
    1. Schulte D, Künzel R, Pepping G, Schulte-Bahrenberg T. Tailor-made versus standardized therapy of phobic patients. Advanc Behav Res Ther. 1992;14(2):67. doi: 10.1016/0146-6402(92)90001-5.
    1. Kennedy MG, Mizuno Y, Hoffman R, Baume C, Strand J. The effect of tailoring a model HIV prevention program for local adolescent target audiences. AIDS Educ Prev. 2000;12(3):225–238.
    1. Cook JM, Dinnen S, Thompson R, Simiola V, Schnurr PP. Changes in implementation of two evidence-based psychotherapies for PTSD in VA residential treatment programs: a national investigation. J Trauma Stress. 2014:n/a-n/a.
    1. Glisson C, Schoenwald SK, Kelleher K, Landsverk J, Hoagwood KE, Mayberg S, Green P. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Adm Policy Ment Health Ment Health Serv Res. 2008;35(1–2):124. doi: 10.1007/s10488-007-0152-9.
    1. Ehlers A, Grey N, Wild J, Stott R, Liness S, Deale A, Handley R, Albert I, Cullen D, Hackmann A. Implementation of cognitive therapy for PTSD in routine clinical care: effectiveness and moderators of outcome in a consecutive sample. Behav Res Ther. 2013;51(11):742–752. doi: 10.1016/j.brat.2013.08.006.
    1. Schoenwald SK, Garland AF, Chapman JE, Frazier SL, Sheidow AJ, Southam-Gerow MA. Toward the effective and efficient measurement of implementation fidelity. Adm Policy Ment Health. 2011;38(1):32–43. doi: 10.1007/s10488-010-0321-0.
    1. Surís A, Link‐Malcolm J, Chard K, Ahn C, North C. A randomized clinical trial of cognitive processing therapy for Veterans with PTSD related to military sexual trauma. J Trauma Stress. 2013;26(1):28–37. doi: 10.1002/jts.21765.
    1. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89:1322–1327. doi: 10.2105/AJPH.89.9.1322.
    1. Tanielian T, Jaycox L. Invisible wounds of war : psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: RAND Corporation; 2008.
    1. Smith MW, Barnett PG. The role of economics in the QUERI program: QUERI Series. Implement Sci. 2008;3:20. doi: 10.1186/1748-5908-3-20.
    1. Aarons G, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health Ment Health Serv Res. 2011;38(1):4–23. doi: 10.1007/s10488-010-0327-7.
    1. Brown PM, Cameron LD, Ramondt S. Sustainability of behavioral interventions: beyond cost-effectiveness analysis. Int J Behav Med. 2015;22(3):425–33. doi: 10.1007/s12529-014-9437-z.
    1. Kessler RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry. 2000;61(suppl 5):4–12.
    1. Lunney CA, Schnurr PP. Domains of quality of life and symptoms in male Veterans treated for posttraumatic stress disorder. J Trauma Stress. 2007;20(6):955–964. doi: 10.1002/jts.20269.
    1. Ahrens J, Rexford L. Cognitive processing therapy for incarcerated adolescents with PTSD. J Aggress Maltreat Trauma. 2002;6(1):201–216. doi: 10.1300/J146v06n01_10.
    1. Chard KM. An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. J Consult Clin Psychol. 2005;73(5):965. doi: 10.1037/0022-006X.73.5.965.
    1. Resick PA, Nishith P, Weaver TL, Astin MC, Feuer CA. A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J Consult Clin Psychol. 2002;70(4):867. doi: 10.1037/0022-006X.70.4.867.
    1. Kaysen D, Lindgren K, Zangana GAS, Murray L, Bass J, Bolton P. Adaptation of cognitive processing therapy for treatment of torture victims: experience in Kurdistan, Iraq. Psychological Trauma: Theory, Research, Practice, and Policy. 2011;5(2):184.
    1. Kaysen D, Schumm J, Pedersen ER, Seim RW, Bedard-Gilligan M, Chard K. Cognitive processing therapy for veterans with comorbid PTSD and alcohol use disorders. Addict Behav. 2014;39(2):420–427. doi: 10.1016/j.addbeh.2013.08.016.
    1. Beidas R, Kendall PC. Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clin Psychol Sci Pract. 2010;17(1):1. doi: 10.1111/j.1468-2850.2009.01187.x.
    1. Herschell AD, Kolko DJ, Baumann BL, Davis AC. The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations. Clin Psychol Rev. 2010;30(4):448–466. doi: 10.1016/j.cpr.2010.02.005.
    1. Rakovshik SG, McManus F. Establishing evidence-based training in cognitive behavioral therapy: a review of current empirical findings and theoretical guidance. Clin Psychol Rev. 2010;30(5):496–516. doi: 10.1016/j.cpr.2010.03.004.
    1. Stirman SW, Kimberly JR, Calloway A, Cook N, Castro F, Charns MP. The sustainability of new programs and interventions: a review of the empirical literature and recommendations for future research. Implement Sci. 2012;7:17. doi: 10.1186/1748-5908-7-17.
    1. Bein E, Anderson T, Strupp HH, Henry WP, Schacht TE, Binder J, Butler S. The effects of training in time-limited dynamic psychotherapy: changes in therapeutic outcome. Psychother Res. 2000;10(2):119–132. doi: 10.1080/713663669.
    1. Fauth J, Mathisen A, Smith S. North American Society of Psychotherapy Research 2006 Annual Conference 2006; Columbus, OH. 2006. Reflections on a time-limited dynamic psychotherapy training project: new directions for brief psychotherapy training.
    1. Webb CA, Derubeis RJ, Barber JP. Therapist adherence/competence and treatment outcome: a meta-analytic review. J Consult Clin Psychol. 2010;78(2):200–211. doi: 10.1037/a0018912.
    1. Farmer CC, Mitchell KS, Parker-Guilbert K, Galovski TE. Fidelity to the cognitive processing therapy protocol: evaluation of critical elements. Behav Ther. 2016.
    1. Schoenwald SK, Sheidow AJ, Chapman JE. Clinical supervision in treatment transport: effects on adherence and outcomes. J Consult Clin Psychol. 2009;77(3):410–421. doi: 10.1037/a0013788.
    1. Watts BV, Shiner B, Zubkoff L, Carpenter-Song E, Ronconi JM, Coldwell CM. Implementation of evidence-based psychotherapies for posttraumatic stress disorder in VA specialty clinics. Psychiatr Serv. 2014;65(5):648–653. doi: 10.1176/appi.ps.201300176.
    1. Aarons GA, Sommerfeld DH, Hecht DB, Silovsky JF, Chaffin MJ. The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect. J Consult Clin Psychol. 2009;77(2):270. doi: 10.1037/a0013223.
    1. Harned MS, Dimeff LA, Woodcock EA, Contreras I. Predicting adoption of exposure therapy in a randomized controlled dissemination trial. J Anxiety Disord. 2013;27(8):754–62. doi: 10.1016/j.janxdis.2013.02.006.
    1. Bond GR, Drake RE, McHugo GJ, Peterson AE, Jones AM, Williams J. Long-term sustainability of evidence-based practices in community mental health agencies. Adm Policy Ment Health Ment Health Serv Res. 2014;41(2):228–236. doi: 10.1007/s10488-012-0461-5.
    1. Creed TA, Stirman SW, Evans AC, Beck AT. A model for implementation of cognitive therapy in community mental health: The Beck Initiative. Behav Therapist. 2014;37(3):56-64.
    1. Finley EP, Garcia HA, Ketchum NS, McGeary DD, McGeary CA, Stirman SW, Peterson AL. Utilization of evidence-based psychotherapies in Veterans Affairs posttraumatic stress disorder outpatient clinics. Psychological services. 2015;12(1):73. doi: 10.1037/ser0000014.
    1. Stirman SW, Gutierrez-Colina A, Toder K, Castro F, Esposito G, Barg F, Beck AT, Crits-Christoph P. Clinicians’ perspectives on cognitive therapy in community mental health settings: implications for training and implementation. Adm Policy Ment Health Ment Health Serv Res. 2013;40(4):274–285. doi: 10.1007/s10488-012-0418-8.
    1. Stirman SW, Shields N, Deloriea J, Landy MSH, Belus JM, Maslej MM, Monson CM. A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for posttraumatic stress disorder. Implement Sci. 2013;8(82):1–8.
    1. Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainability amid ongoing change. Implement Sci. 2013;8(1):117. doi: 10.1186/1748-5908-8-117.
    1. Haine-Schlagel R, Brookman-Frazee L, Janis B, Gordon J. Evaluating a learning collaborative to implement evidence-informed engagement strategies in community-based services for young children. Child Youth Care Forum. 2013;42(5):457–473. doi: 10.1007/s10566-013-9210-5.
    1. Chovil N. One small step at a time: implementing continuous quality improvement in child and youth mental health services. Child & Youth Services. 2010;31(1–2):21–34. doi: 10.1080/01459350903505561.
    1. Aarons GA, Green A, Palinkas LA, Self-Brown S, Whitaker DJ, Lutzker JR, Silovsky JF, Hecht DB, Chaffin MJ. Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implementation Sci. 2012;7(1):32. doi: 10.1186/1748-5908-7-32.
    1. LeBrasseur R, Whissell R, Ojha A. Organisational learning, transformational leadership and implementation of continuous quality improvement in Canadian hospitals. Aust J Manag. 2002;27(2):141–162. doi: 10.1177/031289620202700203.
    1. Nadeem E, Olin SS, Hill LC, Hoagwood KE, Horwitz SM. A literature review of learning collaboratives in mental health care: used but untested. Psychiatr Serv. 2014;65(9):1088–1099. doi: 10.1176/appi.ps.201300229.
    1. Raghavan R: The role of economic evaluation in dissemination and implementation research. In: Brownson RC, Colditz G, Proctor E, editors. Dissemination and implementation research in health: translating science into practice. edn. Oxford University Press; 2012: 94–113.
    1. Raghavan R, Bright C, Shadoin A. Toward a policy ecology of implementation of evidence-based practices in public mental health settings. Implement Sci. 2008;3(1):26. doi: 10.1186/1748-5908-3-26.
    1. Curran G, Bauer MS, Mittman BS, Pyne JM, Stetler CB. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012.
    1. Proctor E, Silmere H, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health Ment Health Serv Res. 2011;38(2):65-76.
    1. Spillane J, Pareja A, Dorner L, Barnes C, May H, Huff J, Camburn E. Mixing methods in randomized controlled trials (RCTs): validation, contextualization, triangulation, and control. Educ Assess, Eval Account. 2010;22(1):5–28. doi: 10.1007/s11092-009-9089-8.
    1. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD checklist for DSM–5 (PCL-5). In. Scale available from the National Center for PTSD. website: ; 2010.
    1. Brown CH, Ten Have TR, Jo B, Dagne G, Wyman PA, Muthén B, Gibbons RD. Adaptive designs for randomized trials in public health. Annu Rev Public Health. 2009;30:1. doi: 10.1146/annurev.publhealth.031308.100223.
    1. Kanter JW, Tsai M, Holman G, Koerner K. Preliminary data from a randomized pilot study of web-based functional analytic psychotherapy therapist training. Psychotherapy. 2013;50(2):248. doi: 10.1037/a0029814.
    1. Puspitasari A, Kanter JW, Murphy J, Crowe A, Koerner K. Developing an online, modular, active learning training program for behavioral activation. Psychotherapy. 2013;50(2):256. doi: 10.1037/a0030058.
    1. Nadeem E, Olin SS, Hill LC, Hoagwood KE, Horwitz SM. Understanding the components of quality improvement collaboratives: a systematic literature review. Milbank Q. 2013;91(2):354–394. doi: 10.1111/milq.12016.
    1. Stirman SW, Shields N, Deloriea J, Landy MS, Belus JM, Maslej MM, Lane J, Monson CM. Association for Behavioral and Cognitive Therapies: 2014; Philadelphia, PA. 2014. A randomized comparison of three post-workshop consultation strategies.
    1. Institute for Healthcare Improvement. The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003.
    1. Gustafson DH, Quanbeck AR, Robinson JM, Ford JH, Pulvermacher A, French MT, McConnell KJ, Batalden PB, Hoffman KA, McCarty D. Which elements of improvement collaboratives are most effective? A cluster‐randomized trial. Addiction. 2013;108(6):1145–1157. doi: 10.1111/add.12117.
    1. Stirman SW, Calloway A, Rasmusson AM, McDonald A, Monson CM, Resick PA. Association for Behavioral and Cognitive Therapies: 2011; Toronto, Canada. 2011. The relationship between treatment fidelity and clinical outcomes in the implementation of CPT in VA settings.
    1. Garvin DA, Edmondson AE, Gino F. Is yours a learning organization? Harvard Business Review. 2008;86(3):109.
    1. OQ Analyst. In. Salt Lake City, UT: .
    1. Lambert MJ, Finch AE. The outcome questionnaire. 1999.
    1. Lambert MJ. Administration and scoring manual for the OQ-45.2 (Outcome Questionnaire). OQ Measures, LLC; 2004.
    1. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;16:606–613. doi: 10.1046/j.1525-1497.2001.016009606.x.
    1. Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD. Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann. 1979;2(3):197–207. doi: 10.1016/0149-7189(79)90094-6.
    1. Mauskopf JA, Sullivan SD, Annemans L, Caro J, Mullins CD, Nuijten M, Orlewska E, Watkins J, Trueman P. Principles of good practice for budget impact analysis: report of the ISPOR task force on good research practices—budget impact analysis. Value Health. 2007;10(5):336–347. doi: 10.1111/j.1524-4733.2007.00187.x.
    1. Vallis TM, Shaw BF, Dobson K. The cognitive therapy scale: psychometric properties. J Consult Clin Psychol. 1986;54:381–385. doi: 10.1037/0022-006X.54.3.381.
    1. Stirman SW, Miller CJ, Toder K, Calloway A. Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implementation Sci. 2013;8(65).
    1. Ehrhart MG, Aarons GA, Farahnak LR. Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS) Implementation Science. 2014;9(1):157. doi: 10.1186/s13012-014-0157-1.
    1. Beidas R, Marcus S, Aarons GA, Hoagwood KE, Schoenwald SK, Evans AC, Hurford MO, Hadley T, Barg FK, Walsh LM, et al. Predictors of community therapists’ use of therapy techniques in a large public mental health system. JAMA Pediatr. 2015;169(4):374–82. doi: 10.1001/jamapediatrics.2014.3736.
    1. Glisson C, Landsverk J, Schoenwald S, Kelleher K, Hoagwood K, Mayberg S, Green P. Assessing the organizational social context (OSC) of mental health services: implications for research and practice. Adm Policy Ment Health Ment Health Serv Res. 2008;35(1):98–113. doi: 10.1007/s10488-007-0148-5.
    1. Aarons G, Ehrhart M, Farahnak L. The implementation leadership scale (ILS): development of a brief measure of unit level implementation leadership. Implement Sci. 2014;9(1):45. doi: 10.1186/1748-5908-9-45.
    1. Cook JM, Thompson R, Schnurr PP. Perceived Characteristics of Intervention Scale: Development and Psychometric Properties. Assessment. 2015;22(6):704–14. doi: 10.1177/1073191114561254.
    1. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4(1):50. doi: 10.1186/1748-5908-4-50.
    1. Blackwelder W. Current issues in clinical equivalence trials. J Dent Res. 2004;83(suppl 1):C113–C115. doi: 10.1177/154405910408301s23.
    1. Schafer JL, Graham JW. Missing data: our view of the state of the art. Psychol Methods. 2002;7(2):147–177. doi: 10.1037/1082-989X.7.2.147.
    1. Foa EB, Yusko DA, McLean CP, et al. Concurrent naltrexone and prolonged exposure therapy for patients with comorbid alcohol dependence and PTSD: a randomized clinical trial. J Am Med Assoc. 2013;310(5):488–495. doi: 10.1001/jama.2013.8268.
    1. Zalta AK, Gillihan SJ, Fisher AJ, Mintz J, McLean CP, Yehuda R, Foa EB. Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure. J Consult Clin Psychol. 2014;82(1):171. doi: 10.1037/a0034735.
    1. Granger CW. Investigating causal relations by econometric models and cross-spectral methods. Econometrica: J Econometric Soc. 1969;37(3):424-38.
    1. Baldwin SA, Imel ZE, Braithwaite SR, Atkins DC. Analyzing multiple outcomes in clinical research using multivariate multilevel models. J Consult Clin Psychol. 2014;82(5):920. doi: 10.1037/a0035628.
    1. Cohen J. Statistical power analysis for the behavioral sciences. 2. Hillsdale: Erlbaum; 1988.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–174. doi: 10.2307/2529310.
    1. Raudenbush SW. Statistical analysis and optimal design for cluster randomized trials. Psychol Methods. 1997;2(2):173. doi: 10.1037/1082-989X.2.2.173.
    1. Snijders TA. Power and sample size in multilevel linear models. Encyclopedia of Statistics in Behavioral Science. 2005;3:1570–73.
    1. Nadeem E, Gleacher A, Pimentel S, Hill LC, McHugh M, Hoagwood KE. The role of consultation calls for clinic supervisors in supporting large-scale dissemination of evidence-based treatments for children. Administration and Policy in Mental Health and Mental Health Services Research. 2013;40(6):530-40.
    1. Dennhag I, Gibbons MBC, Barber JP, Gallop R, Crits-Christoph P. How many treatment sessions and patients are needed to create a stable score of adherence and competence in the treatment of cocaine dependence? Psychother Res. 2012;22(4):475–488. doi: 10.1080/10503307.2012.674790.
    1. Garattini L, van de Vooren K. Budget impact analysis in economic evaluation: a proposal for a clearer definition. Eur J Health Econ. 2011;12(6):499–502. doi: 10.1007/s10198-011-0348-5.
    1. Palinkas L, Aarons G, Horwitz S, Chamberlain P, Hurlburt M, Landsverk J. Mixed method designs in implementation Research. Adm Policy Ment Health Ment Health Serv Res. 2010;38(1):44–53. doi: 10.1007/s10488-010-0314-z.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit