Improving the dissemination of evidence-based treatments: Facilitators and barriers to participating in case consultation.

Abstract Background The Ostrobothnia Depression Programme (ODP) had a hybrid-design incorporating an implementation programme for two evidence-based treatments (EBTs), behavioural activation and motivational interviewing, and a study on their effectiveness. It was carried out regionally in secondary psychiatric care in a Finnish district. We evaluated the ODP through a mixed-methods analysis to extract organization- and programme-related knowledge to make future programmes more effective in terms of sustaining and scaling up the desired programme outcomes. Methods A cross-sectional mixed-methods survey was conducted with the programme addressees 4-5 months after the end of the ODP. The realization of case consultation groups analysed further by interviewing those responsible for them and making use of attendance lists. Results Out of 72 original programme addressees 33 completed the survey. The results showed that the ODP succeeded in initiating the desired change in clinical practices. Case consultations and training videos intended as reinforcers were underutilized. Deficits in the implementation plan and the hybrid design of the ODP jeopardized the maintenance of the implementation outcomes in the long term. Conclusions We discuss our results in light of the Normalization Process Theory (NPT) related sub-processes ‘implementation’, ‘embedding’ and ‘integration’. The complete training intervention in the target EBTs should comprise both workshops and non-optional case consultations. Access to case consultations should be made as convenient as possible. Means to decentralize the clinical support in everyday work should be elaborated in collaboration with the teams. Coaching team leaders to employ evidence-based active managerial practices that are connected e.g. to the concept of ‘transformational leadership’ would likely be fruitful. The original programme plan should be checked for means to sustain and scale up the implementation outcomes after the active programme phase.

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Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽

10.1024/1662-9647/a000127 ◽

2015 ◽

Vol 28 (2) ◽

pp. 67-76

Author(s):

Grace C. Niu ◽

Patricia A. Arean

Keyword(s):

Older Adults ◽

Mental Illness ◽

Brain Plasticity ◽

Late Life ◽

Aging Population ◽

The United States ◽

Future Research ◽

Evidence Based ◽

Late Life Depression ◽

Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

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