The Dissemination and Implementation of Evidence-Based Psychological Treatments: A Review of Current Efforts

2018 ◽  
pp. 409-432
Author(s):  
R. Kathryn McHugh ◽  
David H. Barlow
Author(s):  
Sonja K. Schoenwald ◽  
R. Kathryn McHugh ◽  
David H. Barlow

This chapter explores the science of dissemination and implementation. It aims to familiarize readers with key constructs from the dominant theories, conceptual frameworks, and heuristic models increasingly informing research on facilitation of the systematic use of evidence-based psychological treatments in routine care. It highlights factors associated with dissemination or implementation in other fields and, where available, in mental health, and summarizes what is known about strategies to support dissemination or implementation. This chapter will serve as a framework for subsequent chapters describing efforts specific to the dissemination and implementation of psychological interventions.


Psichologija ◽  
2013 ◽  
Vol 47 ◽  
pp. 102-115 ◽  
Author(s):  
E. Kazlauskas

Straipsnyje analizuojamas psichologinės pagalbos būdų suaugusiems asmenims psichotraumatolo­gijoje veiksmingumas. Įsigilinus į 1998–2012 m. paskelbtas metaanalizes, sistemines apžvalgas, geros praktikos vadovus, daromos išvados, kad daugelis tyrimų patvirtina trumpalaikės į traumą orientuotos kognityviosios elgesio terapijos bei nujautrinimo akių judesiais ir perdirbimo (EMDR) terapijos veiksmin­gumą potrauminio streso sutrikimų turintiems asmenims. Tyrimų rezultatai rodo, kad asmenims iš kar­to po trauminio įvykio nerekomenduojama taikyti formalias psichosocialinės intervencijos procedūras, kaip antai psichologinis susirinkimas (angl. debriefing). Yra mokslinių įrodymų, kad trumpalaikė eklekti­nė terapija (BEPP), internetu teikiamos pagalbos ar virtualios realybės taikymo metodai gali veiksmingai padėti asmenims, kurie turi potrauminio streso sutrikimą. Straipsnyje aptariamos tyrimais paremtų psi­chologinės pagalbos metodų diegimo psichotraumatologijos praktikoje problemos. Pagrindiniai žodžiai: psichologinė trauma, potrauminio streso sutrikimas, pagalbos veiksmingumas.   EFFECTIVE PSYCHOLOGICAL TREATMENTS IN PSYCHOTRAUMATOLOGYEvaldas Kazlauskas SummaryThe present article gives an overview of the psycho­logical treatments of psychological trauma. The article is oriented towards practitioners who want to update their knowledge of the recent developments in psychotraumatology. The research findings, based on meta-analyses and good practice guidelines, are presented and the issues related to the implementation of evidence-based treatments are discussed.The study has shown that the critical stress incident debriefing developed by J. T. Mitchell in 1983 (or psychological debriefing) is not recommended imme­diately after trauma. Metaanalysis (Rose et al., 2003; van Emmeric et al., 2002) revealed no positive long-term effects of debriefing immediately after trauma, with indications of negative outcomes in some studies. Practical guidelines of the International Society of Traumatic Stress Studies, as well as other guidelines do not recommend debriefing as a regular procedure for all survivors. Practical, social or legal assistance provided in an empathic way is recommended during the first month after the trauma. Meta-analytical studies published since 1998 concerning the effectiveness of posttraumatic stress disorder treatments demonstrated the efficacy of trauma-focused cognitive-behavioral therapies (TF-CBT) and eye movement reprocessing and desen­sitization therapy (EMDR). Evidence from studies on the effects of a brief eclectic psychotherapy for posttraumatic stress disorder (BEPP), developed by B. Gersons, internet-based treatments, and virtual reality are promising, and these treatments in the future are possible effective alternatives for TF-CBT and EMDR in evidence-based practice. Psychological treatments should be the first option for the treatment of PTSD, with medication used only when the appro­priate psychological treatments are unavailable or the client prefers medication over psychosocial treatment. While a number of RCT studies have shown the efficacy of TF-CBT and EMDR treatment for PTSD, there is still a gap between research and everyday clinical practice. From the practitioner’s point of view, transfer of manual-based methods from RCT efficacy studies to daily practice is not easy. Clinicians are facing complicated cases, and comorbid disorders are widely prevalent with PTSD. We must also be aware that with the new treatments developed, training of these methods and particularly the availability of sys­tematic supervisions are not always easily accessible; this slows down the dissemination and implementation of evidence-based treatments. Clinicians have to take their own responsibility for selecting what is best for a particular client; however, practitioners also need to make decisions based on what science shows to be the most effective treatment.Key words: psychological trauma, posttraumatic stress disorder, effectiveness of treatment.   o:OfficeDocumentSettings> Veiksmingi psichologinės pagalbos būdai psichotraumatologijoje 


Author(s):  
Jennifer D. Allen ◽  
Rachel C. Shelton ◽  
Karen M. Emmons ◽  
Laura A. Linnan

There is substantial variability in the implementation of evidence-based interventions across the United States, which leads to inconsistent access to evidence-based prevention and treatment strategies at a population level. Increased dissemination and implementation of evidence-based interventions could result in significant public health gains. While the availability of evidence-based interventions is increasing, study of implementation, adaptation, and dissemination has only recently gained attention in public health. To date, insufficient attention has been given to the issue of fidelity. Consideration of fidelity is necessary to balance the need for internal and external validity across the research continuum. There is also a need for a more robust literature to increase knowledge about factors that influence fidelity, strategies for maximizing fidelity, methods for measuring and analyzing fidelity, and examining sources of variability in implementation fidelity.


Author(s):  
Gregory A. Aarons ◽  
Joanna C. Moullin ◽  
Mark G. Ehrhart

Both organizational characteristics and specific organizational strategies are important for the effective dissemination and implementation of evidence-based practices (EBPs) in health and allied health care settings, as well as mental health, alcohol/drug treatment, and social service settings. One of the primary goals of this chapter is to support implementers and leaders within organizations in attending to and shaping the context in which implementation takes place in order to increase the likelihood of implementation success and long-term sustainment. The chapter summarizes some of the most critical organizational factors and strategies likely to impact successful evidence-based practice implementation. There are myriad approaches to supporting organizational development and change—this chapter focuses on issues supported by relevant scientific literatures, particularly those germane to EBP implementation in health care and related settings.


Fifteen to twenty years is how long it takes for the billions of dollars of health-related research to translate into evidence-based policies and programs suitable for public use. Over the past 15 years, an exciting science has emerged that seeks to narrow the gap between the discovery of new knowledge and its application in public health, mental health, and health care settings. Dissemination and implementation (D&I) research seeks to understand how to best apply scientific advances in the real world, by focusing on pushing the evidence-based knowledge base out into routine use. To help propel this crucial field forward, leading D&I scholars and researchers have collaborated to put together this volume to address a number of key issues, including: how to evaluate the evidence base on effective interventions; which strategies will produce the greatest impact; how to design an appropriate study; and how to track a set of essential outcomes. D&I studies must also take into account the barriers to uptake of evidence-based interventions in the communities where people live their lives and the social service agencies, hospitals, and clinics where they receive care. The challenges of moving research to practice and policy are universal, and future progress calls for collaborative partnerships and cross-country research. The fundamental tenet of D&I research—taking what we know about improving health and putting it into practice—must be the highest priority. This book is nothing less than a roadmap that will have broad appeal to researchers and practitioners across many disciplines.


Author(s):  
C. Richard Spates ◽  
Sophie Rubin

In this chapter we review the empirical foundation for Eye Movement Desensitization and Reproessing Therapy (EMDR) for posttraumatic stress disorder. We present a brief description of the therapy, critically review recent primary and meta-analytic investigations concerning its efficacy and effectiveness, offer a summary of recent primary investigations that addressed the mechanism of action for EMDR, and based on this overall review, we suggest limitations with recommendations for future research. Recent empirical investigations of the efficacy of EMDR have improved along a number of important dimensions, and these along with the few completed effectiveness trials, position this therapy among evidence-based frontline interventions for PTSD. What is less thoroughly researched, and thus less well understood, are putative models of its theoretical mechanism of action. In addition to continuing specific improvements in research concerning efficacy and effectiveness, we recommend more and higher quality empirical studies of its mechanism of action.


2018 ◽  
Vol 14 (2) ◽  
pp. 112-124
Author(s):  
Daniel J. Kilpatrick ◽  
Kathleen B. Cartmell ◽  
Abdoulaye Diedhiou ◽  
K. Michael Cummings ◽  
Graham W. Warren ◽  
...  

Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.


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