The role of context in the implementation of trauma-focused treatments: effectiveness research and implementation in higher and lower income settings

Current Opinion in Psychology

Volumn 14, Issue , 2017, Pages 61-66

  Chen, Jessica A ^a,b   Olin, Cecilia C ^c   Stirman, Shannon Wiltsey ^d,e   Kaysen, Debra ^a,c  

^a UNIVERSITY OF WASHINGTON   (United States)

^b VA PUGET SOUND HEALTH CARE SYSTEM   (United States)

^c UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

^d VETERANS AFFAIRS MEDICAL CENTER   (United States)

^e STANFORD UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 85006482183     PISSN: 2352250X     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.copsyc.2016.11.007     Document Type: Review

References (49)

1. 1 Schnyder, U., Ehlers, A., Elbert, T., Foa, E., Gersons, B., Resick, P., Shapiro, F., Cloitre, M., Psychotherapies for PTSD: what do they have in common?. Eur J Psychotraumatol, 6, 2015, 10.3402/ejpt.v6.28186.
2. 2 Foa, E.B., Keane, T.M., Friedman, M.J., Cohen, J.A., Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies. 2008, Guilford Press.
3. 3 Forbes, D., Creamer, M., Bisson, J.I., Cohen, J.A., Crow, B.E., Foa, E.B., Friedman, M.J., Keane, T.M., Kudler, H.S., Ursano, R.J., A guide to guidelines for the treatment of PTSD and related conditions. J Trauma Stress 23 (2010), 537–552, 10.1002/jts.20565.
4. 4 Shiner, B., D'Avolio, L.W., Nguyen, T.M., Zayed, M.H., Young-Xu, Y., Desai, R.A., Schnurr, P.P., Fiore, L.D., Watts, B.V., Measuring use of evidence based psychotherapy for posttraumatic stress disorder. Adm Policy Ment Health Ment Health Serv Res 40 (2013), 311–318, 10.1007/s10488-012-0421-0.
5. 5 Sigel, B., Kramer, T., Conners-Burrow, N., Church, J., Worley, K., Mitrani, N., Statewide dissemination of trauma-focused cognitive-behavioral therapy (TF-CBT). Child Youth Serv Rev 35 (2013), 1023–1029, 10.1016/j.childyouth.2013.03.012.
6. 6 Patel, V., Chowdhary, N., Rahman, A., Verdeli, H., Improving access to psychological treatments: lessons from developing countries. Behav Res Ther 49 (2013), 523–528, 10.1016/j.brat.2011.06.012.
7. 7 Brownson, R.C., Colditz, G.A., Proctor, E.K., Dissemination and Implementation Research in Health: Translating Science to Practice. 2012, Oxford University Press, Oxford.
8. 8 Monson, C.M., Fredman, S.J., Macdonald, A., Pukay-Martin, N.D., Resick, P.A., Schnurr, P.P., Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial. JAMA, 308, 2012, 700, 10.1001/jama.2012.9307.
9. 9•• Rosen, C.S., Matthieu, M.M., Wiltsey Stirman, S., Cook, J.M., Landes, S., Bernardy, N.C., Chard, K.M., Crowley, J., Eftekhari, A., Finley, E.P., Hamblen, J.L., Harik, J.M., Kehle-Forbes, S.M., Meis, L.A., Osei-Bonsu, P.E., Rodriguez, A.L., Ruggiero, K.J., Ruzek, J.I., Smith, B.N., Trent, L., Watts, B.V., A review of studies on the system-wide implementation of evidence-based psychotherapies for posttraumatic stress disorder in the Veterans Health Administration. Adm Policy Ment Health Ment Health Serv Res, 2016, 1–21, 10.1007/s10488-016-0755-0 This review summarizes the research evidence on implementation of EBPs for PTSD within the Veterans Health Administration (VA). The authors identify success in training a large number of VA clinicians, but highly variable levels of EBP receipt among patients at various VA sites. Positive clinicians beliefs and local organizational support were identified as the two most important facilitators of implementation. Patient engagement and retention was noted as the most prominent barrier.
10. 10•• Stirman, S.W., Gutner, C.A., Langdon, K., Graham, J.R., Bridging the gap between research and practice in mental health service settings: an overview of developments in implementation theory and research. Behav Ther, 2015, 10.1016/j.beth.2015.12.001 This narrative review provides an overview of implementation research for evidence-based mental health treatments. The review discusses two influential implementation models: the Exploration, Planning, Implementation, and Sustainment Framework (EPIS; [50]) and the Consolidated Framework for Implementation Research (CFIR; [17]). The models provide a framework for identifying characteristics of implementation that are thought to influence success. The authors review studies addressing each implementation characteristic and rate the strength of the evidence.
11. 11 Ruzek, J.I., Eftekhari, A., Rosen, C.S., Crowley, J.J., Kuhn, E., Foa, E.B., Hembree, E.A., Karlin, B.E., Factors related to clinician attitudes toward prolonged exposure therapy for PTSD. J Trauma Stress 27 (2014), 423–429, 10.1002/jts.21945.
12. 12 Killeen, T.K., Back, S.E., Brady, K.T., Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs. Drug Alcohol Rev 34 (2015), 234–241, 10.1111/dar.12229.
13. 13 Cook, J.M., Dinnen, S., Coyne, J.C., Thompson, R., Simiola, V., Ruzek, J., Schnurr, P.P., Evaluation of an implementation model: a national investigation of VA residential programs. Adm Policy Ment Health Ment Health Serv Res 42 (2015), 147–156, 10.1007/s10488-014-0555-3.
14. 14 Bass, J.K., Annan, J., McIvor Murray, S., Kaysen, D., Griffiths, S., Cetinoglu, T., Wachter, K., Murray, L.K., Bolton, P.A., Controlled trial of psychotherapy for Congolese survivors of sexual violence. N Engl J Med 368 (2013), 2182–2191, 10.1056/NEJMoa1211853.
15. 15•• Patel, V., Rethinking mental health care: bridging the credibility gap. Intervention 12 (2014), 15–20, 10.1097/WTF.0000000000000065 Patel asserts that D&I mental health researchers need to think not only about ‘supply side barriers,’ such as limited access to effective treatments, but also ‘demand side barriers,’ such as low utilization of mental health treatments even in high resource settings. Patel ascribes demand side barriers to a discrepancy between the biomedical explanatory models and language of mental health specialists and how the majority of the world conceptualizes psychological suffering. Patel notes that it is ‘credibility gap’ that must be bridged to sufficiently meet the mental needs of populations around the globe.
16. 16 Murray, L.K., Tol, W., Jordans, M., Sabir, G., Amin, A.M., Bolton, P., Bass, J., Bonilla-Escobar, F.J., Thornicroft, G., Dissemination and implementation of evidence based, mental health interventions in post conflict, low resource settings. Intervention 12 (2014), 94–112, 10.1097/WTF.0000000000000070.
17. 17 Damschroder, L.J., Aron, D.C., Keith, R.E., Kirsh, S.R., Alexander, J.A., Lowery, J.C., Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci, 4, 2009, 50, 10.1186/1748-5908-4-50.
18. 18 Valentine, S.E., Borba, C.P.C., Dixon, L., Vaewsorn, A.S., Guajardo, J.G., Resick, P.A., Wiltsey Stirman, S., Marques, L., Cognitive processing therapy for Spanish-speaking Latinos: a formative study of a model-driven cultural adaptation of the manual to enhance implementation in a usual care setting. J Clin Psychol, 2016, 10.1002/jclp.22337.
19. 19 Southam-Gerow, M.A., Arnold, C.C., Rodriguez, A., Cox, J.R., Acting locally and globally: dissemination implementation around the world and next door. Cogn Behav Pract 21 (2014), 127–133, 10.1016/j.cbpra.2013.12.007.
20. 20 Hoge, M.A., Wolf, J., Migdole, S., Cannata, E., Gregory, F.X., Workforce development and mental health transformation: a state perspective. Community Ment Health J 52 (2016), 323–331, 10.1007/s10597-015-9953-6.
21. 21 Beidas, R.S., Marcus, S., Wolk, C.B., Powell, B., Aarons, G.A., Evans, A.C., Hurford, M.O., Hadley, T., Adams, D.R., Walsh, L.M., Babbar, S., Barg, F., Mandell, D.S., A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practices in a publicly-funded mental health system. Adm Policy Ment Health Ment Health Serv Res 43 (2016), 640–649, 10.1007/s10488-015-0673-6.
22. 22 Murray, L.K., Dorsey, S., Bolton, P., Jordans, M.J.D., Rahman, A., Bass, J., Verdeli, H., Building capacity in mental health interventions in low resource countries: an apprenticeship model for training local providers. Int J Ment Health Syst, 5, 2011, 10.1186/1752-4458-5-30.
23. 23 Finley, E.P., Garcia, H.A., Ketchum, N.S., McGeary, D.D., McGeary, C.A., Stirman, S.W., Peterson, A.L., Utilization of evidence-based psychotherapies in Veterans Affairs posttraumatic stress disorder outpatient clinics. Psychol Serv 12 (2015), 73–82, 10.1037/ser0000014.
24. 24 Nadeem, E., Ringle, V.A., De-adoption of an evidence-based trauma intervention in schools: a retrospective report from an urban school district. School Ment Health, 2016, 10.1007/s12310-016-9179-y.
25. 25 Karlin, B.E., Cross, G., From the laboratory to the therapy room: National dissemination and implementation of evidence-based psychotherapies in the U.S. Department of Veterans Affairs Health Care System. Am Psychol 69 (2014), 19–33, 10.1037/a0033888.
26. 26 Eftekhari, A., Crowley, J.J., Ruzek, J.I., Garvert, D.W., Karlin, B.E., Rosen, C.S., Training in the implementation of prolonged exposure therapy: provider correlates of treatment outcome. J Trauma Stress 28 (2015), 65–68, 10.1002/jts.21980.
27. 27 Hundt, N.E., Harik, J.M., Barrera, T.L., Cully, J.A., Stanley, M.A., Treatment decision-making for posttraumatic stress disorder: the impact of patient and therapist characteristics. Psychol Trauma Theory Res Pract Policy, 2016, 10.1037/tra0000102.
28. 28 Salloum, A., Swaidan, V.R., Torres, A.C., Murphy, T.K., Storch, E.A., Parents’ perception of stepped care and standard care trauma-focused cognitive behavioral therapy for young children. J Child Fam Stud, 2015, 10.1007/s10826-015-0207-6.
29. 29 Humayun, A., Azad, N., Haq, I.U., Khan, F.R., Ahmad, A., Farooq, R.K., Mental health and psychosocial support for the internally displaced persons in Bannu, Pakistan. Intervention 14 (2016), 33–49, 10.1097/WTF.0000000000000105.
30. 30 Bolton, P., Bass, J.K., Murray, M., Murray, L.K., Van Wyk, S., Zangana, S., Kamal, T., Kaysen, D., Lejuez, C.W., Lindgren, K., Pagoto, S., Ahmed, A., Mohammad Amin, N.M., Rosenblum, M., A randomized controlled trial of mental health interventions for survivors of systematic violence in Kurdistan, Northern Iraq. BMC Psychiatry, 14, 2014, 10.1186/s12888-014-0360-2.
31. 31 Jacob, N., Neuner, F., Maedl, A., Schaal, S., Elbert, T., Dissemination of psychotherapy for trauma spectrum disorders in postconflict settings: a randomized controlled trial in Rwanda. Psychother Psychosom 83 (2014), 354–363.
32. 32 Tebes, J.K., Matlin, S.L., Migdole, S.J., Farkas, M.S., Money, R.W., Shulman, L., Hoge, M.A., Providing competency training to clinical supervisors through an interactional supervision approach. Res Soc Work Pract 21 (2011), 190–199, 10.1177/1049731510385827.
33. 33 Beidas, R.S., Edmunds, J.M., Marcus, S.C., Kendall, P.C., Training and consultation to promote implementation of an empirically supported treatment: a randomized trial. Psychiatr Serv 63 (2012), 660–665, 10.1176/appi.ps.201100401.
34. 34 Nadeem, E., Gleacher, A., Beidas, R.S., Consultation as an implementation strategy for evidence-based practices across multiple contexts: unpacking the black box. Adm Policy Ment Health Ment Health Serv Res 40 (2013), 439–450, 10.1007/s10488-013-0502-8.
35. 35 Dorsey, S., Pullmann, M.D., Deblinger, E., Berliner, L., Kerns, S.E., Thompson, K., Unützer, J., Weisz, J.R., Garland, A.F., Improving practice in community-based settings: a randomized trial of supervision – study protocol. Implement Sci, 8, 2013, 89, 10.1186/1748-5908-8-89.
36. 36 Gearing, R.E., El-Bassel, N., Ghesquiere, A., Baldwin, S., Gillies, J., Ngeow, E., Major ingredients of fidelity: a review and scientific guide to improving quality of intervention research implementation. Clin Psychol Rev, 31, 2011, 79, 10.1016/j.cpr.2010.09.007.
37. 37 Stirman, S., Miller, C., Toder, K., Calloway, A., Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implement Sci, 8, 2013, 65, 10.1186/1748-5908-8-65.
38. 38 Wiltsey Stirman, S., Gutner, C.A., Crits-Christoph, P., Edmunds, J., Evans, A.C., Beidas, R.S., Relationships between clinician-level attributes and fidelity-consistent and fidelity-inconsistent modifications to an evidence-based psychotherapy. Implement Sci, 10, 2015, 115.
39. 39 Kemp, L., Adaptation and fidelity: a recipe analogy for achieving both in population scale implementation. Prev Sci 17 (2016), 429–438, 10.1007/s11121-016-0642-7.
40. 40•• Chambers, D., Glasgow, R., Stange, K., The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci, 8, 2013, 117, 10.1186/1748-5908-8-117 Chambers et al. propose a new implementation framework, the Dynamic Sustainability Framework, which puts ongoing adaptation at the center of a long-term, sustainable implementation process. The authors propose this model in response to two frequent, but possibly misguided assumptions in implementation science: ‘voltage drop,’ which is an expectation intervention effects will decrease as they move from efficacy to implementation, and ‘program drift,’ an expectation that deviations from manualized protocols reduce effectiveness.
41. 41 Karlin, B.E., Ruzek, J.I., Chard, K.M., Eftekhari, A., Monson, C.M., Hembree, E.A., Resick, P.A., Foa, E.B., Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration. J Trauma Stress 23 (2010), 663–673, 10.1002/jts.20588.
42. 42 Bearman, S.K., Schneiderman, R.L., Zoloth, E., Building an evidence base for effective supervision practices: an analogue experiment of supervision to increase EBT fidelity. Adm Policy Ment Health Ment Health Serv Res, 2016, 1–15, 10.1007/s10488-016-0723-8.
43. 43 Dorsey, S., Lyon, A.R., Pullmann, M.D., Jungbluth, N., Berliner, L., Beidas, R., Behavioral rehearsal for analogue fidelity: feasibility in a state-funded children's mental health initiative. Adm Policy Ment Health Ment Health Serv Res, 2016, 10.1007/s10488-016-0727-4.
44. 44 Murray, L.K., Dorsey, S., Skavenski, S., Kasoma, M., Imasiku, M., Bolton, P., Bass, J., Cohen, J.A., Identification, modification, and implementation of an evidence-based psychotherapy for children in a low-income country: the use of TF-CBT in Zambia. Int J Ment Health Syst, 7, 2013, 10.1186/1752-4458-7-24.
45. 45 Weiss, W., Murray, L., Kaysen, D., Dorsey, S., Lindgren, K., Gross, A., Bass, J., Bolton, P., Community-based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial. BMC Psychiatry, 15, 2015.
46. 46•• Murray, L.K., Dorsey, S., Haroz, E., Lee, C., Alsiary, M.M., Haydary, A., Weiss, W.M., Bolton, P., A common elements treatment approach for adult mental health problems in low- and middle-income countries. Cogn Behav Pract 21 (2014), 111–123, 10.1016/j.cbpra.2013.06.005 This paper describes the development of a transdiagnostic, cognitive behavioral approach developed for treating adult mood and anxiety issues in LMICs. The Common Elements Treatment Approach is conceptualized as an approach to training lay counselors. The treatment includes training in treatment engagement, risk planning, and screening and brief intervention for alcohol use, in addition to standard CBT components like exposure, cognitive restructuring, behavioral activation, and anxiety management. The results of two D&I pilot studies indicated acceptable fidelity, low client attrition, and promising results for symptom reduction.
47. 47 Marques, L., Eustis, E.H., Dixon, L., Valentine, S.E., Borba, C.P.C., Simon, N., Kaysen, D., Wiltsey-Stirman, S., Delivering cognitive processing therapy in a community health setting: the influence of Latino culture and community violence on posttraumatic cognitions. Psychol Trauma Theory Res Pract Policy 8 (2016), 98–106, 10.1037/tra0000044.
48. 48 Cook, J.M., Dinnen, S., Thompson, R., Simiola, V., Schnurr, P.P., Changes in implementation of two evidence-based psychotherapies for PTSD in VA residential treatment programs: a national investigation. J Trauma Stress 27 (2016), 137–143, 10.1002/jts.21902.
49. 50 Aarons, G.A., Hurlburt, M., Horwitz, S.M., Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health Ment Health Serv Res 38 (2011), 4–23, 10.1007/s10488-010-0327-7.