A Review of Studies on the System-Wide Implementation of Evidence-Based Psychotherapies for Posttraumatic Stress Disorder in the Veterans Health Administration

C. S. Rosen, M. M. Matthieu, S. Wiltsey Stirman, J. M. Cook, S. Landes, N. C. Bernardy, K. M. Chard, J. Crowley, A. Eftekhari, E. P. Finley, J. L. Hamblen, J. M. Harik, S. M. Kehle-Forbes, L. A. Meis, P. E. Osei-Bonsu, A. L. Rodriguez, K. J. Ruggiero, J. I. Ruzek, B. N. Smith, L. TrentB. V. Watts

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Since 2006, the Veterans Health Administration (VHA) has instituted policy changes and training programs to support system-wide implementation of two evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). To assess lessons learned from this unprecedented effort, we used PubMed and the PILOTS databases and networking with researchers to identify 32 reports on contextual influences on implementation or sustainment of EBPs for PTSD in VHA settings. Findings were initially organized using the exploration, planning, implementation, and sustainment framework (EPIS; Aarons et al. in Adm Policy Ment Health Health Serv Res 38:4–23, 2011). Results that could not be adequately captured within the EPIS framework, such as implementation outcomes and adopter beliefs about the innovation, were coded using constructs from the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework (Glasgow et al. in Am J Public Health 89:1322–1327, 1999) and Consolidated Framework for Implementation Research (CFIR; Damschroder et al. in Implement Sci 4(1):50, 2009). We highlight key areas of progress in implementation, identify continuing challenges and research questions, and discuss implications for future efforts to promote EBPs in large health care systems.

Original languageEnglish (US)
Pages (from-to)957-977
Number of pages21
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Volume43
Issue number6
DOIs
StatePublished - Nov 1 2016

Keywords

  • Competency-based training
  • Diffusion of innovation
  • Evidence-based practice
  • Implementation science
  • Posttraumatic stress disorders
  • Psychotherapy
  • Veterans

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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