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Evaluation of an Implementation Model: A National Investigation of VA Residential Programs

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Abstract

This national investigation utilizes qualitative data to evaluate an implementation model regarding factors influencing provider use of two evidence-based treatments for posttraumatic stress disorder (PTSD). Semi-structured qualitative interviews with 198 mental health providers from 38 Department of Veterans Affairs’ (VA) residential treatment programs were used to explore these issues regarding prolonged exposure (PE) and cognitive processing therapy (CPT) in VA residential PTSD programs. Several unique and some overlapping predictors emerged. Leadership was viewed as an influence on implementation for both CPT and PE, while a lack of dedicated time and resources was viewed as a deterrent for both. Compatibility of CPT with providers’ existing practices and beliefs, the ability to observe noticeable patient improvement, a perceived relative advantage of CPT over alternative treatments, and the presence of a supportive peer network emerged as influential on CPT implementation. Leadership was associated with PE implementation. Implications for the design and improvement of training and implementation efforts are discussed.

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Notes

  1. The semi-structured interview is available upon request to the first author.

  2. A full list of the constructs and copy of the survey is available from the first author.

  3. Further information about these comparisons by level of adoption is available from the first author.

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Acknowledgments

This project described was supported by Award Number RC1 MH088454 from the National Institute of Mental Health (NIMH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH, the National Institutes of Health or the Department of Veterans Affairs.

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Authors and Affiliations

  1. Yale School of Medicine and National Center for PTSD, 950 Campbell Avenue, NEPEC/182, West Haven, CT, 06516, USA

    Joan M. Cook, Stephanie Dinnen & Vanessa Simiola

  2. University of Groningen, Groningen, The Netherlands

    James C. Coyne

  3. University of Illinois at Chicago, Chicago, IL, USA

    Richard Thompson

  4. National Center for PTSD and Palo Alto University, Palo Alto, CA, USA

    Josef Ruzek

  5. National Center for PTSD and Geisel School of Medicine at Dartmouth, White River Junction, NH, USA

    Paula P. Schnurr

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  1. Joan M. Cook
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  2. Stephanie Dinnen
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  3. James C. Coyne
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  4. Richard Thompson
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  5. Vanessa Simiola
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  6. Josef Ruzek
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  7. Paula P. Schnurr
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Correspondence to Joan M. Cook.

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Cook, J.M., Dinnen, S., Coyne, J.C. et al. Evaluation of an Implementation Model: A National Investigation of VA Residential Programs. Adm Policy Ment Health 42, 147–156 (2015). https://doi.org/10.1007/s10488-014-0555-3

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  • DOI: https://doi.org/10.1007/s10488-014-0555-3

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