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. Trent
  • B. V. Watts
Original Paper

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.

Keywords

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

References

* Indicates empirical study included in the review

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Copyright information

© Springer Science+Business Media New York (outside the USA) 2016

Authors and Affiliations

  • C. S. Rosen
    • 1
    • 2
  • M. M. Matthieu
    • 3
  • S. Wiltsey Stirman
    • 1
    • 2
  • J. M. Cook
    • 4
    • 5
  • S. Landes
    • 1
  • N. C. Bernardy
    • 6
    • 7
  • K. M. Chard
    • 8
    • 9
  • J. Crowley
    • 1
  • A. Eftekhari
    • 1
  • E. P. Finley
    • 10
    • 11
  • J. L. Hamblen
    • 6
    • 7
  • J. M. Harik
    • 6
  • S. M. Kehle-Forbes
    • 12
    • 13
    • 14
  • L. A. Meis
    • 13
    • 14
  • P. E. Osei-Bonsu
    • 13
    • 14
  • A. L. Rodriguez
    • 1
  • K. J. Ruggiero
    • 15
    • 16
  • J. I. Ruzek
    • 1
    • 2
    • 17
  • B. N. Smith
    • 1
  • L. Trent
    • 1
    • 2
  • B. V. Watts
    • 7
    • 18
  1. 1.Dissemination & Training Division, National Center for PTSDVA Palo Alto Health Care SystemMenlo ParkUSA
  2. 2.Department of Psychiatry & Behavioral SciencesStanford University School of MedicineStanfordUSA
  3. 3.School of Social WorkSaint Louis UniversitySaint LouisUSA
  4. 4.Evaluation Division, National Center for PTSDVA Connecticut Health Care SystemWest HavenUSA
  5. 5.Yale School of MedicineWest HavenUSA
  6. 6.Executive Division, National Center for PTSDVeterans Affairs Medical CenterWhite River JunctionUSA
  7. 7.Department of PsychiatryThe Geisel School of Medicine at DartmouthHanoverUSA
  8. 8.Cincinnati Department of Veterans Affairs (VA) Medical CenterCincinnatiUSA
  9. 9.University of Cincinnati College of MedicineCincinnatiUSA
  10. 10.South Texas Veterans Health Care SystemSan AntonioUSA
  11. 11.The University of Texas Health Science Center at San AntonioSan AntonioUSA
  12. 12.Women’s Health Sciences Division at VA Boston Healthcare SystemNational Center for PTSDBostonUSA
  13. 13.Center for Chronic Disease Outcomes ResearchMinneapolis VA Healthcare SystemMinneapolisUSA
  14. 14.Department of MedicineUniversity of MinnesotaMinneapolisUSA
  15. 15.Ralph H. Johnson VA Medical CenterCharlestonUSA
  16. 16.Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharlestonUSA
  17. 17.Palo Alto UniversityPalo AltoUSA
  18. 18.Veterans Affairs Medical CenterWhite River JunctionUSA

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