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Stakeholder Perspectives on Implementing Cognitive Behavioral Social Skills Training on Assertive Community Treatment Teams

  • David H. SommerfeldEmail author
  • Gregory A. Aarons
  • Jeanean B. Naqvi
  • Jason Holden
  • Dimitri Perivoliotis
  • Kim T. Mueser
  • Eric Granholm
Original Article
  • 78 Downloads

Abstract

This study examined stakeholder perceptions of the “fit” between cognitive-behavioral social skills training (CBSST) and assertive community treatment (ACT) when implementing CBSST into existing community-based ACT teams. Focus group feedback was collected from a diverse set of stakeholders (i.e., clients, providers, supervisors, agency administrators, public sector representatives, and intervention developers). Results identified perceived client and provider benefits for integrating CBSST into ACT while highlighting the importance of purposeful adaptations, training, and implementation tools to facilitate structural and values fit between CBSST and ACT. Study findings will inform future endeavors to implement CBSST and other relevant EBPs into ACT. Trial Registry: ClinicalTrials.gov #NCT02254733.

Keywords

Schizophrenia Cognitive behavioral social skills training Assertive community treatment Implementation Intervention fit 

Notes

Acknowledgements

We thank the participants who volunteered for this study. Research reported in this publication was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Rehabilitation Research and Development Service, the National Institute of Mental Health of the National Institutes of Health (Grant R01MH091057-05 to Dr. Granholm). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs or National Institutes of Health. Dr. Granholm has an equity interest in Granholm Consulting, Inc., a company that may potentially benefit from the research results as he receives income from the company for CBSST workshops and consulting and royalties for a CBSST book. The terms of this arrangement have been reviewed and approved by the University of California, San Diego in accordance with its conflict of interest policies.

Funding

This study was funded by the Veterans Medical Research Foundation (5R01MH091057-05).

Compliance with Ethical Standards

Conflict of interest

David H. Sommerfeld, Gregory A. Aarons, Jeanean Naqvi, Dimitri Perivoliotis and Kim Mueser declare that they have no conflict of interest. Jason Holden conducts CBSST training workshops as a paid consultant and receives royalties from Guildford Press for CBSST book sales. Eric Granholm conducts CBSST training workshops as a paid consultant through Granholm Consulting Inc. and receives royalties from Guildford Press for CBSST book sales.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Aarons, G. A., Green, A. E., Palinkas, L. A., Self-Brown, S., Whitaker, D. J., Lutzker, J. R., et al. (2012). Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implementation Science, 7, 32.  https://doi.org/10.1186/1748-5908-7-32.Google Scholar
  2. Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4–23.Google Scholar
  3. Allness, D. J., & Knoedler, W. H. (1998). The PACT model of community-based treatment for persons with severe and persistent mental illnesses: A manual for PACT start-up. NAMI Campaign to End Discrimination, NAMI Anti Stigma Foundation.Google Scholar
  4. Burroughs, T., & Somerville, J. (2013). Utilization of evidenced based dialectical behavioral therapy in assertive community treatment: Examining feasibility and challenges. Community Mental Health Journal, 49(1), 25–32.Google Scholar
  5. Corbin, J., & Strauss, A. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory (3rd edn.). Thousand Oaks: Sage.Google Scholar
  6. Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012). Effectiveness-implementation hybrid designs: Combining elements of clinical effectiveness and implementation research to enhance public health impact. Medical Care, 50(3), 217–226.Google Scholar
  7. Dixon, L. B., Dickerson, F., Bellack, A. S., Bennett, M., Dickinson, D., Goldberg, R. W., et al. (2010). The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophrenia Bulletin, 36(1), 48–70.Google Scholar
  8. Drake, R. E., Bond, G. R., & Essock, S. M. (2009). Implementing evidence-based practices for people with schizophrenia. Schizophrenia Bulletin, 35(4), 704–713.Google Scholar
  9. Ehrhart, M. G., Aarons, G. A., & Farahnak, L. R. (2014). Assessing the organizational context for EBP implementation: The development and validity testing of the implementation climate scale (ICS). Implementation Science, 9, 157.  https://doi.org/10.1186/s13012-014-0157-1.Google Scholar
  10. Gaebel, W., Weinmann, S., Sartorius, N., Rutz, W., & McIntyre, J. (2005). Schizophrenia practice guidelines: International survey and comparison. British Journal of Psychiatry, 187(1), 248–255.Google Scholar
  11. Granholm, E., Holden, J., Link, P. C., McQuaid, J. R., & Jeste, D. V. (2013). Randomized controlled trial of cognitive behavioral social skills training for older consumers with schizophrenia: Defeatist performance attitudes and functional outcome. The American Journal of Geriatric Psychiatry, 21(3), 251–262.Google Scholar
  12. Granholm, E., Holden, J. L., Sommerfeld, D., Rufener, C., Perivoliotis, D., Mueser, K., & Aarons, G. A. (2015). Enhancing assertive community treatment with cognitive behavioral social skills training for schizophrenia: Study protocol for a randomized controlled trial. Trials, 16(1), 438.Google Scholar
  13. Granholm, E., McQuaid, J. R., McClure, F. S., Auslander, L. A., Perivoliotis, D., Pedrelli, P., & Jeste, D. V. (2005). A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia. American Journal of Psychiatry, 162, 520–529.Google Scholar
  14. Granholm, E., McQuaid, J. R., McClure, F. S., Link, P. C., Perivoliotis, D., Gottlieb, J. D., & Jeste, D. V. (2007). Randomized controlled trial of cognitive behavioral social skills training for older people with schizophrenia: 12-month follow-up. Journal of Clinical Psychiatry, 68(5), 730–737.Google Scholar
  15. Granholm, E. L., McQuaid, J. R., & Holden, J. L. (2016). Cognitive-behavioral social skills training for schizophrenia: A practical treatment guide. New York: Guilford.Google Scholar
  16. Granholm, E. L., McQuaid, J. R., Link, P. C., Fish, S., Patterson, T., & Jeste, D. V. (2008). Neuropsychological predictors of functional outcome in Cognitive Behavioral Social Skills Training for older people with schizophrenia. Schizophrenia Research, 100(1), 133–143.Google Scholar
  17. Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly, 82(4), 581–629.Google Scholar
  18. Haddock, G., Devane, S., Bradshaw, T., McGovern, J., Tarrier, N., Kinderman, P., & Harris, N. (2001). An investigation into the psychometric properties of the Cognitive Therapy Scale for Psychosis (CTS-Psy). Behavioural & Cognitive Psychotherapy, 29, 221–233.Google Scholar
  19. Horner, R., Blitz, C., & Ross, S. (2014). The importance of contextual fit when implementing evidence-based interventions. Washington, DC: U.S. Department of Health & Human Services, Office of the Assistant Secretary for Planning and Evaluation.Google Scholar
  20. Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. The Academy of Management Review, 21(4), 1055–1080.Google Scholar
  21. Kurtz, M. M., & Mueser, K. T. (2008). A meta-analysis of controlled research on social skills training for schizophrenia. Journal of Consulting and Clinical Psychology, 76(3), 491.Google Scholar
  22. Lehman, A. F., Steinwachs, D. M., Dixon, L. B., Postrado, L., Scott, J. E., Fahey, M., et al. (1998). Patterns of usual care for schizophrenia: Initial results from the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey. Schizophrenia Bulletin, 24(1), 11.Google Scholar
  23. Mojtabai, R., Fochtmann, L., Chang, S. W., Kotov, R., Craig, T. J., & Bromet, E. (2009). Unmet need for mental health care in schizophrenia: An overview of literature and new data from a first-admission study. Schizophrenia Bulletin, 35(4), 679–695.Google Scholar
  24. Monroe-DeVita, M., Morse, G., & Bond, G. R. (2012). Program fidelity and beyond: Multiple strategies and criteria for ensuring quality of assertive community treatment. Psychiatric Services, 63(8), 743–750.Google Scholar
  25. Monroe-DeVita, M., Teague, G. B., & Moser, L. L. (2011). The TMACT: A new tool for measuring fidelity to assertive community treatment. Journal of the American Psychiatric Nurses Association, 17(1), 17–29.Google Scholar
  26. Mueser, K. T., Bond, G. R., Drake, R. E., & Resnick, S. G. (1998). Models of community care for severe mental illness: A review of research on case management. Schizophrenia Bulletin, 24(1), 37–74.Google Scholar
  27. QSR International. (2012). NVivo 10 [computer software]. Retrieved from http://www.qsrinternational.com/pr oducts_nvivo.aspx.
  28. Salyers, M. P., McGuire, A. B., Rollins, A. L., Bond, G. R., Mueser, K. T., & Macy, V. R. (2010). Integrating assertive community treatment and illness management and recovery for consumers with severe mental illness. Community Mental Health Journal, 46(4), 319–329.Google Scholar
  29. Sedlar, G., Bruns, E. J., Walker, S. C., Kerns, S. E. U., & Negrete, A. (2017). Developing a quality assurance system for multiple evidence based practices in a statewide service improvement initiative. Administration and Policy in Mental Health and Mental Health Services Research, 44(1), 29–41.Google Scholar
  30. Shea, C. M., Jacobs, S. R., Esserman, D. A., Bruce, K., & Weiner, B. J. (2014). Organizational readiness for implementing change: A psychometric assessment of a new measure. Implementation Science: IS, 9, 7.  https://doi.org/10.1186/1748-5908-9-7.Google Scholar
  31. Stein, L. I., & Santos, A. B. (1998). Assertive community treatment of persons with severe mental illness. New York: Norton.Google Scholar
  32. Stirman, S. W., Miller, C. J., Toder, K., & Calloway, A. (2013). Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implementation Science, 8, 65.Google Scholar
  33. Teague, G. B., Bond, G. R., & Drake, R. E. (1998). Program fidelity in assertive community treatment: Development and use of a measure. American Journal of Orthopsychiatry, 68, 216–232.Google Scholar
  34. Williams, C. H. J. (2008). Cognitive behaviour therapy within assertive outreach teams: Barriers to implementation: A qualitative peer audit. Journal of Psychiatric and Mental Health Nursing, 15(10), 850–856.Google Scholar
  35. Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2008). Cognitive behavior therapy for schizophrenia: Effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 34(3), 523–537.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • David H. Sommerfeld
    • 1
    Email author
  • Gregory A. Aarons
    • 1
  • Jeanean B. Naqvi
    • 2
  • Jason Holden
    • 1
  • Dimitri Perivoliotis
    • 1
    • 3
  • Kim T. Mueser
    • 4
  • Eric Granholm
    • 1
    • 3
  1. 1.Department of PsychiatryUniversity of California, San DiegoSan DiegoUSA
  2. 2.Department of PsychologyCarnegie Mellon UniversityPittsburghUSA
  3. 3.Psychology ServiceVeterans Affairs San Diego Healthcare SystemSan DiegoUSA
  4. 4.Center for Psychiatric RehabilitationBoston UniversityBostonUSA

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