Paving the Way to Successful Implementation: Identifying Key Barriers to Use of Technology-Based Therapeutic Tools for Behavioral Health Care

  • Alex Ramsey
  • Sarah Lord
  • John Torrey
  • Lisa Marsch
  • Michael Lardiere


This study aimed to identify barriers to use of technology for behavioral health care from the perspective of care decision makers at community behavioral health organizations. As part of a larger survey of technology readiness, 260 care decision makers completed an open-ended question about perceived barriers to use of technology. Using the Consolidated Framework for Implementation Research (CFIR), qualitative analyses yielded barrier themes related to characteristics of technology (e.g., cost and privacy), potential end users (e.g., technology literacy and attitudes about technology), organization structure and climate (e.g., budget and infrastructure), and factors external to organizations (e.g., broadband accessibility and reimbursement policies). Number of reported barriers was higher among respondents representing agencies with lower annual budgets and smaller client bases relative to higher budget, larger clientele organizations. Individual barriers were differentially associated with budget, size of client base, and geographic location. Results are discussed in light of implementation science frameworks and proactive strategies to address perceived obstacles to adoption and use of technology-based behavioral health tools.


Behavioral Health Setting Domain Behavioral Health Care Outer Setting Implementation Climate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This research study was supported by NIDA 1P30DA029926-01. The preparation of this manuscript was partially supported by NIMH T32 MH019960.

Conflict of Interest

The authors have no conflicts of interest to report.


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Copyright information

© National Council for Behavioral Health 2014

Authors and Affiliations

  • Alex Ramsey
    • 1
  • Sarah Lord
    • 2
  • John Torrey
    • 3
  • Lisa Marsch
    • 2
  • Michael Lardiere
    • 4
  1. 1.Center for Mental Health Services Research, Brown School of Social WorkWashington University in St. LouisSt. LouisUSA
  2. 2.Center for Technology and Behavioral Health, Dartmouth Psychiatric Research CenterLebanonUSA
  3. 3.Dartmouth Psychiatric Research CenterLebanonUSA
  4. 4.National Council for Behavioral HealthWashingtonUSA

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