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The Adoption and Implementation of an Evidence Based Practice in Child and Family Mental Health Services Organizations: A Pilot Study of Functional Family Therapy in New York State

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Numerous challenges persist in providing evidence-based treatments to children and families in community-based settings. Functional Family Therapy (FFT), one such evidence-based treatment, is a family prevention and intervention program for adolescents with conduct disorder or oppositional defiant disorder. This paper presents pilot data in support of a conceptual framework explaining the adoption and implementation of FFT in a small sample of family and child mental health services organizations in New York State. The conceptual framework is grounded in the diffusion of innovations and the organizational behavior literatures, as well as previously published accounts of the adoption and implementation of evidence-based treatments in mental health. Pilot study data demonstrated that factors associated with the adoption of FFT included: The program fitting with the mission of the organization, as well as the organization having a strong interest in evidence-based treatments. Once a decision to adopt FFT was made, the degree to which it fit with organizational characteristics (e.g., available resource sets, organizational structure, and culture) influenced the ease with which it was implemented. Implications for the adoption and implementation of other evidence-based treatments are discussed.

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  1. For two of the organizations included in the sample, an additional administrator was interviewed because the original key respondent said the additional administrator was likely to have important information about the adoption and implementation of the FFT program.

  2. Due to resource constraints and the limited number of interviews, only one RAND researcher coded the interviews. It is recommended that future tests of the framework include reliability tests using two or more coders.


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We are grateful to Bradley D. Stein M.D., Ph.D. and Bonnie Zima M.D., M.P.H. for their thoughtful comments on the conceptual framework and its application to mental health settings, and to Kenneth B. Wells M.D., M.P.H. and David Chambers, Ph.D. for their helpful feedback on how to improve our manuscript. This pilot study was supported by the UCLA/RAND Health Services Research Center on Quality in Managed Care via a grant from the National Institute of Mental Health (P30 MH068639).

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Correspondence to James L. Zazzali.

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Zazzali, J.L., Sherbourne, C., Hoagwood, K.E. et al. The Adoption and Implementation of an Evidence Based Practice in Child and Family Mental Health Services Organizations: A Pilot Study of Functional Family Therapy in New York State. Adm Policy Ment Health 35, 38–49 (2008).

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