Barriers to Adoption of New Treatments: An Internet Study of Practicing Community Psychotherapists

Original paper


Over 1,600 North American psychotherapists from a wide range of disciplines and practice settings completed an open-ended question on perceived barriers to adoption of new treatments as part of an internet survey. Content analysis indicated that there were five overall themes: clinician attitudes, client characteristics, contextual or institutional factors, training issues and other. The most frequently endorsed theme revolved around training issues, particularly, insufficient time and cost for training, lack of confidence in mastering the technique, and lack of opportunities for refining skills. Specific ideas for overcoming these barriers are identified.


Psychotherapy Education Evidence-based medicine 


  1. Aarons, G. A. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The evidence-based practice attitude scale (EBPAS). Mental Health Services Research, 6, 61–74. doi:10.1023/B:MHSR.0000024351.12294.65.PubMedCrossRefGoogle Scholar
  2. Addis, M. E., Wade, W. A., & Hatgis, C. (1999). Barriers to dissemination of evidence-based practices: Addressing practitioners’ concerns about manual-based psychotherapies. Clinical Psychology: Science and Practice, 6, 430–441. doi:10.1093/clipsy/6.4.430.CrossRefGoogle Scholar
  3. Brown, T. L., Swenson, C. C., Cunningham, P. B., Henggeler, S. W., Schoenwald, S. K., & Rowland, M. (1997). Multisystemic treatment of violent and chronic juvenile offenders: Bridging the gap between research and practice. Administration and Policy in Mental Health, 25, 221–238. doi:10.1023/A:1022247207249.PubMedCrossRefGoogle Scholar
  4. Cook, J. M., Schnurr, P., Biyanova, T., & Coyne, J. C. (2008). Apples don’t fall far from the trees: An internet survey of influences on psychotherapists’ adoption and sustained use of new therapies. Psychiatric Services (Washington, DC) (in press).Google Scholar
  5. Haynes, B., & Haines, A. (1998). Getting research findings into practice: Barriers and bridges to evidence based clinical practice. British Medical Journal, 317, 273–276.PubMedGoogle Scholar
  6. Hohmann, A. A., & Shear, M. K. (2002). Community-based intervention research: Coping with the “noise” of real life in study design. The American Journal of Psychiatry, 159, 201–207. doi:10.1176/appi.ajp.159.2.201.PubMedCrossRefGoogle Scholar
  7. Nelson, T. D., Steele, R. G., & Mize, J. A. (2006). Practitioner attitudes toward evidence-based practice: Themes and challenges. Administration and Policy in Mental Health and Mental Health Services Research, 33, 398–409. doi:10.1007/s10488-006-0044-4.PubMedCrossRefGoogle Scholar
  8. Orlinsky, D. E., Botermans, J. F., & Ronnestad, M. H. (2001). Towards an empirically grounded model of psychotherapy training: Four thousand therapists rate influences on their development. Australian Psychologist, 36, 139–148. doi:10.1080/00050060108259646.CrossRefGoogle Scholar
  9. Pagoto, S. L., Spring, B., Coups, E. J., Mulvaney, S., Coutu, M. F., & Ozakinci, G. (2007). Barriers and facilitators of evidence-based practice perceived by behavioral science health professionals. Journal of Clinical Psychology, 63, 695–705. doi:10.1002/jclp.20376.PubMedCrossRefGoogle Scholar
  10. Robiner, W. N. (2006). The mental health professions: Workforce supply and demand, issues, and challenges. Clinical Psychology Review, 26, 600–625. doi:10.1016/j.cpr.2006.05.002.PubMedCrossRefGoogle Scholar
  11. Schmidt, F. T., & Taylor, K. (2002). Putting empirically supported treatments into practice: Lessons learned in a children’s mental health center. Professional Psychology, Research and Practice, 33, 483–489. doi:10.1037/0735-7028.33.5.483.CrossRefGoogle Scholar
  12. Varra, A. A., Hayes, S. C., Roget, N., & Fisher, G. (2008). A randomized control trial examining the effect of acceptance and commitment training on clinician willingness to use evidence-based pharmacotherapy. Journal of Consulting and Clinical Psychology, 76, 449–458. doi:10.1037/0022-006X.76.3.449.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Joan M. Cook
    • 1
    • 2
  • Tatyana Biyanova
    • 3
  • James C. Coyne
    • 4
  1. 1.Department of PsychiatryYale University School of MedicineWest HavenUSA
  2. 2.National Center for PTSDWest HavenUSA
  3. 3.Division of Mental Health Services and Outcomes ResearchYale University School of MedicineWest HavenUSA
  4. 4.University of PennsylvaniaPhiladelphiaUSA

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