Evaluation of an Implementation Model: A National Investigation of VA Residential Programs

  • Joan M. CookEmail author
  • Stephanie Dinnen
  • James C. Coyne
  • Richard Thompson
  • Vanessa Simiola
  • Josef Ruzek
  • Paula P. Schnurr
Original Article


This national investigation utilizes qualitative data to evaluate an implementation model regarding factors influencing provider use of two evidence-based treatments for posttraumatic stress disorder (PTSD). Semi-structured qualitative interviews with 198 mental health providers from 38 Department of Veterans Affairs’ (VA) residential treatment programs were used to explore these issues regarding prolonged exposure (PE) and cognitive processing therapy (CPT) in VA residential PTSD programs. Several unique and some overlapping predictors emerged. Leadership was viewed as an influence on implementation for both CPT and PE, while a lack of dedicated time and resources was viewed as a deterrent for both. Compatibility of CPT with providers’ existing practices and beliefs, the ability to observe noticeable patient improvement, a perceived relative advantage of CPT over alternative treatments, and the presence of a supportive peer network emerged as influential on CPT implementation. Leadership was associated with PE implementation. Implications for the design and improvement of training and implementation efforts are discussed.


Implementation Evidence-based practice Posttraumatic stress disorders 



This project described was supported by Award Number RC1 MH088454 from the National Institute of Mental Health (NIMH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH, the National Institutes of Health or the Department of Veterans Affairs.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Joan M. Cook
    • 1
    Email author
  • Stephanie Dinnen
    • 1
  • James C. Coyne
    • 2
  • Richard Thompson
    • 3
  • Vanessa Simiola
    • 1
  • Josef Ruzek
    • 4
  • Paula P. Schnurr
    • 5
  1. 1.Yale School of Medicine and National Center for PTSDWest HavenUSA
  2. 2.University of GroningenGroningenThe Netherlands
  3. 3.University of Illinois at ChicagoChicagoUSA
  4. 4.National Center for PTSD and Palo Alto UniversityPalo AltoUSA
  5. 5.National Center for PTSD and Geisel School of Medicine at DartmouthWhite River JunctionUSA

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