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Are Inner Context Factors Related to Implementation Outcomes in Cognitive-Behavioral Therapy for Youth Anxiety?

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Abstract

Among the challenges facing the mental health field are the dissemination and implementation of evidence-based practices. The present study investigated the relationships between inner context variables (i.e., adopter characteristics and individual perceptions of intra-organizational factors) and two implementation outcomes—independently rated therapist fidelity on a performance-based role-play (i.e., adherence and skill) and self-reported penetration of cognitive behavioral therapy for youth anxiety following training. A significant relationship was found between inner context variables and fidelity. Specifically, adopter characteristics were associated with adherence and skill; individual perceptions of intra-organizational factors were associated with adherence. Inner context variables were not associated with penetration. Future directions are discussed.

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Notes

  1. 92 participants completed the ITAY.

  2. Given the finding that both adherence and skill were negatively related to EBPAS requirements, it is of note that if a therapist was rated as very low on adherence, they would also be rated low on skill.

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Acknowledgments

Funding for this research project was supported by the following grants from NIMH: (MH083333, MH099179 Beidas; MH086436, MH063747 Kendall). Additionally, the preparation of this article was supported in part by the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916) and Quality Enhancement Research Initiative (QUERI), Department of Veterans Affairs Contract, Veterans Health Administration, Office of Research & Development, Health Services Research & Development Service. Dr. Beidas is an IRI fellow.

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Authors and Affiliations

  1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA

    Rinad S. Beidas & Lucia Walsh

  2. Center for Effective Child Therapy, Judge Baker Children’s Center, Boston, MA, USA

    Julie Edmunds

  3. School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA

    Matthew Ditty & Steven Marcus

  4. Bryn Mawr College, Bryn Mawr, PA, USA

    Jessica Watkins

  5. Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA

    Steven Marcus

  6. Department of Psychology, Temple University, Philadelphia, PA, USA

    Philip Kendall

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  1. Rinad S. Beidas
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Correspondence to Rinad S. Beidas.

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Beidas, R.S., Edmunds, J., Ditty, M. et al. Are Inner Context Factors Related to Implementation Outcomes in Cognitive-Behavioral Therapy for Youth Anxiety?. Adm Policy Ment Health 41, 788–799 (2014). https://doi.org/10.1007/s10488-013-0529-x

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