What is important for the sustained implementation of evidence-based brief psychotherapy interventions in psychiatric care? A quantitative evaluation of a real-world programme

Abstract

Purpose: Behavioural activation and motivational interviewing, both evidence-based treatments (EBTs), were implemented in secondary psychiatric care. This longitudinal evaluation of a real-world programme focused on the penetration of EBT adoption and its associations with therapist-related and perceived intervention-related variables. The implementation plan was also compared to sub-processes of Normalization Process Theory.

Material and methods: Six participating units employed 72 therapists regularly and they comprise the target group. Due to staff turnover, a total of 84 therapists were trained stepwise. Three survey points (q1, q2, q3) were set for a four-year cycle beginning a year after the initial training and completed 4–5 months after closing patient recruitment. The implementation plan included two workshop days, one for each EBT, and subsequent case consultation groups and other more general strategies.

Results: Fifty-seven (68%) of programme-trained therapists responded to one or more of three questionnaires. The self-reported penetration covers about a third of the target group a few months after the completion of the programme. Therapists' favourable perceptions of the EBTs regarding relative advantage, compatibility and complexity were associated with their sustained adoption. Therapists’ background factors (e.g. work experience) and positive adoption intention at q1 did not predict the actual adoption of the EBTs at q3. No specific sustainment strategies were included in the implementation plan.

Conclusion: Brief but multi-faceted training with subsequent case consultations promoted the adoption of EBTs in a real-world setting. Adding specific sustainment strategies to the implementation plan is proposed to ensure the long-term survival of the implementation outcomes.

Trial registration: ClinicalTrials.gov identifier: NCT02520271.

Keywords:

• Brief psychotherapy
• evidence-based practice
• mental healthcare
• programme evaluation
• sustained implementation

Acknowledgments

We thank all attendees involved in ODS-I and research nurses Susanna Ahola and Marja Koivumäki for their great contributions to this study. We also thank the South Ostrobothnia Hospital District research fund for supporting ODS-I.

Disclosure statement

The study sponsor had no role in the study design, data collection, data analysis, interpretation of the data, or any other contribution. The authors declare that they have no competing interests.

Additional information

Funding

The South Ostrobothnia Hospital District Research Fund supported the present evaluation study of ODS-I