Context Matters: Team and Organizational Factors Associated with Reach of Evidence-Based Psychotherapies for PTSD in the Veterans Health Administration

Nina A. Sayer, Craig S. Rosen, Nancy C. Bernardy, Joan M. Cook, Robert J. Orazem, Kathleen M. Chard, David C. Mohr, Shannon M. Kehle-Forbes, Afsoon Eftekhari, Jill Crowley, Josef I. Ruzek, Brandy N. Smith, Paula P. Schnurr

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Evidence-based psychotherapies for PTSD are often underused. The objective of this mixed-method study was to identify organizational and clinic factors that promote high levels of reach of evidence-based psychotherapies for PTSD 10 years into their dissemination throughout the Veterans Health Administration. We conducted 96 individual interviews with staff from ten outpatient PTSD teams at nine sites that differed in reach of evidence-based psychotherapies for PTSD. Major themes associated with reach included clinic mission, clinic leader and staff engagement, clinic operations, staff perceptions, and the practice environment. Strategies to improve reach of evidence-based psychotherapies should attend to organizational and team-level factors.

Original languageEnglish (US)
Pages (from-to)904-918
Number of pages15
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Volume44
Issue number6
DOIs
StatePublished - Nov 1 2017

Bibliographical note

Funding Information:
This research was supported by the Department of Veterans Affairs, Health Services Research and Development (HSR&D) (Grant No. CRE 12-021). The sponsor was not involved in any aspect of the study?s design and conduct; data collection, management, analysis, or interpretation of data; or in the preparation, review or approval of the manuscript. The findings and conclusions presented in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or HSR&D. N. Sayer, C. Rosen, N. Bernardy, K. Chard, S. Kehle-Forbes, D. Mohr and P. Scbnurr have received grants from the Department of Veterans Affairs. J. Cook has received grants from NIH. The authors report no additional competing interests.

Funding Information:
Acknowledgements This research was supported by the Department of Veterans Affairs, Health Services Research and Development (HSR&D) (Grant No. CRE 12-021). The sponsor was not involved in any aspect of the study’s design and conduct; data collection, management, analysis, or interpretation of data; or in the preparation, review or approval of the manuscript. The findings and conclusions presented in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or HSR&D.

Keywords

  • Evidence-based practices
  • Implementation
  • Mental health services
  • Mixed methods
  • Organization
  • Posttraumatic stress disorder

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