Many challenges face researchers, developers of innovative programs, and practitioners as they attempt to promote the spread of new clinical interventions. Traditional dissemination methods such as journal articles and conferences have many limits. Three examples of successful utilization are described concerning, respectively, the Behavior Analysis and Modification Project, the Teaching Family Model for group home treatment of deviant adolescents, and the Fairweather Hospital-Community Treatment Program (Lodge Program). Interpersonal contact between potential adopters and those knowledgeable about innovations, outside consultation on the adoption process, organizational support for innovation, persistent championship by agency staff, adaptability of the innovation, and availability of credible evidence of success were the six main factors that appeared to promote utilization in these three examples. These factors are consistent with findings from the larger literature on utilization, and most are relevant to adoption of innovations by individual psychotherapists as well.Practitioners do not adopt innovations in psychotherapy or psychosocial interventions readily. Despite efforts to enliven the scientist-practitioner model in professional psychology, psychiatry, and other mental health disciplines, most clinicians continue to use the treatment techniques learned through observing role models and supervision in graduate school, internships, and residencies. Therapeutic procedures are modified by trial-and-error, cumulative clinical experience with little influence by continuing education (Barlow, 1981). To surmount the many obstacles to the diffusion of innovations, those disseminating new treatment methods must carefully plan promotional strategies.In this article, we will highlight some of the challenges that face researchers, field developers of innovative programs, and practitioners as they attempt to spur utilization of new psychosocial methods. How can these methods be spread to mental health practitioners and institutions in such a way as to promote successful, long-lasting adoptions in new settings?When Is an Innovation Ready for Utilization? First and foremost, a new development in psychotherapy or psychosocial programming must have satisfactory types of empirical validation before being considered worthy of adoption by

Clinicians expressed concerns about competing priorities and the need for organizational leadership involvement for successful SBIRT implementation. A unique suggestion for successful implementation is to utilize existing primary care clinic-based psychologists to conduct brief intervention and facilitate referral to treatment. Patient stakeholders supported universal screening, but cultural differences in opinions and current experience were noted, indicating the importance of including this perspective when evaluating implementation potential.

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Cognitive impairments can increase significantly a person's level of risk for becoming or remaining homeless. Five topics are explored that address these impairments in preventing homelessness: (1) the nature and estimated prevalence of cognitive impairments among people who are homeless, especially those with vulnerabilities like mental illness or substance abuse; (2) the multiple origins of these impairments; (3) how these impairments impact services for people at risk for homelessness; (4) good practice approaches to handling cognitive impairments in homeless shelters, supported housing programs, and other service systems for people at risk for homelessness; and, (5) important research and practice issues requiring further action.