Most mental health centers implemented these evidence-based practices with moderate to high fidelity. The critical time period for implementation was approximately 12 months, after which few gains were made, although sites sustained their attained levels of evidence-based practice fidelity for another year.

Implementation of illness management and recovery in community mental health settings is facilitated through strong leadership, an organizational culture that embraces innovation, effective training, and committed staff. Where these factors are lacking, strategies may need to be developed to effectively implement and sustain illness management and recovery.

Guided primarily by attachment theory, this longitudinal study explored how adult mental representations of attachment relationships and memories of childhood experiences with parents contributed to a mother's anxiety about separation from her own infant. The Maternal Separation Anxiety Scale, the Adult Attachment Interview, and the Mother-Father-Peer Scale were administered to a sample of 49 first-time mothers. The mothers with insecure attachment representations, when asked to remember details of their own childhood, reported more negative recollections of early parental caregiving, particularly rejection and discouragement of independence. When their own infants were 2 months old, these mothers experienced heightened levels of maternal separation anxiety. The findings provide theoretical and empirical support for the view that very high levels of maternal separation anxiety may indicate dysfunction.

Common facilitators and barriers to implementation of integrated dual disorders treatment emerged across sites. The results confirmed the importance of the use of the consultant-trainer in the model of implementation, as well as the need for intensive activities at multiple levels to facilitate implementation. Further research on service implementation is needed, including but not limited to clarifying strategies to overcome barriers.

Forty-eight mothers and their 11-year-old children, who were participants in a longitudinal study, were interviewed in their home after the terrorist attacks of September 11, 2001. Children's verbatim statements were analyzed for fear, separation anxiety, denial, rationalization, anger, and empathy. In the final model, preexisting child anxiety and maternal worry significantly explained 33% of the variance in children's self-reported fearful feelings.