Dissemination and adoption of innovative psychosocial interventions.

Abstract

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

Triple P-Positive Parenting Program as a public health approach to strengthening parenting.

“…Specifically, professional change is thought more likely to occur when supervisors, managers, and professional colleagues support the adoption or change process (Backer, Liberman, & Kuehnel, 1986;Parcel, Perry, & Taylor, 1990); when peer supervision, feedback, and support are available (Henggeler, Melton, Brondino, Scherer, & Hanley, 1997); and when computer technologies, such as the Web and e-mail services, are used to support and provide consultative backup to professionals. In organizations in which a culture of innovation is supported by management through the provision of resources and attention, a greater success in establishing and implementing new initiatives is predicted (Ash, 1997).…”

Evidence-based treatment practices for drug-involved adults in the criminal justice system

“…Such models view an organization's institutional and external environments as influencing its structures and processes (Marsden, 1998). Institutional factors associated with the quality treatment practices for substance-abusing clients include organizational culture and climate (Knudsen et al, 2006,Friedmann, Alexander, & D'Aunno, 1999a,Friedmann, Alexander, Jin, & D'Aunno, 1999b,Wheeler, Fadel, & D'Aunno, 1992, leadership background and attitudes (Roman & Johnson, 2002,Heinrich et al, 2002, and staff background and training (Knudsen et al, 2006,Friedmann et al, 1999a,D'Aunno & Vaughn, 1995,Backer, Liberman, & Kuehnel, 1986. Characteristics of the external environment associated with treatment practices include requirements of regulatory or accreditation agencies (Brown & Flynn, 2002,Friedmann et al, 1999a,D'Aunno & Vaughn, 1992,Anttewell & Gerstein, 1979, resources and funding (Lehman, Greener, & Simpson, 2002,D'Aunno, Vaughn, & McElroy, 1999,D'Aunno et al, 1995,Simpson, 2002,Friedmann et al, 1999a, and network connectedness (Knudsen & Roman, 2004,Taxman et al, 2000.…”

The Triple P‐Positive Parenting Programme: a universal population‐level approach to the prevention of child abuse

“…A major concern for prevention researchers and policymakers is the lack of uptake of empirically supported interventions by clinical practitioners (Backer et al, 1986;Biglan, 1995;Fixen and Blas´e, 1993). The gap between intervention research and clinical practice has been ascribed to a range of possible factors, including practitioner views that clinical research is irrelevant, difficulties in flexibly tailoring university-designed interventions in the field and a lack of resources, training and supervision in community based clinical settings (Henggeler et al, 1995).…”