Early assessment of implementing evidence-based brief therapy interventions among secondary service psychiatric therapists

Lindholm, Lars H.; Koivukangas, Antti; Lassila, Antero; Kampman, Olli

doi:10.1016/j.evalprogplan.2015.05.004

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…To analyse the discriminant validity of the 12 ICS items for BA and MI, factor analysis using a two-factor rotated solution (Varimax) with generalized least squares extraction was performed. For the Usefulness scale, Cronbach's alpha in q1 was 0.869 (37)…”

Section: Methodsmentioning

confidence: 99%

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

Lindholm

Koivukangas

Lassila

et al. 2019

Nordic Journal of Psychiatry

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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 2 implementation plan is proposed to ensure the long-term survival of the implementation outcomes.

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Section: Methodsmentioning

confidence: 99%

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

Lindholm

Koivukangas

Lassila

et al. 2019

Nordic Journal of Psychiatry

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“…BA and MIs were implemented by the regional staff (registered psychiatric nurses, psychiatric practical nurses and psychologists) responsible for the patient. The regional staff was systematically trained to use the selected interventions [ 7 ]. The minimum duration of BA was set at four appointments.…”

Section: Methodsmentioning

confidence: 99%

“…Often, chosen therapeutic methods are not standardized or evidence based, although there are well-documented therapeutic options available [ 5 , 6 ]. Evidence-based brief protocols should be used more widely; these are easy to implement among the usual psychiatric services [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Behavioral activation versus treatment as usual in naturalistic sample of psychiatric patients with depressive symptoms: a benchmark controlled trial

et al. 2018

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BackgroundMore systematic use of evidence-based brief therapies is needed in the treatment of depression within psychiatric care. The aim of this study was to explore the impact of behavioral activation therapy (BA) for patients with depressive symptoms in a routine clinical setting of secondary psychiatric care.MethodsThe BA-treated intervention group (n = 242) comprised patients with depressive symptoms (Beck Depression Inventory (BDI) score ≥ 17 at baseline). The control group (n = 205) patients received treatment as usual in the same catchment area. The groups were matched at baseline using BDI and Alcohol Use Disorders Identification Test scores and inpatient/outpatient status. The groups were compared at 6-, 12- and 24-month follow-up points on functional outcome (Global Assessment of Functioning scale), service use, dropout and deaths. The Montgomery–Åsberg Depression Rating Scale was used to assess depressive symptoms in the intervention group.ResultsThe estimated difference in GAF score between intervention and control group patients was significant at 12- and 24-months follow-up points in favor of intervention group (GAF score difference 4.85 points, p = 0.006 and 5.71 points, p = 0.005, respectively; estimate for patient group 2.26, p = 0.036). The rates of dropout, mortality and service use were similar between the groups. Among the intervention group patients, the estimated improvement in MADRS score compared to baseline was statistically significant throughout the follow-up (p < 0.001 at all follow-up points).ConclusionsThe systematic use of BA among secondary psychiatric care depressive patients provides encouraging results despite the patients had various comorbid non-psychotic disorders.Trial registrationClinicalTrials.gov, Identifier NCT02520271, Release Date: 06/27/2015, retrospectively registered.

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“…We collected the present data in March 2015, 16 months after the end of the ODP. The time gap was because the analyses of the final summative inquiry and mixed-methods process evaluation, both administered to the frontline therapists in spring 2014, revealed a need to complement our understanding about the realization of the ODP (20,28). The present authors' relations to ODP and the managing organization as well as their mutual professional relationships are presented in Additional file 3.…”

Section: Settingmentioning

confidence: 99%

Importance of internal consistency in implementation programmes. A qualitative study of focus-group interviews.

Lindholm

Laitila

Lassila

et al. 2020

Preprint

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Background Programmes for implementing evidence-based treatments (EBTs) reach their goals if they succeed in institutionalizing the EBTs into routine clinical practices. Resistance to change is a common response to such programmes, undermining their ultimate output. This also happened with Ostrobothnia Depression Programme (ODP) in Finland, which was targeted at several regional psychiatric teams. We conducted a process evaluation of it to ascertain how managerial and executive practices enable or inhibit implementation and how to overcome resistance.Methods We conducted focus group interviews to scrutinize the phases of preparation and practical execution of the ODP from the perspectives of management and programme executives. To gather the data, we applied the revised Socratic approach for health technology assessment and the rapid assessment process model. We analysed the data deductively according to the Normalization Process Theory.Results We identified two main critical issues: 1) The ODP comprised two simultaneously administered programmes, one for the implementation of two EBTs and the other to study their effectiveness. Tension between these two programmes was apparent right from the beginning. 2) The programme had a simplistic top-down design and, in the preparation phase, collaboration with its target groups was delayed and minimal. No formal implementation theory or framework was applied. In addition, independent internal processes in the separate teams influenced their reception of the ODP.Conclusion We recommend early collaboration between team leaders and prospective treatment providers right from the preparation phase of an EBT implementation programme. Agreement on goals and the instruments for achieving them is essential. The strategies for execution should be adjusted with respect to the prevailing implementation climates within the separate target teams. A collaborative approach may enhance the implementation climate and mitigate resistance. Applying some appropriate implementation theories and frameworks may facilitate that work.

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Early assessment of implementing evidence-based brief therapy interventions among secondary service psychiatric therapists

Cited by 6 publications

References 28 publications

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

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

Behavioral activation versus treatment as usual in naturalistic sample of psychiatric patients with depressive symptoms: a benchmark controlled trial

Importance of internal consistency in implementation programmes. A qualitative study of focus-group interviews.

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