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Transl Behav Med. 2014 Jun;4(2):175-83. doi: 10.1007/s13142-013-0248-6.

Implementing brief cognitive behavioral therapy in primary care: A pilot study.

Author information

1
Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030 USA ; Baylor College of Medicine, Houston, TX USA ; VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX USA.
2
Oklahoma Veterans Affairs Medical Center, Oklahoma City, OK USA ; University of Oklahoma Health Sciences Center, Oklahoma City, OK USA.
3
Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030 USA ; Baylor College of Medicine, Houston, TX USA.
4
Michael E. DeBakey VA Medical Center, Houston, TX USA.

Abstract

Effective implementation strategies are needed to improve the adoption of evidence-based psychotherapy in primary care settings. This study provides pilot data on the test of an implementation strategy conducted as part of a multisite randomized controlled trial examining a brief cognitive-behavioral therapy versus usual care for medically ill patients in primary care, using a hybrid (type II) effectiveness/implementation design. The implementation strategy was multifaceted and included (1) modular-based online clinician training, (2) treatment fidelity auditing with expert feedback, and (3) internal and external facilitation to provide ongoing consultation and support of practice. Outcomes included descriptive and qualitative data on the feasibility and acceptability of the implementation strategy, as well as initial indicators of clinician adoption and treatment fidelity. Results suggest that a comprehensive implementation strategy to improve clinician adoption of a brief cognitive-behavioral therapy in primary care is feasible and effective for reaching high levels of adoption and fidelity.

KEYWORDS:

Anxiety; Cognitive behavioral therapy; Depression; Hybrid effectiveness-implementation designs; Primary care; Veterans

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