Clinicians’ Perspectives on Cognitive Therapy in Community Mental Health Settings: Implications for Training and Implementation

Policymakers are investing significant resources in large-scale training and implementation programs for evidence-based psychological
treatments (EBPTs) in public mental health systems. However, relatively little research has been conducted to understand factors
that may influence the success of efforts to implement EBPTs for adult consumers of mental health services. In a formative
investigation during the development of a program to implement cognitive therapy (CT) in a community mental health system,
we surveyed and interviewed clinicians and clinical administrators to identify potential influences on CT implementation within
their agencies. Four primary themes were identified. Two related to attitudes towards CT: (1) ability to address client needs
and issues that are perceived as most central to their presenting problems, and (2) reluctance to fully implement CT. Two
themes were relevant to context: (1) agency-level barriers, specifically workload and productivity concerns and reactions
to change, and (2) agency-level facilitators, specifically, treatment planning requirements and openness to training. These
findings provide information that can be used to develop strategies to facilitate the implementation of CT interventions for
clients being treated in public-sector settings.