About
Despite efforts by the U.S. Department of Defense to train behavioral health (BH) providers in evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD), numerous barriers limit EBP implementation. TACTICS, a context-tailored implementation approach, was tested to improve the implementation of prolonged exposure therapy in military treatment facilities.
Outcomes
- For this study, the TACTICS intervention was developed as a collaboration of the Center for Deployment Psychology, the National Center for PTSD Dissemination and Training Division, University of Texas at San Antonio and Austin, and CSPAR
- Although all of the sites in this project were favorable toward EBPs and chosen to participate in a project to increase PE use, the study found they faced multiple challenges to doing so.
- Half the sites reported challenges in four key areas (i.e., staff time, provider comfort implementing PE, patient education/matching, and scheduling); the remainder reported barriers in three of these four domains.
- At all sites, several changes needed to happen in concert to increase the use of PE. Some changes were specific to PE, but many were more focused on more general issues such as increasing capacity for weekly psychotherapy, which are relevant to the implementation of most EBPs
Citations
- Rosen, C. S., Davis, C. A., Riggs, D., Cook, J., Peterson, A. L., Young-McCaughan, S., Comtois, K. A., Haddock, C. K., Borah, E. V., Dondanville, K. A., Finley, E. P., Jahnke, S. A., Poston, W. S. C., Wiltsey-Stirman, S., Neitzer, A., Broussard, C. R., Brzuchalski, M. A., Clayton, M. S. P., Conforte, L. A. M., … McLean, C. P. (2020). Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS) to increase evidence based psychotherapy in military behavioral health clinics: Design of a cluster-randomized stepped-wedge implementation study. Contemporary Clinical Trials, 93, 106008. https://doi.org/10.1016/j.cct.2020.106008
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McLean, C. P., Cook, J., Riggs, D. S., Peterson, A. L., Young-McCaughan, S., Borah, E. V., Comtois, K. A., Dondanville, K. A., Frick, E., Haddock, C. K., Mann, J., Reynolds, D., Mistretta, M., Neitzer, A., Brzuchalski, A., Clayton, S. P., Conforte, A. M., DuMars, T. D., Ekundayo, K., … Rosen, C. S. (2022). Barriers and Potential Solutions to Implementing Evidence-Based PTSD Treatment in Military Treatment Facilities. Military Medicine, usac240. https://doi.org/10.1093/milmed/usac240
