Principal Investigators: Keith Haddock
Posttraumatic stress disorder (PTSD) is a significant problem in the military, making the availability of effective evidence-based psychotherapies (EBPs) for PTSD a major priority to maintain the fighting force. However, efforts to disseminate EBPs for PTSD throughout the Military Health System (MHS) have met with decidedly mixed results. The primary strategy used to date has been provider training. Studies conducted by our team show that training increases knowledge and preparedness to utilize EBPs, but the frequency, consistency, and fidelity with which these treatments are used is limited (Borah et al., 2013; Wilk et al., 2013). Indeed, estimates of the reach of EBPs within the military (i.e., proportion of patients who receive the treatment) are low, even when provider adoption (i.e., the proportion of providers who use the treatment with any patients) is moderate to high.
Barriers to the use of behavioral health EBPs within the MHS are complex, existing at various levels of organization, from the provider level to the “outer context” (i.e., higher headquarter policies, guidelines) (Center for Deployment Psychology [CDP], 2015). Despite the recognition that EBP implementation falls short of the goal of providing effective treatment to service members in need, the barriers to successful EBP implementation are not well understood. In addition, barriers may vary considerably from one military treatment facility (MTF) to another. Thus, research is needed to develop a more comprehensive understanding of the factors impacting EBP use within MHS, as to test the effectiveness of scalable implementation strategies.