Hostname: page-component-7479d7b7d-767nl Total loading time: 0 Render date: 2024-07-12T02:12:03.512Z Has data issue: false hasContentIssue false
  • English
  • Français

From training to practice: a survey study of clinical challenges in implementing cognitive behavioural therapy in Norway

Published online by Cambridge University Press:  06 August 2015

Annette Kjøge ,
Tone Turtumøygard ,
Torkil Berge  and
Terje Ogden
Annette Kjøge*
Affiliation:
Telemark Hospital, Skien, Norway University of Oslo, Oslo, Norway
Tone Turtumøygard
Affiliation:
University of Oslo, Oslo, Norway
Torkil Berge
Affiliation:
Community Mental Health Centre Vinderen, Diakonhjemmet Hospital, Oslo, Norway
Terje Ogden
Affiliation:
The Norwegian Centre for Child Behavioural Development, University of Oslo, Norway
*
*Author for correspondence: Ms. A. Kjøge, Sykehuset Telemark, 3710 Skien, Norway (email: annette.kjoge@gmail.com).
Get access Rights & Permissions [Opens in a new window]

Abstract

This study examines potential barriers to the implementation of CBT as perceived by therapists participating in the training programmes of the Norwegian Association for Cognitive and Behavioural Therapy (NACBT). Based on a questionnaire to members of the NACBT, a factor analysis identified five underlying dimensions of implementation barriers. A one-way analysis of variance was conducted to examine differences in how barriers were perceived by therapists working in medicine, mental health and social services. A multiple regression analysis was performed to examine the relationship between the barriers and the therapists’ global satisfaction with CBT. The five factor-based barriers identified were related to Therapeutic skills, Aspects of the workplace, Supervision, Training, and Clients. Problems related to Supervision and Therapeutic skills were reported to be the most important obstacles. Nurses and others working at psychiatric wards reported the largest number, and psychologists and others working with outpatients, reported the lowest number of barriers. The study highlights the importance of implementation quality in the process of linking training and practice of CBT in Norway. Even if aspects of the training programmes were perceived to be among the smallest threats to implementation, training was not sufficient in order for candidates to implement CBT in clinical practice.

Keywords

Cognitive behaviour therapyimplementationimplementation barrierssupervisiontherapist satisfaction
Type
Education and supervision
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e16
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

Fixsen, DL, Naoom, SF, Blase, KA, Friedman, RM, Wallace, F (2005). Implementation research: a synthesis of the literature (http://cfs.cbcs.usf.edu/_docs/publications/NIRN_Monograph_Full.pdf).Google Scholar
Kauth, MR, Greer, S, Blevins, D, Cully, JA, Landes, RD, Said, Q, Teasdale, TA (2010). Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study. Implementation Science 5, 75.CrossRefGoogle ScholarPubMed

References

Beidas, RS, Kendall, PC (2010). Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice 17, 1–30.Google ScholarPubMed
Beutler, LE, Malik, M, Alimohamed, S, Harwood, TM, Talebi, H, Noble, S, Wong, E (2004). Therapist variables. In: Handbook of Psychotherapy and Behavior Change (ed. Lambert, M. J.), pp. 227–306. New York: Wiley.Google Scholar
Dorsey, S, Pullmann, MD, Deblinger, E, Berliner, L, Kerns, SE, Thompson, K, Unützer, J, Weisz, JR, Garland, AF (2013). Improving practice in community-based settings: a randomized trial of supervision – study protocol. Implementation Science 8, 2–11.CrossRefGoogle ScholarPubMed
Durlak, JA, Dupre, EP (2008). Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology 41, 327–350.CrossRefGoogle ScholarPubMed
Fixsen, DL, Blase, KA, Naoom, SF, Wallace, F (2009). Core implementation components. Research on Social Work Practice 19, 531–540.CrossRefGoogle Scholar
Fixsen, DL, Naoom, SF, Blase, KA, Friedman, RM, Wallace, F (2005). Implementation research: a synthesis of the literature (http://cfs.cbcs.usf.edu/_docs/publications/NIRN_Monograph_Full.pdf).Google Scholar
Grande, M, Røssberg, JI, Gjermundsen, K, Taraldsen, K, Berge, T (2012). Challenges in the implementation of cognitive therapy. Tidsskrift for Norsk Forening for Kognitiv Terapi 2, 6–13.Google Scholar
Greenhalgh, T, Robert, G, MacFarlane, F, Bate, P, Kyriakidou, O (2004). Diffusion of innovations in service organizations: Systematic Review and recommendation. The Milbank Quarterly 82, 581–629.CrossRefGoogle Scholar
Haraldsen, G (1999). How to develop a questionnaire: a cookbook method. Oslo: Ad Notam Gyldendal.Google Scholar
Herschell, AD, Kolko, DJ, Baumann, BL, Davis, AC (2010). The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations. Clinical Psychology Review 30, 448–466.CrossRefGoogle ScholarPubMed
Juklestad, SI (2010). Health practitioners' use of cognitive behavioural therapy. Master thesis in nursing science, University of Oslo, Oslo. (http://www.duo.uio.no/publ/sykepleie/2011/132515/master-Juklestad-endelig-oppgave.pdf).Google Scholar
Kauth, MR, Greer, S, Blevins, D, Cully, JA, Landes, RD, Said, Q, Teasdale, TA (2010). Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study. Implementation Science 5, 75.CrossRefGoogle ScholarPubMed
Lewis, CC, Simons, AD (2011). A pilot study disseminating cognitive behavioral therapy for depression: therapist factors and perceptions of barriers to implementation. Administration and Policy in Mental Health and Mental Health Services Research 38, 324–334.CrossRefGoogle ScholarPubMed
Mannix, KA, Blackburn, IM, Garland, A, Gracie, J, Moorey, S, Scott, J (2006). Effectiveness of brief training in cognitive behaviour therapy techniques for palliative care practitioners. Palliative Medicine 20, 579–584.CrossRefGoogle ScholarPubMed
McHugh, RK, Barlow, DH (2010). The dissemination and implementation of evidence-based psychological treatments. A review of current efforts. American Psychologist 65, 73–84.CrossRefGoogle ScholarPubMed
Newton, JR, Yardley, PG (2007). Evaluation of CBT training of clinicians in routine clinical practice. Psychiatric Services 58, 1497.CrossRefGoogle ScholarPubMed
Ogden, T, Fixsen, D (2014). Implementation science: a brief overview and a look ahead. Zeitschrift für Psychologie 222, 4–11.CrossRefGoogle Scholar
Rogers, E (1995). Diffusions of Innovations, 4th edn. New York: Free Press.Google ScholarPubMed
Schoenwald, S, Mehta, TG, Frazier, SL, Shernoff, ES (2013). Clinical supervision in effectiveness and implementation research. Clinical Psychology: Science and Practice 20, 44–59.Google Scholar
Shafran, R, Clark, DM, Fairburn, CG, Arntz, A, Barlow, DH, Ehlers, A, Wilson, T (2009). Mind the gap: Improving the dissemination of CBT. Behavior Research and Therapy 47, 902–909.CrossRefGoogle Scholar
Sholomskas, DE, Syracuse-Siewert, G, Rounsaville, BJ, Ball, SA, Nuro, KF, Caroll, KM (2005). We don't train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology 73, 106–115.CrossRefGoogle Scholar
Skagen, H, Piros, J (2002). A different role in the interdisciplinary community. Sykepleien 90, 30–34.CrossRefGoogle Scholar
Steffensen, V (2007). The role of the psychologist with the inward patient. Tidsskrift for Norsk Psykologforening 44, 761–763.Google Scholar
Young, AS, Klap, R, Sherbourne, CD, Wells, KB (2001). The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry 58, 55–61.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.