Symposia
Dissemination & Implementation Science
Shannon Wiltsey Stirman, Ph.D.
Associate Professor/Acting Deputy Director
Stanford University
Menlo Park, California
Erin Finley, PhD
Associate Professor
UT Health San Antonio
San Antonio, Texas
Jansey Lagdamen, B.S.
Project Coordinator
National Center for PTSD
San Jose, CA
Jiyoung Song, PhD
PhD Student
University of California, Berkeley
Berkeley, California
Tasoula Masina
Project Coordinator
Ryerson University
Toronto, ON, Canada
Syed Aajmain, PhD
Research Assistant
National Center for PTSD
Menlo Park, CA
Taylor Loskot, PhD
Research Assistant
VA National Center for PTSD and Stanford University
Menlo Park, CA
Alayna Park, Ph.D.
University of Oregon
Eugene, Oregon
Kera Swanson, MPH
Project Manager
National Center for PTSD
Menlo Park, California
Heidi La Bash, PhD
Clinical Psychologist
National Center for PTSD
Menlo Park, CA
Jeanine Lane, PhD
Student
Ryerson University
Toronto, ON, Canada
Scott Roesch, PhD
Professor
San Diego State University
San Diego, California
Joan Cook, PhD
Professor
Yale School Of Medicine, Department Of Psychiatry
New Haven, Connecticut
Norman Shields, PhD
Clinical Psychologist
Royal canadian Mounted Police
Westmount, QC, Canada
Candice M. Monson, Ph.D.
Professor
Ryerson University
Toronto, Ontario, Canada
Challenges to sustaining evidence-based treatments have been well-documented (Stirman et al., 2012) and in recent years, attention has turned to identifying strategies to support sustained implementation (Shelton et al., 2018). For psychotherapies, one key challenge is maintaining fidelity over the longer term (Stirman et al., 2018). This cluster randomized controlled trial compared two implementation to support sustained CPT delivery in these programs. We compared a fidelity-oriented learning collaborative to a continuous quality improvement approach in programs in North America that had previously implemented Cognitive Processing Therapy (CPT; Resick et al., 2016). While CPT training is standardized, the systems and organizations differed in terms of implementation supports and policies, and both the populations served and the therapist backgrounds, disciplines, and training levels varied. One hundred thirty-seven therapists across 34 clinics participated in a learning collaborative for one year. Learning collaboratives met 15 times over the year and the providers provided CPT and worked on goals discussed in the learning collaboratives between meetings, using a variety of support materials. Trained observers (who were not informed when during the learning collaborative the session occurred) coded randomly selected audiorecorded CPT sessions collected during the baseline phase and at 3 more timepoints. Multilevel modeling analyses were used to analyze for the nested longitudinal data. There were no significant differences at baseline for the two learning collaborative conditions. Preliminary analyses indicated that clinicians in the fidelity condition exhibited higher adherence ratings than those in the CQI condition. Overall, clinicians in the two groups did not differ in their rates of change in adherence or competence ratings. Consistent with previous findings (Swanson et al., 2021), clinicians received lower fidelity ratings for later sessions, suggesting that additional support may be needed for later sessions when more complex concepts and skills are included. Further analyses will be conducted to explore findings within and across different systems.