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Why do people working in mental health fail to use evidence-based practices? A review of the literature suggests two main barriers to staff dissemination: 1) individual service providers lack the knowledge and skills to assimilate these practices and 2) organisational dynamics undermine staffs‘ ability to implement and maintain innovative approaches. Given these barriers, three strategies to foster dissemination may be useful: 1) packaging evidence-based practices so interventions are more user-friendly 2) educating providers about relevant knowledge and skills, and 3) addressing organisational dynamics that facilitate implementation. Research on dissemination is less developed than the clinical and services research that has led to evidence-based practices. There is a need for continued work on dissemination if evidence-based practices are to be used in the real-world.
There are many reasons why evidence-based strategies are not implemented in routine mental health care. These include administrative policies, funding priorities, community resources, advocate concerns, federal and state laws, local ordinances, local consumer interests and staffing. This article focuses on barriers to staff use of evidence-based treatments and strategies to reduce these barriers.
Barriers to disseminating evidence-based practices
There are two main sets of staff barriers to implementing evidence-based practices in mental health care:
Individual service providers may lack the skills to assimilate evidence-based practices into their regular approach to treatment. Moreover, work-related variables like job burnout undermine some staff‘s interest in new and innovative practices.
Many evidence-based practices require a team of service providers. Organisational barriers such as poor leadership, change-averse culture, insufficient collegial support and bureaucratic constraints may hinder a team‘s effort to implement evidence-based practices.
Providers who wish use an evidence-based approach need to have mastered three basic sets of competencies. They need to acquire attitudes that are the foundation of evidence-based practices.1 Most important among these is a change from seeing treatment as “working on” people to …
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