Dissertation Seminar: Becca Stewart

Rebecca Stewart
Wednesday, June 16, 3:00 pm
Room B35, Solomon Labs

Title: BARRIERS TO AND FACILITATORS OF THE DISSEMINATION OF EMPIRICALLY SUPPORTED TREATMENTS: THREE STUDIES OF PRACTICING PSYCHOLOGISTS

The purpose of this dissertation is to examine the long-standing gap between psychotherapy practice and research from the viewpoint of the front-line practicing psychologist, with a specific focus on responses to empirically supported treatments (ESTs). Three studies provide information about the barriers and facilitators to ESTs that could aid dissemination strategies. Given previous research demonstrating that clinicians rely more on clinical judgment than research findings, Study 1 investigates whether researchers can make EST research more compelling to clinicians through the use of case examples. Psychologists in private practice (N = 742) were randomly assigned to receive a research review of data from randomized controlled trials of cognitive-behavioral treatment (CBT) and medication for bulimia, a case study of CBT for a fictional patient with bulimia, or both. Practitioners who received the case study held more positive attitudes towards the EST described and were more willing obtain training than those who did not receive the case example. Studies 2a and 2b examined perceived barriers (both ideological and logistical) to EST adoption. Psychologists in private practice (N = 1261) were surveyed about reasons to pursue or reject training in ESTs. On average practitioners did not agree that any of the proposed ideological objections were deterrents to their seeking EST training. In Study 2b, the same participants were randomly assigned to receive one of three levels of training demand on their time and money: a 3-hour, 1-day, or 3-day EST workshop. Both practical and theoretical barriers proved to be important in influencing practitioners’ willingness to obtain training in ESTs. Study 3 represents a qualitative analysis of interviews with 25 psychologists in private practice, investigating everyday treatment decisions and attitudes about treatment outcome research and ESTs. Clinicians noted positive aspects about research products, but had misgivings about the application of controlled research findings and manualized protocols to their practices. Clinicians valued learning from clinical experience, peer networks, practitioner-oriented books, and continuing education when it was not too basic. Clinicians suggested they might be interested in ESTs if they could integrate them into their current eclectic frameworks, and if resources for learning ESTs were improved.