Category: Adult Anxiety

Symposium

Community Clinicians' Perception of Facilitators/Barriers to the Implementation of CBT for Anxious Latino Young Adults: Multilevel Consideration

Friday, November 17
3:30 PM - 5:00 PM
Location: Sapphire Ballroom I & J, Level 4, Sapphire Level

Keywords: Anxiety | Implementation | Hispanic Americans
Presentation Type: Symposium

Background: There is an increased effort to implement evidence-based treatments (EBT; i.e., cognitive behavioral therapy [CBT]) in community settings to promote access to EBT for high need populations, such as minority young adults with anxiety. Yet, little is known about the clinicians’ experience during the implementation process. The current study examined multi-level facilitators/barriers to implementing CBT for anxiety among Latino young adults as perceived by community clinicians.

Methods: Twenty outpatient mental health clinicians (65% psychologists, 15% psychiatrists, 15% social workers, and 5% trainees) received training on developmentally and socio-culturally informed CBT for Latino young adults (ages 16-28 years) with anxiety disorders. Clinicians completed the Facilitators and Barriers to Implementation Questionnaire (FBIQ). The FBIQ consisted of 19 facilitators and 24 barriers at intervention, patient, clinician, and institution level rated using a 5-point Likert scale (1 = completely disagree to 5 = completely agree). Items were developed based on a multi-level implementation science framework (Novins et al., 2013) and empirically-supported factors (Chaudoir et al., 2013; Gleacher et al., 2015).

Results: The most probable facilitators (clinician rating of 5) at each level include: 1) intervention: 85% for clinical relevance, 65% user-friendliness; 2) institution: 60% training/supervision, 55% institution/leadership support; 3) clinician: 60% clinician competence in CBT, 55% competence in treatment for AD or young adults, 55% relevance to clinician professional development. Conversely, the most probable barriers are patient-level factors such as low treatment adherence (75%) and clinical complexity (60%), along with lack of training (55%).

Implications: Findings inform multi-level considerations key to successful implementation of CBT in community outpatient clinics: While intervention, institution, and clinician level factors may facilitate the implementation, patient engagement is likely the greatest challenge for clinicians when working with underserved populations in the community.

Chiaying Wei

PostDoctoral Fellow
Columbia University Medical Center

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