The Association Between Clinician and Perceived Organizational Factors with Early Fidelity to Cognitive Processing Therapy for Posttraumatic Stress Disorder in a Randomized Controlled Implementation Trial

Adm Policy Ment Health. 2020 Jan;47(1):8-18. doi: 10.1007/s10488-019-00966-7.


A common metric for determining implementation success is the measurement of clinician adherence to, and competence in, delivering a psychotherapy. The present study examined clinician and organizational factors as predictors of early adherence and competence among 78 clinicians delivering cognitive processing therapy (CPT), an evidence-based psychotherapy (EBP) for posttraumatic stress disorder, in a randomized controlled implementation trial. Results indicated that clinicians' willingness to adopt an EBP if required to do so was significantly associated with early adherence and competence in CPT delivery. Level of clinician education was significantly associated with early competence in delivering CPT. Organizational factors did not predict early adherence or competence. Implications of the findings are discussed.

Keywords: Clinician factors; Cognitive processing therapy; Dissemination; Fidelity; Implementation outcomes; Organizational factors.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude*
  • Clinical Competence / standards*
  • Cognitive Behavioral Therapy / organization & administration*
  • Cognitive Behavioral Therapy / standards
  • Educational Status
  • Female
  • Guideline Adherence
  • Humans
  • Male
  • Middle Aged
  • Organizational Culture*
  • Practice Guidelines as Topic
  • Stress Disorders, Post-Traumatic / therapy*
  • Treatment Outcome

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