ABSTRACT 2: Practitioner example

Dan Fox, & Sonia Combs

Lutheran Community Services Northwest

Title: The challenges in implementing multiple evidence-based practices in a community mental health setting


Lutheran Community Services Northwest (LCSNW) is a community mental health agency that implements multiple evidence-based practices (EBPs) for children, families, and adults. EBPs include: components-based CBT, parent-child interaction therapy, and cognitive processing therapy. Given the numerous EBPs offered at LCSNW, unique challenges arise with respect to maintaining model fidelity, ensuring adequate training in each model, and weaving EBPs into agency culture. Moreover, clinicians struggle to creatively implement each model for a diverse client population.

Materials and methods

Approximately 26 masters-level clinicians and 30 interns at the agency were interviewed. Both positive and negative opinions were gathered in supervisory sessions.


Overall, the LCSNW case study found high attention to self-care as a factor associated with addressing staff turnover. Given the multiplicity of EBPs, developing an integrated training system was proven highly beneficial at LCSNW, including: 1) EBP information during orientation, 2) ongoing in-house training, and 3) attending outside training in line with EBPs. Moreover, maintaining highly trained supervisory staff to continually educate the inevitable staff turnover was both critical and ultimately challenging. Finally, having routine discussions of how EBPs link to clinicians’ desire to help clients improve increases connection to models, producing positive impacts on fidelity.


LCSNW is an exemplary agency, highlighting the benefits observed from fostering an agency-wide culture supporting the use of EBPs and attending to clinician wellbeing. To mirror these benefits, LCSNW suggests creating buy-in at all levels, as well as weaving the EBP lexicon into all aspects of the agency, not simply those relevant to treatment.

Learning Objectives:

  1. Identify barriers to implementation of multiple evidence-based practices within a community mental health agency
  2. Discuss developing an integrated training delivery system to enhance the implementation of evidence-based practices in community mental health care
  3. Identify at least two recommendations for other agencies attempting to improve or increase the implementation and adoption of evidence-based practices

Keywords: Implementation barriers, qualitative, training, evidence-based practices, community mental health

Data collection phase: Data analyzed

Project implementation phase: Completed

Presentation type: Oral presentation