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Apples Don't Fall Far From the Tree: Influences on Psychotherapists' Adoption and Sustained Use of New Therapies

Dr. Cook and Dr. Biyanova are affiliated with the Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut. Dr. Cook is also with the Northeast Program Evaluation Center, Department of Veterans Affairs (VA) Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516 (e-mail: joan.cook{at}yale.edu). Dr. Schnurr is with the VA National Center for PTSD, White River Junction, Vermont. Dr. Coyne is with the Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia.

OBJECTIVE: The purpose of this investigation was to identify influences on the current clinical practices of a broad range of mental health providers as well as influences on their adoption and sustained use of new practices. METHODS: U.S. and Canadian psychotherapists (N=2,607) completed a Web-based survey in which they rated factors that influence their clinical practice, including their adoption and sustained use of new treatments. RESULTS: Empirical evidence had little influence on the practice of mental health providers. Significant mentors, books, training in graduate school, and informal discussions with colleagues were the most highly endorsed influences on current practice. The greatest influences on psychotherapists' willingness to learn a new treatment were its potential for integration with the therapy they were already providing and its endorsement by therapists they respected. Clinicians were more often willing to continue to use a new treatment when they were able to effectively and enjoyably conduct the therapy and when their clients liked the therapy and reported improvement. CONCLUSIONS: Implications for dissemination and sustained use of new psychotherapies by community psychotherapists are discussed. For example, evidence-based treatments may best be promoted through therapy courses and workshops, beginning with graduate studies; to ensure future use of new therapies, developers of training workshops should emphasize ways to integrate their approaches into clinicians' existing practices.

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