Implementation of evidence-based practices for children in four countries: A project of the World Psychiatric Association

Kimberly E. Hoagwood, Kelly Kelleher, Laura K. Murray, Peter S. Jensen

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objective: The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. Method: A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. Results: All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. Conclusions: The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.

Original languageEnglish (US)
Pages (from-to)59-66
Number of pages8
JournalRevista Brasileira de Psiquiatria
Issue number1
StatePublished - Mar 2006


  • Behavior
  • Child
  • Cognitive therapy
  • Evidence-based medicine
  • Feasibility studies

ASJC Scopus subject areas

  • Psychiatry and Mental health


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