Barriers to implementation of evidence-based addiction treatment: a national study

Abstract

Prior studies have identified that working in an addiction treatment unit with higher levels of organizational capacity is a factor associated with positive staff attitudes about evidence-based addiction treatment practices (EBPs). The study presented here explored whether staff perceptions about the organizational capacity of their treatment unit are also associated with staff experience of barriers to implementing EBPs. Multivariate regression methods examined the relationship between the clinical staff (n = 510) and director (n = 296) perceptions of organizational capacity (Texas Christian University Organizational Readiness for Change [TCU ORC]-staff and TCU ORC-director) and level of barriers experienced when implementing a new EBP controlling for a range of treatment unit characteristics, staff characteristics, and type of EBP implemented. For both samples, reporting higher levels of stress in their organizations was significantly associated with reporting higher levels of barriers when implementing a new EBP. For clinical staff only, experiencing lower levels of program needs in their organization, working in a program that had been in existence for a shorter period, and implementing motivational interviewing techniques compared with other EBPs were all factors significantly associated with experiencing lower levels of barriers with EBP implementation.