Tailored Strategies to Increase the Use of an Evidence-Based Psychotherapy for Posttraumatic Stress Disorder: A Stepped-Wedge Randomized Trial in Military Clinics

This study investigates the implementation of tailored strategies to enhance the adoption of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) within military treatment facilities. Although training is a critical element, the research highlights the necessity of additional implementation support to overcome organizational barriers and sustain EBP utilization.

• Design: Stepped-wedge randomized trial conducted across military treatment facilities.
• Participants: Clinicians from military treatment facilities.
• Intervention: Tailored implementation strategies, including external facilitation, aimed at increasing the use of EBPs for PTSD.
• Measures: Outcomes focused on EBP adoption rates and the contextual factors influencing implementation.

The study found that tailored implementation strategies were effective in improving the use of EBPs for PTSD in military settings. Key findings include:

• External facilitation enhanced the adoption of EBPs beyond the effects of training alone.
• Variability in EBP adoption across sites highlighted the influence of local organizational factors.
• Sustainable implementation may require broader systemic changes, such as improved staffing and supportive policies.

This research underscores the importance of addressing organizational barriers to sustain the use of EBPs for PTSD in military treatment facilities. While training is a foundational step, additional support, such as external facilitation and system-level changes, is crucial for long-term implementation success. Military healthcare systems should consider adopting tailored implementation strategies and addressing systemic challenges to ensure consistent and effective PTSD care.