Dissemination in psychotherapy: The case of progress monitoring measures.

The practice-research gap in psychotherapy limits the efficacy of practice and utility of research. The poor uptake of Progress Monitoring (PM) measures exemplifies this gap: despite PM’s strong evidence base, most psychologists do not use the measures. In this thesis, the Knowledge-to-Action model was used to determine the next steps in bridging this gap. In doing so, a need for improved PM dissemination was identified. Three questions were posed to improve PM dissemination: (1) what are the means by which innovations are disseminated in psychotherapy? (2) how can we measure the impact of a dissemination intervention? And (3) what makes a dissemination intervention effective? The answers to these questions were pursued through three manuscripts.In Manuscript 1, the psychotherapy literature was reviewed and the strategies, facilitators and processes that may assist in the dissemination of an innovation were identified. In Manuscript 2, an instrument to assess dissemination interventions was developed and validated. In Manuscript 3, an intervention employing multiple dissemination strategies was evaluated and effective strategies were identified. Overall, this thesis drew several conclusions regarding the process of dissemination. Firstly, low clinician engagement is as an important barrier to dissemination in psychotherapy and time effective interventions are proposed as a possible means of overcoming this barrier. Once clinicians are engaged, research that is succinct and digestible helps them to learn about PM. Certain forms of practical information are also useful; however, these resources may prove more effective when paired with experience. When it comes to improving attitudes and an intent to use PM, anecdotal information appears to be more useful. Implications of these results for the dissemination of PM and other psychotherapy innovations are discussed