Lessons Learned from Implementing the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) in Community Mental Health Centers

This article addresses the facilitators and barriers encountered during the implementation of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) across community mental health centers (CMHCs) in 10 counties in California. Counties were randomized to implement Standard TSC or an adapted version of TSC intended to improve the “fit” of TSC to the CMHC context. Grounded in the i-PARIHS framework, external facilitation was employed to implement TSC and subsequently to implement a Train the Trainer (TTT) program with the goal of training locally embedded providers to train their colleagues in TSC. While each site experienced unique facilitators and barriers, multiple common themes emerged that may help guide future efforts to implement evidence-based psychological treatments and TTT. These themes include features of the facilitation team, the study design and TSC, attitudes towards research studies and sleep, resource availability, leadership and champion support, and cross-site collaboration. Solutions to address barriers, case examples, and recommendations for future implementation efforts are shared. Trial registration: Clinicaltrials.gov identifiers: [Details omitted for double-anonymized reviewing]