The Association Between Clinician and Perceived Organizational Factors with Early Fidelity to Cognitive Processing Therapy for Posttraumatic Stress Disorder in a Randomized Controlled Implementation Trial

  • Iris Sijercic
  • Jeanine E. M. Lane
  • Cassidy A. Gutner
  • Candice M. Monson
  • Shannon Wiltsey StirmanEmail author
Original Article


A common metric for determining implementation success is the measurement of clinician adherence to, and competence in, delivering a psychotherapy. The present study examined clinician and organizational factors as predictors of early adherence and competence among 78 clinicians delivering cognitive processing therapy (CPT), an evidence-based psychotherapy (EBP) for posttraumatic stress disorder, in a randomized controlled implementation trial. Results indicated that clinicians’ willingness to adopt an EBP if required to do so was significantly associated with early adherence and competence in CPT delivery. Level of clinician education was significantly associated with early competence in delivering CPT. Organizational factors did not predict early adherence or competence. Implications of the findings are discussed.


Implementation outcomes Dissemination Fidelity Organizational factors Clinician factors Cognitive processing therapy 



This study was funded by the Canadian Institutes for Health Research Grant [259353].

Compliance with Ethical Standards

Conflict of interest

Dr. Monson receives book royalties from publication of the Cognitive Processing Therapy Comprehensive Manual (Resick et al. 2016). All other authors declare no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019
corrected publication 2019

Authors and Affiliations

  • Iris Sijercic
    • 1
  • Jeanine E. M. Lane
    • 1
  • Cassidy A. Gutner
    • 2
  • Candice M. Monson
    • 1
  • Shannon Wiltsey Stirman
    • 3
    Email author
  1. 1.Ryerson UniversityTorontoCanada
  2. 2.Boston University School of MedicineBostonUSA
  3. 3.National Center for PTSDVA Palo Alto Healthcare System & Stanford UniversityMenlo ParkUSA

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