Initial Clinician Reports of the Bottom-Up Dissemination of an Evidence-Based Intervention for Early Childhood Trauma
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Bottom-up dissemination (BUD) of evidence based treatments (EBT), entailing the spread of an intervention through a peer network in a decentralized manner, is an under-reported phenomenon in the professional literature.
This paper presents findings from a study researching the feasibility of BUD of an evidence-based intervention for young, traumatized children and their families—Child–Parent Psychotherapy (CPP). The research objective was to obtain information regarding whether, how, and where CPP clinicians are using the intervention after training, in a BUD plan.
The research design entailed a post-training survey. Seventy-seven (90.5%) graduates from four cohorts of CPP training completed a questionnaire regarding their use of CPP. Descriptive statistics report how many CPP cases they are treating, their use of supervision, whether they are maintaining fidelity, and if or where they are disseminating CPP onward. Additional qualitative data was obtained from open-ended questions.
Clinicians reported using CPP as an entire intervention, and incorporating elements of it in general practice. They also reported spreading knowledge of the intervention, through teaching and supervising, in their workplaces and in other agencies. While clinicians reported a reasonable level of CPP fidelity, few were receiving regular supervision, and both supervisors and supervisees reported low use of fidelity measures in supervision.
BUD may produce a dual outcome, disseminating both the EBT and elements of the intervention. The training agent’s role in providing support, as well as the possible contribution of “champions”, may be particularly important when other institutional supports are lacking.
KeywordsBottom-up dissemination Child–Parent Psychotherapy (CPP) Evidence-based treatment Fidelity Supervision
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study. The first author takes responsibility for the integrity of the data and the accuracy of the data analysis.
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