Clinical Social Work Journal

, Volume 39, Issue 4, pp 369–378 | Cite as

The Implementation of Mental Health Evidence Based Practices from the Educator, Clinician and Researcher Perspective

  • Victoria Stanhope
  • Ellen Tuchman
  • William Sinclair
Original Paper


Within the different arenas of social work practice, community based mental health is among the most advanced in terms of defining a set of evidence based practices (EBPs). Social workers play a major role in the delivery of community based mental health and are at the forefront of efforts to implement these practices through state and federal initiatives. One such initiative is The New York Office of Mental Health Evidence Based Project, which is designed to increase the knowledge and skills related to evidence-based practice among New York’s mental health human services workforce. The project had a social work component, which trained students in implementing EBP’s through specially designed curricula and field placements. The students participating in the project encountered numerous challenges in the field including lack of agency “buy-in” and infrastructure support; inadequate training and resources; poor supervision; and provider resistance. From the multilevel perspectives of educator, clinician and researcher, this paper addresses these challenges and makes recommendations to facilitate the implementation of EBPs.


Evidence based practices Mental health services Severe mental illnesses Social work education 


  1. Aarons, G. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS). Mental Health Services Research, 6(2), 61–74.PubMedCrossRefGoogle Scholar
  2. Abramson, J. S., & Fortune, A. E. (1990). Improving field instruction. Journal of Social Work Education, 26(3), 273–286.Google Scholar
  3. Anthony, W. A. (2003). Letter: Process, not practice. Psychiatric Services, 54, 402.CrossRefGoogle Scholar
  4. Bellamy, J. L., Fang, L., Bledsoe, S. E., Manuel, J. I., & Mullen, E. J. (2008). Agency-university partnership for evidence-based practice in social work. Journal of Social Work Education, 44(3), 55–73.CrossRefGoogle Scholar
  5. Bhattacharyya, O., Reeves, S., & Zwarenstein, M. (2009). What is implementation research? Rationale, concepts, and practices. Research on Social Work Practice, 19(5), 491–502.CrossRefGoogle Scholar
  6. Bjorklund, R. W., Monroe-DeVita, M., Reed, D., Toulon, A., & Morse, G. (2009). State mental health policy: Washington State’s initiative to disseminate and implement high-fidelity ACT teams. Psychiatric Services, 60(1), 24–27.PubMedCrossRefGoogle Scholar
  7. Bond, G., Drake, R., Rapp, C., McHugo, G., & Xie, H. (2009). Individualization and quality improvement: Two new scales to complement measurement of program fidelity. Administration and Policy in Mental Health and Mental Health Services Research, 36(5), 349–357.PubMedCrossRefGoogle Scholar
  8. Carpinello, S. E., Rosenberg, L., Stone, J., Schwager, M., & Felton, C. J. (2002). Best practices: New York State’s campaign to implement evidence-based practices for people with serious mental disorders. Psychiatric Services, 53(2), 153–155.PubMedCrossRefGoogle Scholar
  9. Davidson, L., Drake, R., Schmutte, T., Dinzeo, T., & Andres-Hyman, R. (2009). Oil and water or oil and vinegar? Evidence-based medicine meets recovery. Community Mental Health Journal, 45(5), 323–332.PubMedCrossRefGoogle Scholar
  10. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD: Author.Google Scholar
  11. Department of Health and Human Services. (2003). New freedom commission on mental health: Achieving the promise: Transforming mental health care in America. Final report. (No. DHHS pub no SMA-03-3832). Rockville, MD: Author.Google Scholar
  12. Department of Health and Human Services. (2004). Mental health United States.Google Scholar
  13. Drake, R. E., Goldman, H. H., Leff, H. S., Lehman, A. F., Dixon, L. B., Mueser, K. T., et al. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services, 52, 179–192.PubMedCrossRefGoogle Scholar
  14. Easterly, L. (2009). An educational model for workforce development: Dissemination of evidence-based practices. Community Mental Health Journal, 45, 199–208.PubMedCrossRefGoogle Scholar
  15. Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: The National Implementation Research Network, Louis de la Parte Florida Mental Health Institute, University of South Florida.Google Scholar
  16. Fraser, M. (2003). Intervention research in social work: A basis for evidence-based practice and practice guidelines. In A. Rosen & E. K. Proctor (Eds.), Developing practice guidelines for social work intervention (pp. 17–36). New York: Columbia University Press.Google Scholar
  17. Gambrill, E. (2006). Social work practice: A critical thinker’s guide. New York: Oxford University Press.Google Scholar
  18. Gellis, Z., & Reid, W. (2004). Strengthening evidence-based practice. Brief Treatment and Crisis Intervention, 4, 155–165.CrossRefGoogle Scholar
  19. Gilgun, J. G. (2005). The four cornerstones of evidence based practice. Research on Social Work Practice, 15(1), 52–61.CrossRefGoogle Scholar
  20. Grimshaw, J. M., Shirran, L., Thomas, R., Mowatt, G., Fraser, C., Bero, L., et al. (2001). Changing provider behavior: An overview of systematic reviews of interventions. Medical Care, 39(8, Supplement 2), 11.2–11.35.Google Scholar
  21. Hoge, M., Huey, L., & O’Connell, M. (2004). Best practices in behavioral health workforce education and training. Administration and Policy in Mental Health and Mental Health Services Research, 32(2), 91–106.PubMedCrossRefGoogle Scholar
  22. Hopper, K., & Lincoln, A. (2009). Capacity building. In J. Wallcraft, B. Schranke, & M. Amering (Eds.), Handbook of service user involvement in mental health research (pp. 73–86). West Sussex, UK: Wiley.CrossRefGoogle Scholar
  23. Hubble, M., Duncan, B. L., & Miller, S. D. (1999). The heart and soul of change: What works in therapy. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  24. Institute for the Advancement of Social Work Research. (2008). Social work care coordinationbrief 2: Translating research. Washington, DC.Google Scholar
  25. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press.Google Scholar
  26. Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38, 357–361.CrossRefGoogle Scholar
  27. Lehman, A. F., Steinwachs, D. M., & Survey Co-Investigators of the PORT Project. (1998). Patterns of usual care for schizophrenia: Initial results from the Schizophrenia Patient Outcomes Research Team (PORT) client survey. Schizophrenia Bulletin, 24, 11–20.PubMedGoogle Scholar
  28. Mancini, A. D., Moser, L. L., Whitley, R., McHugo, G. J., Bond, G. R., Finnerty, M. T., et al. (2009). Assertive community treatment: Facilitators and barriers to implementation in routine mental health settings. Psychiatric Services, 60(2), 189–195.PubMedCrossRefGoogle Scholar
  29. Manuel, J. I., Mullen, E. J., Fang, Lin., Bellamy, J. L., & Bledsoe, S. E. (2009). Preparing social work practitioners to use evidence-based practice: A comparison of experiences from an implementation project. Research on Social Work Practice, 19(5), 613–627.CrossRefGoogle Scholar
  30. Marsh, P., & Fisher, M. (2008). The development of problem-solving knowledge for social care practice. British Journal of Social Work, 38(5), 971–987.CrossRefGoogle Scholar
  31. McHugo, G. J., Drake, R. E., Whitley, R., Bond, G. R., Campbell, K., Rapp, C. A., et al. (2007). Fidelity outcomes in the national implementing evidence-based practices project. Psychiatric Services, 58(10), 1279–1284.PubMedCrossRefGoogle Scholar
  32. McMillen, C. J., Lenze, S., Hawley, K., & Osborne, V. (2009). Revisiting practice-based research networks as a platform for mental health services research. Administration and Policy in Mental Health and Mental Health Services Research, 36(5), 308–321.CrossRefGoogle Scholar
  33. Miller, J., Kovacs, P. J. Wright, L., Corcoran, J., Rosenblum, A. (2005). Field education: Student and field instructor perceptions of the learning process. Journal of Social Work Education, 45(1), 131–145.CrossRefGoogle Scholar
  34. Myers, L. L., & Thyer, B. A. (1997). Should social work clients have the right to effective treatment? Social Work, 42(3), 288–298.PubMedGoogle Scholar
  35. Neugeboren, J. (2006, February 6). Meds alone couldn’t bring Robert back. Newsweek, 17.Google Scholar
  36. Proctor, E., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research, 36(1), 24–34.PubMedCrossRefGoogle Scholar
  37. Ragins, M. (2005). Should the CATIE study be a wake-up call? Psychiatric Services, 56, 1489.PubMedCrossRefGoogle Scholar
  38. Rapp, C. A., Bond, G. R., Becker, D. R., Carpinello, S. E., Nikkel, R. E., & Gintoli, G. (2005). The role of state mental health authorities in promoting improved client outcomes through evidence-based practice. Community Mental Health Journal, 41(3), 347–363.PubMedCrossRefGoogle Scholar
  39. Rapp, C., Etzel-Wise, D., Marty, D., Coffman, M., Carlson, L., Asher, D., et al. (2008). Evidence-based practice implementation strategies: Results of a qualitative study. Community Mental Health Journal, 44(3), 213–224.PubMedCrossRefGoogle Scholar
  40. Resnick, S. G., & Rosenheck, R. A. (2009). Scaling up the dissemination of evidence-based mental health practice to large systems and long-term time frames. Psychiatric Services, 60(5), 682–685.PubMedCrossRefGoogle Scholar
  41. Rosenheck, R. A. (2001). Organizational process: A missing link between research and practice. Psychiatric Services, 52(12), 1607–1612.PubMedCrossRefGoogle Scholar
  42. Rubin, A., & Parrish, D. (2007). Views of evidence-based practice among faculty in master of social work programs: A national survey. Research on Social Work Practice, 17(1), 110–122.CrossRefGoogle Scholar
  43. Shaw, I. (2003). Qualitative research and outcomes in health, social work and education. Qualitative Research, 3, 57–77.Google Scholar
  44. Shlonsky, A., & Stern, S. B. (2007). Reflections on the teaching of evidence-based practice. Research on Social Work Practice, 17(5), 603–611.CrossRefGoogle Scholar
  45. Substance Abuse and Mental Health Service Administration. (2007). About evidence-based practices: Shaping mental health services toward recovery. Retrieved October 14, 2009, from
  46. Teague, G. B., Bond, G. R., & Drake, R. E. (1998). Program fidelity in assertive community treatment: Development and use of a measure. American Journal of Orthopsychiatry, 68, 216–232.PubMedCrossRefGoogle Scholar
  47. Tuchman, E., & LaLane, M. (in press). Evidence based practice: Integrating classroom curriculum and field education. Journal of Teaching in Social Work.Google Scholar
  48. Upshur, R. E. G., VanDenKerhof, E. G., & Goel, V. (2001). Meaning and measurement: an inclusive model of evidence in health care. Journal of Evaluation in Clinical Practice, 7, 91–96.PubMedCrossRefGoogle Scholar
  49. Wampold, B. E., & Brown, G. S. (2005). Estimating variability in outcomes attributable to therapists: A naturalistic study of outcomes in managed care. Journal of Consulting and Clinical Psychology, 73, 914–923.PubMedCrossRefGoogle Scholar
  50. Webb, S. A. (2001). Some considerations of the validity of evidence-based practice in social work. British Journal of Social Work, 31, 57–79.CrossRefGoogle Scholar
  51. Weissman, M. M., Verdeli, H., Gameroff, M. J., Bledsoe, S. E., Betts, K., Mufson, L., et al. (2006). National survey of psychotherapy training in psychiatry, psychology, and social work. Archives of General Psychiatry, 63(8), 925–934.PubMedCrossRefGoogle Scholar
  52. Woltmann, E. M., Whitley, R., McHugo, G. J., Brunette, M., Torrey, W. C., Coots, L., et al. (2008). The role of staff turnover in the implementation of evidence-based practices in mental health care. Psychiatric Services, 59(7), 732–737.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Victoria Stanhope
    • 1
  • Ellen Tuchman
    • 1
  • William Sinclair
    • 2
  1. 1.School of Social WorkNew York UniversityNew YorkUSA
  2. 2.St. Luke’s-Roosevelt HospitalNew YorkUSA

Personalised recommendations