Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Graduation

Spring 5-3-2013

Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Graduate Psychology


Lennis G. Echterling

Cara Meixner

Deborah Sturm


Although evidence-based practices (EBPs) have been identified in the literature, insufficient information exists about how to successfully implement them. As a result, implementation efforts have been met with failures. Little is currently known about what affects the success of implementation efforts for best practices such as Dialectical Behavior Therapy for adolescents (DBT-A) in an acute inpatient psychiatric setting (AIPS). A longitudinal multiphase mixed methods case study examined an implementation effort to provide DBT-A in an AIPS over a 24-month period. The process of implementation was investigated through in-depth interviews, a focus group, and field observations. Six categories were identified that affected the DBT-A implementation in an AIPS: appeal of DBT as a treatment modality, impact on patients, implementer characteristics, the implementation process, organizational dynamics and structure, and staff support. Implications for implementing EBPs within organizational environments are discussed. This study represents the first attempt to use qualitative and mixed methodology to examine the process of DBT implementation in an AIPS.

Included in

Psychology Commons



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