Weaver Addie, LeBeau Richard, Brydon Daphne, Rubyan Marni, Santiago Josefina, Willis James, Kilbourne Amy M, Craske Michelle G, Himle Joseph A
School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI, 48109, USA.
Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
J Behav Health Serv Res. 2025 Apr;52(2):294-308. doi: 10.1007/s11414-024-09911-5. Epub 2024 Oct 30.
Growing mental health treatment access disparities elevate the urgency for identifying and implementing innovative approaches for delivering evidence-supported interventions. Work-related cognitive behavioral therapy (WCBT), a technology-assisted CBT (t-CBT) designed to address social anxiety and employment outcomes among job seekers at vocational service centers and for delivery by vocational service professionals, offers a promising way to increase access to needed mental health care. This qualitative study, guided by the Organizational Transformation Model (OTM), explored factors related to WCBT's implementation at two Jewish Vocational Services (JVS) Human Service sites in Detroit, MI and Los Angeles County, CA. Twenty-seven staff-stakeholders across the two JVS sites completed in-depth, semi-structured interviews focused on their experiences with WCBT over the four-year study period. Thematic analysis identified five core codes that most broadly captured participants' perceptions of WCBT implementation and the factors influencing implementation, including: (1) Need, (2) Buy-in and engagement, (3) Communication, (4) Sustainability concerns, and (5) Implementation facilitators. Core codes aligned with OTM factors related to impetus to transform, improvement initiatives, integration across boundaries, alignment from top to bottom, and leadership. Findings identify implementation strategies likely to optimize uptake and sustainability of WCBT within JVS sites that can be tested in a larger, multi-site implementation trial.
心理健康治疗可及性差距不断扩大，凸显了识别和实施提供循证干预措施的创新方法的紧迫性。工作相关认知行为疗法（WCBT）是一种技术辅助的认知行为疗法（t-CBT），旨在解决职业服务中心求职者的社交焦虑和就业问题，并由职业服务专业人员提供，为增加获得所需心理健康护理的机会提供了一种很有前景的方法。这项定性研究以组织转型模型（OTM）为指导，探讨了密歇根州底特律市和加利福尼亚州洛杉矶县的两个犹太职业服务（JVS）人力服务站点实施WCBT的相关因素。在为期四年的研究期间，两个JVS站点的27名员工利益相关者完成了深入的半结构化访谈，重点是他们在WCBT方面的经历。主题分析确定了五个核心编码，这些编码最广泛地反映了参与者对WCBT实施的看法以及影响实施的因素，包括：（1）需求，（2）认同与参与，（3）沟通，（4）可持续性担忧，以及（5）实施促进因素。核心编码与OTM中与转型动力、改进举措、跨边界整合、自上而下的一致性以及领导力相关的因素一致。研究结果确定了可能优化JVS站点内WCBT采用率和可持续性的实施策略，这些策略可在更大规模的多站点实施试验中进行测试。
