Managing In-Session "Surprises:" Provider Responses to Emergent Life Events during Evidence-Based Treatment Implementation

Adm Policy Ment Health. 2017 Mar;44(2):164-176. doi: 10.1007/s10488-015-0692-3.

Abstract

This study aimed to: (1) pilot a psychotherapy coding system for provider responses to emergent life events (ELEs; unexpected events that have a significant negative impact on the client), (2) examine the impact of ELEs on evidence-based treatment (EBT) delivery in community settings. Raters coded 30 randomly-sampled EBT session recordings with and without reported ELEs. Inter-rater reliability and validity for the system were generally high. When an ELE occurred, providers were significantly less likely to deliver the EBT, and when they did, they rarely linked the EBT to the event. Findings highlight the potential for ELEs to disrupt EBT implementation.

Keywords: Community settings; Dissemination and implementation; Emergent life events; Evidence-based treatment; Therapy providers.

MeSH terms

  • Community Health Services / organization & administration*
  • Evidence-Based Practice / methods*
  • Humans
  • Life Change Events*
  • Psychotherapy / methods*
  • Reproducibility of Results
  • Stress, Psychological / therapy*
  • United States