Facilitators and Barriers of Implementing an Evidence-Based Practice in a Rural Community Setting: A Qualitative Case Study

In the past two decades, multiple federal and state funding initiatives in the United States have been established for empirically supported treatments addressing individuals receiving services in the public behavioral health system. However, many organizations struggle to implement evidence-based practices in community settings. The present study aimed to extend our understanding of implementation facilitators and barriers for an evidence-based practice in a community behavioral health agency. This qualitative case study examined the implementation of an evidence-based treatment, Illness Management Recovery (IMR), in a rural community setting from the perspective of the clinical supervisors, project managers, and clinicians. Eight semi-structured interviews were conducted with individuals involved in implementing IMR to explore their understanding of project implementation facilitators and barriers. Thematic analyses revealed three themes describing facilitators and barriers, including matching personal values and job opportunities, the impact of multiple roles, and the challenges of gaining and maintaining buy-in. These findings inform agency administrators, funders, and project directors in project staff recruitment and retention, carefully considering multiple role synergies and challenges, and developing and maintaining organization champions and advocates when implementing IMR in community settings. Implications for practice include staff recruitment methods that identify values and job opportunity match, purposeful resource allocation, and employee motivational strategies.