Understanding therapists’ perceived determinants of trauma narrative use
Abstract Background Trauma narratives are a critical, exposure-based component of trauma-focused cognitive-behavioral therapy, yet community therapists rarely use them. Given evidence that intentions to deliver elements of cognitive behavioral therapy vary by component, and that intentions to delive...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-021-00231-9 |
| _version_ | 1818573041098031104 |
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| author | Hannah E. Frank Briana S. Last Reem AlRabiah Jessica Fishman Brittany N. Rudd Hilary E. Kratz Colleen Harker Sara Fernandez-Marcote Kamilah Jackson Carrie Comeau Sosunmolu Shoyinka Rinad S. Beidas |
| author_facet | Hannah E. Frank Briana S. Last Reem AlRabiah Jessica Fishman Brittany N. Rudd Hilary E. Kratz Colleen Harker Sara Fernandez-Marcote Kamilah Jackson Carrie Comeau Sosunmolu Shoyinka Rinad S. Beidas |
| author_sort | Hannah E. Frank |
| collection | DOAJ |
| description | Abstract Background Trauma narratives are a critical, exposure-based component of trauma-focused cognitive-behavioral therapy, yet community therapists rarely use them. Given evidence that intentions to deliver elements of cognitive behavioral therapy vary by component, and that intentions to deliver exposure are the weakest, this study focused specifically on trauma narratives. We drew on a social psychology causal theory (Theory of Planned Behavior (TPB)) and an implementation science framework (the Consolidated Framework for Implementation Research (CFIR)) to glean insight into multilevel influences on trauma narrative use. While the CFIR offers a broad list of factors potentially affecting implementation, the TPB offers causal pathways between individual-level constructs that predict behavior, including the uptake of an evidence-based intervention. The integration of these approaches may provide a more complete understanding of factors affecting therapists’ use of TNs. Methods Therapists (n=65) trained in trauma-focused cognitive behavioral therapy completed a survey about their use of and beliefs about trauma narratives. Content analysis was used to identify common beliefs about trauma narratives. A subset of participants (n=17) completed follow-up qualitative interviews, which were analyzed using an integrated approach informed by the CFIR. Results While most participants reported high intentions to use TNs, nearly half reported that they did not use TNs in the last 6 months. Survey data indicate a number of TPB-related determinants related to using trauma narratives. Qualitative interviews identified CFIR-relevant contextual factors that may influence constructs central to TPB. Conclusions These results highlight the importance of integrating approaches that address multiple theoretical determinants of therapist behavior, including therapist, organizational, and client factors with causal explanations to explain implementation behavior. |
| first_indexed | 2024-12-15T00:05:48Z |
| format | Article |
| id | doaj.art-fca9a6faec3045e7a3a659cecf3e2536 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-12-15T00:05:48Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-fca9a6faec3045e7a3a659cecf3e25362022-12-21T22:42:44ZengBMCImplementation Science Communications2662-22112021-12-012111410.1186/s43058-021-00231-9Understanding therapists’ perceived determinants of trauma narrative useHannah E. Frank0Briana S. Last1Reem AlRabiah2Jessica Fishman3Brittany N. Rudd4Hilary E. Kratz5Colleen Harker6Sara Fernandez-Marcote7Kamilah Jackson8Carrie Comeau9Sosunmolu Shoyinka10Rinad S. Beidas11Department of Psychology, Temple UniversityDepartment of Psychology, University of PennsylvaniaDepartment of Psychiatry, University of Pennsylvania Perelman School of MedicineDepartment of Psychiatry, University of Pennsylvania Perelman School of MedicineDepartment of Psychiatry, University of Pennsylvania Perelman School of MedicineDepartment of Psychology, La Salle UniversityDepartment of Psychiatry, University of Pennsylvania Perelman School of MedicineCommunity Behavioral HealthDepartment of Behavioral Health and Intellectual Disability ServicesCommunity Behavioral HealthDepartment of Behavioral Health and Intellectual Disability ServicesDepartment of Psychiatry, University of Pennsylvania Perelman School of MedicineAbstract Background Trauma narratives are a critical, exposure-based component of trauma-focused cognitive-behavioral therapy, yet community therapists rarely use them. Given evidence that intentions to deliver elements of cognitive behavioral therapy vary by component, and that intentions to deliver exposure are the weakest, this study focused specifically on trauma narratives. We drew on a social psychology causal theory (Theory of Planned Behavior (TPB)) and an implementation science framework (the Consolidated Framework for Implementation Research (CFIR)) to glean insight into multilevel influences on trauma narrative use. While the CFIR offers a broad list of factors potentially affecting implementation, the TPB offers causal pathways between individual-level constructs that predict behavior, including the uptake of an evidence-based intervention. The integration of these approaches may provide a more complete understanding of factors affecting therapists’ use of TNs. Methods Therapists (n=65) trained in trauma-focused cognitive behavioral therapy completed a survey about their use of and beliefs about trauma narratives. Content analysis was used to identify common beliefs about trauma narratives. A subset of participants (n=17) completed follow-up qualitative interviews, which were analyzed using an integrated approach informed by the CFIR. Results While most participants reported high intentions to use TNs, nearly half reported that they did not use TNs in the last 6 months. Survey data indicate a number of TPB-related determinants related to using trauma narratives. Qualitative interviews identified CFIR-relevant contextual factors that may influence constructs central to TPB. Conclusions These results highlight the importance of integrating approaches that address multiple theoretical determinants of therapist behavior, including therapist, organizational, and client factors with causal explanations to explain implementation behavior.https://doi.org/10.1186/s43058-021-00231-9Implementation scienceDeterminantsTrauma-focused cognitive behavioral therapyTheory of Planned BehaviorConsolidated Framework for Implementation Research |
| spellingShingle | Hannah E. Frank Briana S. Last Reem AlRabiah Jessica Fishman Brittany N. Rudd Hilary E. Kratz Colleen Harker Sara Fernandez-Marcote Kamilah Jackson Carrie Comeau Sosunmolu Shoyinka Rinad S. Beidas Understanding therapists’ perceived determinants of trauma narrative use Implementation Science Communications Implementation science Determinants Trauma-focused cognitive behavioral therapy Theory of Planned Behavior Consolidated Framework for Implementation Research |
| title | Understanding therapists’ perceived determinants of trauma narrative use |
| title_full | Understanding therapists’ perceived determinants of trauma narrative use |
| title_fullStr | Understanding therapists’ perceived determinants of trauma narrative use |
| title_full_unstemmed | Understanding therapists’ perceived determinants of trauma narrative use |
| title_short | Understanding therapists’ perceived determinants of trauma narrative use |
| title_sort | understanding therapists perceived determinants of trauma narrative use |
| topic | Implementation science Determinants Trauma-focused cognitive behavioral therapy Theory of Planned Behavior Consolidated Framework for Implementation Research |
| url | https://doi.org/10.1186/s43058-021-00231-9 |
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