Implementation of an Evidence-Based Safety Aid Reduction Group Psychotherapy Treatment in Military Health System Mental Health Clinics.

INTRODUCTION: Safety Aid Reduction Treatment for Anxiety and Related Disorders (START) is a transdiagnostic group therapy found to reduce self-reported anxiety symptoms among veterans. The Practice Based Implementation (PBI) Network, a program designed to assess small-scale implementation pilots of mental health therapies and trainings, partnered with START experts and military mental health (MH) clinics to implement START. Evaluation of perceptions of facilitators and barriers in these trials is important before considering wider Military Health System (MHS) adoption. MATERIALS AND METHODS: Following training, providers used the START protocol to facilitate in-person START group sessions. Pilot champions provided qualitative data on implementation in the form of verbal feedback to semi-structured questions during facilitation calls held throughout the study. Providers shared qualitative data at the end of the study in the form of verbal feedback during semi-structured interviews. Providers and champions also responded to surveys developed for this study assessing their perceptions of barriers to and facilitators of START delivery. RESULTS: Overall, the manualized protocol and therapeutic techniques used in START helped providers engage patients. Although providers and champions acknowledged barriers, all were modifiable and most barriers were described as having minimal impact. The 10-session length was cited as impractical given station changes and work schedules. CONCLUSIONS: The study was successful in identifying facilitators and barriers common across sites. Results reinforce the value of identifying provider, clinic, and organizational obstacles and supports to intervention implementation in MHS BH clinics. Findings may have applicability to future efforts to introduce START and similar treatments in military BH clinics.