Making implementation programmes better. Mixed methods case study of an implementation process for two evidence-based brief psychotherapies

The Ostrobothnia Depression Programme (ODP) was launched to implement two evidence-based treatments (EBTs), behavioural activation and motivational interviewing, and to study their effectiveness. We performed a mixed methods evaluation to extract organization- and programme-related knowledge crucial in sustaining and scaling up the desired programme outcomes. A cross-sectional mixed methods survey was conducted with the programme addressees 4-5 months after the end of the ODP. The realization of case consultation groups was analysed further by interviewing those responsible for them and referring to attendance lists. The results showed that the ODP succeeded in initiating the desired change in clinical practice. Case consultations and training videos intended as reinforcers were underutilized. Weaknesses in the implementation plan and conducting the implementation programme and effectiveness study simultaneously hampered achieving progress and jeopardized the maintenance of the implementation outcomes in the long term. The complete training intervention in the intended EBTs should comprise both workshops and non-optional case consultations. Means to decentralize the clinical support in everyday work should be elaborated in collaboration with the participating teams. It is recommended coaching team leaders to deploy evidence-based managerial practices for facilitation.