ArticleFrontiers in health services2022
Clinician Maladaptive Anxious Avoidance in the Context of Implementation of Evidence-Based Interventions: A Commentary.
Article in Frontiers in health services, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
- Experiences of Peer Mentoring Sexual and Gender Minority Emerging Adults Who Are at Risk for Suicide: Mixed Methods Study.JMIR formative research · 2025Trial
- Supervisory Alliance as a Moderator of the Effects of Behavioral Rehearsal on TF-CBT Fidelity: Results from a Randomized Trial of Supervision Strategies.Administration and policy in mental health · 2024Trial
- Practitioners' Use and Acceptability of Time-Out.Child psychiatry and human development · 2026Article
- Fear of Fear: Challenges and Negative Beliefs About Gradual Exposure Use in TF-CBT.Evidence-based practice in child and adolescent mental health · 2026Article
- Therapist Anxious Distress and Avoidance of Implementing Time-Out.Child psychiatry and human development · 2026Article
- Clinical symptoms and risk factors in people with mental disorders: findings from the interRAI emergency screener for psychiatry in Brazil.Frontiers in psychiatry · 2026Article
- Psychologists' Perspectives on Behavioral Versus Attachment- and Emotion-Focused Parenting Interventions.Child psychiatry and human development · 2025Article
- A Qualitative Examination of Clinician Anxiety about Suicide Prevention and Its Impact on Clinical Practice.Community mental health journal · 2025Article
- Integrating insights from implementation science and behavioral economics to strengthen suicide screening strategies for pediatric populations.Current opinion in psychology · 2024Review
- Helping Practitioners Stop, Drop, and Roll: Suggestions to Help Improve Responses to Intense Clinical Events.Psychiatric services (Washington, D.C.) · 2024Article
- An exposure-based implementation strategy to decrease clinician anxiety about implementing suicide prevention evidence-based practices: protocol for development and pilot testing (Project CALMER).Implementation science communications · 2023Article
- Applying the Theoretical Domains Framework to Develop an Intervention to 'Re-implement' Parent-Child Interaction Therapy (PCIT).Administration and policy in mental health · 2023Article
- Therapist perceptions of experiential training for exposure therapy.Behavioural and cognitive psychotherapy · 2023Article
- Editorial: Implementation of evidence-based treatments for child anxiety and related disorders across diverse contexts.Frontiers in psychiatry · 2023Article
- Exposure to exposure: A protocol for leveraging exposure principles during training to address therapist-level barriers to exposure implementation.Frontiers in psychiatry · 2023Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
This paper posits that a clinician's own anxious reaction to delivering specific evidence-based interventions (EBIs) should be better accounted for within implementation science frameworks. A key next step for implementation science is to delineate the causal processes most likely to influence successful implementation of evidence-based interventions (EBIs). This is critical for being able to develop tailored implementation strategies that specifically target mechanisms by which implementation succeeds or fails. First, we review the literature on specific EBIs that may act as negatively valenced stimuli for clinicians, leading to a process of clinician maladaptive anxious avoidance that can negatively impact EBI delivery. In the following sections, we argue that there are certain EBIs that can cause emotional distress or discomfort in a clinician, related to either: (1) a clinicians' fear of the real or predicted short-term distress the EBI can cause patients, or (2) fears that the clinician will inadvertently cause the patient harm and/or face liability. This distress experienced by the clinician can perpetuate a cycle of maladaptive anxious avoidance by the clinician, contributing to lack of or suboptimal EBI implementation. We illustrate how this cycle of maladaptive anxious avoidance can influence implementation by providing several examples from leading EBIs in the psychosocial literature. To conclude, we discuss how leveraging decades of treatment literature aimed at mitigating maladaptive anxious avoidance can inform the design of more tailored and effective implementation strategies for EBIs that are negatively valenced.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.