Regular article Barriers to implementation of evidence-based addiction treatment: A national study Lena Lundgren, (Ph.D.) a , Deborah Chassler, (M.S.W.) a, ⁎ , Maryann Amodeo, (Ph.D., M.S.W.) a , Melinda D'Ippolito, (M.S.W.) a , Lisa Sullivan, (Ph.D.) b a Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA 02215, USA b Boston University School of Public Health, Boston, MA 02118, USA Received 11 February 2011; received in revised form 12 August 2011; accepted 15 August 2011 Abstract Prior studies have identified that working in an addiction treatment unit with higher levels of organizational capacity is a factor associated with positive staff attitudes about evidence-based addiction treatment practices (EBPs). The study presented here explored whether staff perceptions about the organizational capacity of their treatment unit are also associated with staff experience of barriers to implementing EBPs. Multivariate regression methods examined the relationship between the clinical staff (n = 510) and director (n = 296) perceptions of organizational capacity (Texas Christian University Organizational Readiness for Change [TCU ORC]-staff and TCU ORC-director) and level of barriers experienced when implementing a new EBP controlling for a range of treatment unit characteristics, staff characteristics, and type of EBP implemented. For both samples, reporting higher levels of stress in their organizations was significantly associated with reporting higher levels of barriers when implementing a new EBP. For clinical staff only, experiencing lower levels of program needs in their organization, working in a program that had been in existence for a shorter period, and implementing motivational interviewing techniques compared with other EBPs were all factors significantly associated with experiencing lower levels of barriers with EBP implementation. © 2012 Elsevier Inc. All rights reserved. Keywords: Implementation of evidence-based addiction treatment practices; Barriers to implementation of evidence-based addiction treatment; Organizational capacity of addiction treatment organizations; Community-based addiction treatment organizations 1. Introduction An increasing number of empirically valid, efficacious behavioral and pharmacological therapies are available for the treatment of alcohol and drug use disorders (McCarty, McConnell, & Schmidt, 2010). Clinical trials of addiction treatment therapies conducted within the National Drug Abuse Treatment Clinical Trials Network suggest that evidence-based treatments can be effective in real-world clinical environments and with heterogeneous clinical populations (Amass et al., 2004; Carroll et al., 2006; Ling et al., 2005; Peirce et al., 2006; Petry et al., 2005), and in the past decade, the federal government, through its various institutions including the Substance Abuse and Mental Health Services Administration (SAMHSA) and Centers for Disease Control, has actively encouraged community- based addiction treatment organizations to implement evidence-based practices (EBPs). The study presented here adds to the body of literature on EBP implementation in community-based addiction treat- ment organizations; it examined the association between clinical staff and program director ratings of the organiza- tional capacity of their treatment unit and the level of barriers experienced when implementing a new EBP. 1.1. Organizational capacity and implementation of evidence-based addiction treatment The Simpson and Flynn (2007) Organizational Readiness for Change model, further refined in the Lehman, Simpson, Journal of Substance Abuse Treatment 42 (2012) 231 – 238 ⁎ Corresponding author. Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA. Tel.: +1 617 353 1748; fax: +1 617 353 5612. E-mail address: chassler@bu.edu (D. Chassler). 0740-5472/11/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.jsat.2011.08.003