EMPIRICAL ARTICLES
Closing the Research–Practice Gap: Factors Affecting Adoption
and Implementation of a Children’s Mental Health Program
Joanna L. Henderson and Sherri MacKay
Centre for Addiction and Mental Health, University of Toronto
Michele Peterson-Badali
Ontario Institute for Studies in Education, University of Toronto
Despite the availability of effective interventions, they are not widely used in commu-
nity mental health centers. This study examined the adoption and implementation of
The Arson Prevention Program for Children (TAPP–C), a program for juvenile
firesetters developed at a teaching hospital and disseminated to community settings.
Questionnaire data from mental health professionals were used to evaluate the roles
of adopter, innovation, and dissemination characteristics in TAPP–C adoption and
implementation. Results indicate that different factors are important at different diffu-
sion stages. Moreover, they suggest that innovation characteristics may be particu-
larly important to adoption, whereas adopter and dissemination characteristics may
be more influential in implementation.
Although the efficacy of several psychological in-
terventions for various children’s mental health prob-
lems has been established in academic and research
laboratories (Kazdin & Weisz, 1998), they are not
widely used in community children’s mental health
centers. Indeed, this “research–practice gap” in chil-
dren’s mental health service has been identified as one
of the most pressing issues facing children’s mental
health (Kazdin & Kendall, 1998; Webster-Stratton
& Taylor, 1998). Clearly, effective, empirically based
treatments are limited in value if they are not used by
the children’s mental health community at large.
Many explanations have been suggested to account
for the discrepancy between what is known in the clini-
cal research arena and what is used in the practice
arena. Current explanations can be grouped into three
broad categories: reasons related to the original re-
search or innovation itself, explanations related to dis-
semination of the innovation, and reasons related to
implementation of the innovation in the practice set-
ting. Community clinicians perceive clinical research
as not relevant to clinical practice (Cicchetti & Toth,
1998), reportedly because of its emphasis on tradi-
tional experimental methodology, its highly specified
samples (Borkovec & Castonguay, 1998; Garfield,
1996; Goldfried & Wolfe, 1996; Weisz, Donenberg,
Han, & Weiss, 1995), and its focus on statistically sig-
nificant group differences instead of clinically signifi-
cant changes (Borkovec & Castonguay, 1998; Gold-
fried & Wolfe, 1998; Jacobson, Follette, & Revenstorf,
1984; Jacobson & Truax, 1991). In addition, research-
based interventions may not be perceived as compati-
ble with existing clinical practice as they often include
aspects of practice that are not perceived to reflect the
reality of resource-strapped, individualized, multidis-
ciplinary community services (Barlow, Levitt, & Buf-
ka, 1999; Borkovec & Castonguay, 1998; Weisz et al.,
1995). For example, to replicate previous efficacy find-
ings, research-based interventions may require com-
prehensive standardized assessments (Sobell, 1996),
strict treatment adherence with a fixed number of ses-
sions (Goldfried & Wolfe, 1998), or implementation
by highly trained psychology staff with research back-
grounds (Henggeler, Schoenwald, Liao, Letourneau, &
Edwards, 2002).
Other explanations for the research–practice gap
have focused on the efforts that have been made to dis-
Journal of Clinical Child and Adolescent Psychology
2006, Vol. 35, No. 1, 2–12
Copyright © 2006 by
Lawrence Erlbaum Associates, Inc.
2
This study was supported in part by a fellowship awarded to
Joanna L. Henderson by the Social Sciences and Humanities Research
Council of Canada (Grant 752-97-0279) and by a grant awarded to
Joanna L. Henderson and Sherri MacKay by the Development and
Dissemination Fund of the Centre for Addiction and Mental Health.
We thank C. Root, T. Skilling, and K. Zucker for their helpful
comments on an earlier version of this article.
Correspondence should be addressed to Joanna L. Henderson,
Child, Youth, and Family Program, Centre for Addiction and Mental
Health, 250 College Street, Toronto, Ontario, Canada, M5T 1R8.
E-mail: joanna_henderson@camh.net