Factors that Constrain Implementation

Many factors constrain implementation of evidence-based practices (Ganju, 2003, p.126), such as:

• Evidence-based practices may not be reimbursed by Medicaid or other health insurance.
• Clinicians and providers may not have been trained to deliver EBPs.
• Relative advantages of EBPs may not be clear to stakeholders.
• Innovative services may be perceived as a threat to the existing organizational structure and hierarchy.
• Regulations and policies may not support EBPs.
• Rapid turnover in staff may inhibit efforts to sustain implementation.
• New funding for training and transitioning service delivery procedures may not be available.
• Mental health systems may lack ability to provide incentives for innovative practices.