Hostname: page-component-5c6d5d7d68-tdptf Total loading time: 0 Render date: 2024-08-20T09:45:49.093Z Has data issue: false hasContentIssue false
  • English
  • Français

Barriers to Psychologists’ Adherence to Evidence-Based Practice Guidelines for Treating Musculoskeletal Injuries Within the State Insurance Regulatory Authority Compensation Schemes

Published online by Cambridge University Press:  05 August 2019

Tahira Haider Open the ORCID record for Tahira Haider [Opens in a new window]  and
Debra A. Dunstan
Tahira Haider*
Affiliation:
University of New England, Australia
Debra A. Dunstan
Affiliation:
University of New England, Australia
*
Address for correspondence: Tahira Haider, PhD, Clinical Psychologist, School of Psychology & Social Science, University of New England, Armidale NSW 2351 Australia. Email: thaider@myune.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The use of evidence-based practice (EBP) guidelines by psychologists working within the State Insurance Regulatory Authority (SIRA) compensation schemes for treating musculoskeletal injuries has been found to vary. The aim of this study was to qualitatively explore psychologists’ perceived barriers to adhering with EBP guidelines implemented by the New South Wales (NSW) SIRA.

Methods:

Registered psychologists (n = 20) working within the NSW SIRA compensation schemes participated in four focus groups conducted face-to-face (F2F) and online. Participants’ responses were audiotaped, transcribed verbatim and entered into NVivo 11 software. Text data were analysed to identify recurrent themes within and across groups (metropolitan, regional and rural).

Results:

Thematic analysis revealed three key issues: (a) a lack of trust in the validity of the recommended EBP guidelines; (b) lack of knowledge of the psychologist’s role in this context and insufficient skills to fully apply the guidelines, protocols and procedures; and (c) a poor fit between EBP guidelines, client presentations and circumstances, and the SIRA compensation schemes.

Conclusion

The findings showed that both individual practitioner variables and contextual barriers influenced adherence to EBP. Practical implications for future research include generating recommendations to overcome the identified barriers using a collaborative approach between policymakers, researchers and practitioners.

Keywords

disability management interventionmusculoskeletal injuriesevidence based practice guidelines
Type
Article
Information
International Journal of Disability Management , Volume 14 , 2019 , e2
Copyright
© The Author(s) 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addis, M.E. (2002). Methods for disseminating research products and increasing evidence-based practice: Promises, obstacles, and future directions. Clinical Psychology: Science and Practice, 9(4), 367–378.Google Scholar
Ahn, H.-N., & Wampold, B.E. (2001). Where oh where are the specific ingredients? A meta-analysis of component studies in counseling and psychotherapy. Journal of Counseling Psychology, 48(3), 251–257.CrossRefGoogle Scholar
Barkham, M., Margison, F., Leach, C., Lucock, M., Mellor-Clark, J., Evans, C., … McGrath, G. (2001). Service profiling and outcomes benchmarking using the CORE-OM: Toward practice-based evidence in the psychological therapies. Journal of Consulting and Clinical Psychology, 69(2), 184.CrossRefGoogle ScholarPubMed
Bauer, M.S. (2002). A review of quantitative studies of adherence to mental health clinical practice guidelines. Harvard Review of Psychiatry, 10(3), 138–153.CrossRefGoogle ScholarPubMed
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi: 10.1191/1478088706qp063oa CrossRefGoogle Scholar
Byham-Gray, L.D., Gilbride, J.A., Dixon, L.B., & Stage, F.K. (2005). Evidence-based practice: What are dietitians’ perceptions, attitudes, and knowledge? Journal of the American Dietetic Association, 105(10), 1574–1581.CrossRefGoogle ScholarPubMed
Cabana, M.D., Rand, C.S., Powe, N.R., Wu, A.W., Wilson, M.H., Abboud, P.-A. C., & Rubin, H.R. (1999). Why don’t physicians follow clinical practice guidelines?: A framework for improvement. Jama, 282(15), 1458–1465.CrossRefGoogle Scholar
Corrigan, P., McCracken, S., & Blaser, B. (2003). Disseminating evidence-based mental health practices. Evidence-Based Mental Health, 6(1), 4–5.CrossRefGoogle ScholarPubMed
Damush, T., Kroenke, K., Bair, M., Wu, J., Tu, W., Krebs, E., & Poleshuck, E. (2016). Pain self-management training increases self-efficacy, self-management behaviours and pain and depression outcomes. European Journal of Pain, 20(7), 1070–1078.CrossRefGoogle ScholarPubMed
Davidson, K.W., & Spring, B. (2006). Developing an evidence base in clinical psychology. Journal of clinical psychology, 62(3), 259–271.CrossRefGoogle ScholarPubMed
Dysart, A.M., & Tomlin, G.S. (2002). Factors related to evidence-based practice among US occupational therapy clinicians. American Journal of Occupational Therapy, 56(3), 275–284.CrossRefGoogle Scholar
Efstathiou, G., Papastavrou, E., Raftopoulos, V., & Merkouris, A. (2011). Factors influencing nurses’ compliance with Standard Precautions in order to avoid occupational exposure to microorganisms: A focus group study. BMC Nursing, 10(1), 1.CrossRefGoogle ScholarPubMed
Fabrissin, J., Garay, C.J., Keegan, E., Sarudiansky, M., & Korman, G.P. (2014). The gap in knowledge of clinical practice guidelines by mental health residents in Buenos Aires (Argentina). SAGE Open, 4(2), 2158244014535412.CrossRefGoogle Scholar
Fereday, J., & Muir-Cochrane, E. (2006). The role of performance feedback in the self-assessment of competence: a research study with nursing clinicians. Collegian, 13(1), 10–15.CrossRefGoogle ScholarPubMed
Feuerstein, M., Hartzell, M., Rogers, H.L., & Marcus, S.C. (2006). Evidence-based practice for acute low back pain in primary care: patient outcomes and cost of care. Pain, 124(1), 140–149.CrossRefGoogle ScholarPubMed
Flor, H., Fydrich, T., & Turk, D.C. (1992). Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain, 49(2), 221–230.CrossRefGoogle ScholarPubMed
Force, A.T. (2006). APA presidential task force on evidence based practice. American Psychologist, 61, 271–285.Google Scholar
Forsner, T., Hansson, J., Brommels, M., Wistedt, A.Å., & Forsell, Y. (2010). Implementing clinical guidelines in psychiatry: a qualitative study of perceived facilitators and barriers. BMC Psychiatry, 10(1), 8.Google ScholarPubMed
Forsner, T., Wistedt, A. Å., Brommels, M., & Forsell, Y. (2008). An approach to measure compliance to clinical guidelines in psychiatric care. BMC Psychiatry, 8(1), 64.CrossRefGoogle ScholarPubMed
Fortney, J., Rost, K., Zhang, M., & Pyne, J. (2001). The relationship between quality and outcomes in routine depression care. Psychiatric Services, 52(1), 56–62.CrossRefGoogle ScholarPubMed
Fritz, J.M., Cleland, J. A., & Brennan, G.P. (2007). Does adherence to the guideline recommendation for active treatments improve the quality of care for patients with acute low back pain delivered by physical therapists? Medical Care, 45(10), 973–980.CrossRefGoogle ScholarPubMed
Frueh, B.C., Cusack, K.J., Grubaugh, A.L., Sauvageot, J.A., & Wells, C. (2006). Clinicians’ perspectives on cognitive-behavioral treatment for PTSD among persons with severe mental illness. Psychiatric Services, 57(7), 1027–1031.CrossRefGoogle ScholarPubMed
Frueh, B.C., Grubaugh, A.L., Cusack, K.J., & Elhai, J.D. (2009). Disseminating evidence-based practices for adults with PTSD and severe mental illness in public-sector mental health agencies. Behavior Modification, 33(1), 66–81.CrossRefGoogle ScholarPubMed
Ganju, V. (2003). Implementation of evidence-based practices in state mental health systems: Implications for research and effectiveness studies. Schizophrenia Bulletin, 29(1), 125–131.CrossRefGoogle ScholarPubMed
Gatchel, R.J., & Okifuji, A. (2006). Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic nonmalignant pain. The Journal of Pain, 7(11), 779–793.CrossRefGoogle ScholarPubMed
Gatchel, R.J., Polatin, P.B., Noe, C., Gardea, M., Pulliam, C., & Thompson, J. (2003). Treatment-and cost-effectiveness of early intervention for acute low-back pain patients: a one-year prospective study. Journal of Occupational Rehabilitation, 13(1), 1–9.CrossRefGoogle ScholarPubMed
Gatchel, R.J., & Schultz, I.Z. (2014). Handbook of musculoskeletal pain and disability disorders in the workplace. Springer.CrossRefGoogle Scholar
Gaudiano, B.A., Brown, L.A., & Miller, I.W. (2011). Let your intuition be your guide? Individual differences in the evidence-based practice attitudes of psychotherapists. Journal of Evaluation in Clinical Practice, 17(4), 628–634.CrossRefGoogle ScholarPubMed
Gaudiano, B.A., & Miller, I.W. (2013). The evidence-based practice of psychotherapy: Facing the challenges that lie ahead. Clinical Psychology Review, 33(7), 813–824.Google ScholarPubMed
Godin, G., Bélanger-Gravel, A., Eccles, M., & Grimshaw, J. (2008). Healthcare professionals’ intentions and behaviours: A systematic review of studies based on social cognitive theories. Implementation Science, 3(1), 36.CrossRefGoogle ScholarPubMed
Gondek, D., Edbrooke-Childs, J., Fink, E., Deighton, J., & Wolpert, M. (2016). Feedback from outcome measures and treatment effectiveness, treatment efficiency, and collaborative practice: A systematic review. Administration and Policy in Mental Health and Mental Health Services Research, 43(3), 325–343.CrossRefGoogle ScholarPubMed
Goodheart, C.D. (2011). Psychology practice: Design for tomorrow. American Psychologist, 66(5), 339.CrossRefGoogle ScholarPubMed
Grimshaw, J.M., & Russell, I.T. (1993). Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet, 342(8883), 1317–1322.CrossRefGoogle ScholarPubMed
Grol, R. (1997). Personal paper. Beliefs and evidence in changing clinical practice. Bmj, 315(7105), 418.CrossRefGoogle ScholarPubMed
Grol, R., & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients’ care. Lancet, 362(9391), 1225–1230.CrossRefGoogle ScholarPubMed
Grol, R., & Wensing, M. (2004). What drives change? Barriers to and incentives for achieving evidence-based practice. Medical Journal of Australia, 180 (6 Suppl), S57.Google ScholarPubMed
Harmsen, I.A., Mollema, L., Ruiter, R. A., Paulussen, T.G., de Melker, H.E., & Kok, G. (2013). Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health, 13(1), 1183.CrossRefGoogle ScholarPubMed
Hasson, H., Andersson, M., & Bejerholm, U. (2011). Barriers in implementation of evidence-based practice: Supported employment in Swedish context. Journal of Health Organization and Management, 25(3), 332–345.CrossRefGoogle ScholarPubMed
Hatfield, D.R., & Ogles, B.M. (2004). The use of outcome measures by psychologists in clinical practice. Professional Psychology Research and Practice, 35(5), 485–491.CrossRefGoogle Scholar
Iles, R., & Davidson, M. (2006). Evidence based practice: a survey of physiotherapists’ current practice. Physiotherapy Research International, 11(2), 93–103.CrossRefGoogle ScholarPubMed
Kamper, S.J., Apeldoorn, A., Chiarotto, A., Smeets, R., Ostelo, R., Guzman, J., & van Tulder, M. (2015). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ, 350, h444.CrossRefGoogle ScholarPubMed
Kilgour, E., Kosny, A., McKenzie, D., & Collie, A. (2015a). Healing or harming? Healthcare provider interactions with injured workers and insurers in workers’ compensation systems. Journal of Occupational Rehabilitation, 25(1), 220–239.CrossRefGoogle ScholarPubMed
Kilgour, E., Kosny, A., McKenzie, D., & Collie, A. (2015b). Interactions between injured workers and insurers in workers’ compensation systems: a systematic review of qualitative research literature. Journal of Occupational Rehabilitation, 25(1), 160–181.CrossRefGoogle ScholarPubMed
Kordy, H., Hannöver, W., & Richard, M. (2001). Computer-assisted feedback-driven quality management for psychotherapy: The Stuttgart-Heidelberg Model. Journal of Consulting and Clinical Psychology, 69(2), 173.CrossRefGoogle ScholarPubMed
Kroll, T., Barbour, R., & Harris, J. (2007). Using focus groups in disability research. Qualitative Health Research, 17(5), 690–698.CrossRefGoogle ScholarPubMed
Krueger, R.A., & Casey, M.A. (2015). Focus groups: A practical guide for applied research. Singapore: SAGE.Google Scholar
Lambert, M.J., Whipple, J.L., Smart, D.W., Vermeersch, D.A., Nielsen, S.L., & Hawkins, E.J. (2001). The effects of providing therapists with feedback on patient progress during psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11(1), 49–68.CrossRefGoogle ScholarPubMed
Lambert, M.J., Whipple, J.L., Vermeersch, D.A., Smart, D.W., Hawkins, E.J., Nielsen, S.L., & Goates, M. (2002). Enhancing psychotherapy outcomes via providing feedback on client progress: A replication. Clinical Psychology & Psychotherapy, 9(2), 91–103.CrossRefGoogle Scholar
Lilienfeld, S.O., Ritschel, L.A., Lynn, S.J., Cautin, R.L., & Latzman, R.D. (2013). Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies. Clinical Psychology Review, 33(7), 883–900.CrossRefGoogle ScholarPubMed
Littleton, S., Cameron, I.D., Poustie, S., Hughes, D., Robinson, B., Neeman, T., & Smith, P.N. (2011). The association of compensation on longer term health status for people with musculoskeletal injuries following road traffic crashes: emergency department inception cohort study. Injury, 42(9), 927–933.CrossRefGoogle ScholarPubMed
Loisel, P., Buchbinder, R., Hazard, R., Keller, R., Scheel, I., Van Tulder, M., & Webster, B. (2005). Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence. Journal of Occupational Rehabilitation, 15(4), 507–524.CrossRefGoogle ScholarPubMed
Lueger, R.J., Howard, K.I., Martinovich, Z., Lutz, W., Anderson, E.E., & Grissom, G. (2001). Assessing treatment progress of individual patients using expected treatment response models. Journal of Consulting and Clinical Psychology, 69(2), 150.CrossRefGoogle ScholarPubMed
McHugh, R.K., & Barlow, D.H. (2010). The dissemination and implementation of evidence-based psychological treatments: A review of current efforts. American Psychologist, 65(2), 73.CrossRefGoogle ScholarPubMed
Melfi, C.A., Chawla, A.J., Croghan, T.W., Hanna, M.P., Kennedy, S., & Sredl, K. (1998). The effects of adherence to antidepressant treatment guidelines on relapse and recurrence of depression. Archives of General Psychiatry, 55(12), 1128–1132.CrossRefGoogle Scholar
Miller, S.D., Hubble, M.A., Chow, D.L., & Seidel, J.A. (2013). The outcome of psychotherapy: yesterday, today, and tomorrow. Psychotherapy, 50(1), 88–97.CrossRefGoogle ScholarPubMed
Miller, W.R., Yahne, C.E., Moyers, T.B., Martinez, J., & Pirritano, M. (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology, 72(6), 1050.CrossRefGoogle ScholarPubMed
Milne, D., Gorenski, O., Westerman, C., Leek, C., & Keegan, D. (2000). What does it take to transfer training? Psychiatric Rehabilitation Skills, 4(2), 259–281.CrossRefGoogle Scholar
Murgatroyd, D.F., Casey, P.P., Cameron, I.D., & Harris, I.A. (2015). The effect of financial compensation on health outcomes following musculoskeletal injury: systematic review. PLoS One, 10(2), e0117597.CrossRefGoogle ScholarPubMed
National Health and Medical Research Council. (2000). A guide to the development, implementation and evaluation of clinical practice guidelines (p. 88). Canberra, Australia: Author.Google Scholar
New South Wales Government. (2014). NSW Workers Compensation Statistics. Retrieved from https://www.opengov.nsw.gov.au/publications/15444.Google Scholar
Nyamathi, A., & Shuler, P. (1990). Focus group interview: a research technique for informed nursing practice. Journal of Advanced Nursing, 15(11), 1281–1288.CrossRefGoogle ScholarPubMed
Pagoto, S.L., Spring, B., Coups, E.J., Mulvaney, S., Coutu, M.F., & Ozakinci, G. (2007). Barriers and facilitators of evidence-based practice perceived by behavioral science health professionals. Journal of Clinical Psychology, 63(7), 695–705.CrossRefGoogle ScholarPubMed
Parry, G., Cape, J., & Pilling, S. (2003). Clinical practice guidelines in clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy, 10(6), 337–351.CrossRefGoogle Scholar
Pettigrew, S., Donovan, R., Pescud, M., Boldy, D., & Newton, R. (2010). Mature adults’ attitudes to mental health service utilisation. Australian Psychologist, 45(2), 141–150.CrossRefGoogle Scholar
Reichstadt, J., Depp, C.A., Palinkas, L.A., & Jeste, D.V. (2007). Building blocks of successful aging: A focus group study of older adults’ perceived contributors to successful aging. American Journal of Geriatric Psychiatry, 15(3), 194–201.CrossRefGoogle ScholarPubMed
Reid, D.J., & Reid, F.J. (2005). Online focus groups. International Journal of Market Research, 47(2), 131.CrossRefGoogle Scholar
Richmond, H., Hall, A.M., Copsey, B., Hansen, Z., Williamson, E., Hoxey-Thomas, N., … Lamb, S.E. (2015). The Effectiveness of Cognitive Behavioural Treatment for Non-Specific Low Back Pain: A Systematic Review and Meta-Analysis. PLoS One, 10(8), e0134192. doi: 10.1371/journal.pone.0134192 CrossRefGoogle ScholarPubMed
Rogerson, M.D., Gatchel, R.J., & Bierner, S.M. (2010). A Cost Utility Analysis of Interdisciplinary Early Intervention Versus Treatment as Usual For High-Risk Acute Low Back Pain Patients. Pain Practice, 10(5), 382–395.CrossRefGoogle ScholarPubMed
Rutten, G.M., Degen, S., Hendriks, E.J., Braspenning, J.C., Harting, J., & Oostendorp, R.A. (2016). Adherence to clinical practice guidelines for low back pain in physical therapy: do patients benefit? Physical Therapy, 90(8), 1111–1122.CrossRefGoogle Scholar
Scascighini, L., Toma, V., Dober-Spielmann, S., & Sprott, H. (2008). Multidisciplinary treatment for chronic pain: a systematic review of interventions and outcomes. Rheumatology, 47(5), 670–678.CrossRefGoogle ScholarPubMed
Schoenwald, S.K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52(9), 1190–1197.CrossRefGoogle Scholar
Schultz, I.Z., & Gatchel, R.J. (Eds.). (2006). Handbook of complex occupational disability claims: Early risk identification, intervention, and prevention. New York, NY: Springer Science & Business Media.Google Scholar
Schweikert, B., Jacobi, E., Seitz, R., Cziske, R., Ehlert, A., Knab, J., & Leidl, R. (2006). Effectiveness and cost-effectiveness of adding a cognitive behavioral treatment to the rehabilitation of chronic low back pain. The Journal of Rheumatology, 33(12), 2519–2526.Google ScholarPubMed
Sholomskas, D.E., Syracuse-Siewert, G., Rounsaville, B.J., Ball, S.A., Nuro, K.F., & Carroll, K.M. (2005). We don’t train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 73(1), 106.CrossRefGoogle ScholarPubMed
State Insurance Regulatory Authority. (2016). Acute whiplash. Retrieved from http://www.maa.nsw.gov.au/for-professionals/for-health-professionals/acute-whiplash Google Scholar
Spring, B. (2007). Evidence-based practice in clinical psychology: What it is, why it matters; what you need to know. Journal of Clinical Psychology, 63(7), 611–631.CrossRefGoogle ScholarPubMed
Sullivan, M.J., Adams, H., Rhodenizer, T., & Stanish, W.D. (2006). A psychosocial risk factor–targeted intervention for the prevention of chronic pain and disability following whiplash injury. Physical Therapy, 86(1), 8–18.CrossRefGoogle ScholarPubMed
Swinkels, A., Albarran, J.W., Means, R.I., Mitchell, T., & Stewart, M.C. (2002). Evidence-based practice in health and social care: where are we now? Journal of Interprofessional Care, 16(4), 335–347.CrossRefGoogle ScholarPubMed
Tasca, G.A. (2015). What Canadian clinical psychologists want from psychotherapy research. Canadian Psychology/Psychologie canadienne, 56(1), 16.CrossRefGoogle Scholar
Torrey, W.C., Drake, R.E., Dixon, L., Burns, B.J., Flynn, L., Rush, A.J., … Klatzker, D. (2001). Implementing evidence-based practices for persons with severe mental illnesses. Psychiatric Services, 52(1), 45–50.CrossRefGoogle ScholarPubMed
Transport Accident Commission & WorkSafe Victoria. (2012). Clinical framework for the delivery of health services. Transport Accident Commission, WorkSafe Victoria & State Government Victoria Retrieved from https://www.tac.vic.gov.au/__data/assets/pdf_file/0010/27595/clinical-framework-single.pdf.Google Scholar
Wampold, B. (2001). The great psychotherapy debate: Models, methods, and findings (counseling and psychotherapy: Investigating practice from scientific, historical, and cultural perspectives). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Webb, C.A., DeRubeis, R.J., Amsterdam, J.D., Shelton, R.C., Hollon, S.D., & Dimidjian, S. (2011). Two aspects of the therapeutic alliance: differential relations with depressive symptom change. Journal of Consulting and Clinical Psychology, 79(3), 279.CrossRefGoogle ScholarPubMed
Weisz, J.R., Jensen-Doss, A., & Hawley, K.M. (2006). Evidence-based youth psychotherapies versus usual clinical care: a meta-analysis of direct comparisons. American Psychologist, 61(7), 671.CrossRefGoogle ScholarPubMed
Whipple, J.L., Lambert, M.J., Vermeersch, D.A., Smart, D.W., Nielsen, S.L., & Hawkins, E.J. (2003). Improving the effects of psychotherapy: The use of early identification of treatment and problem-solving strategies in routine practice. Journal of Counseling Psychology, 50(1), 59.CrossRefGoogle Scholar
Whitfill, T., Haggard, R., Bierner, S.M., Pransky, G., Hassett, R.G., & Gatchel, R.J. (2010). Early intervention options for acute low back pain patients: a randomized clinical trial with one-year follow-up outcomes. Journal of Occupational Rehabilitation, 20(2), 256–263.CrossRefGoogle ScholarPubMed