Provider Perception of the Acceptability, Appropriateness, and Feasibility of a Transdiagnostic Intervention in a Youth Partial Hospitalization Setting: A Mixed Methods Implementation Process Evaluation

Partial hospitalization programs (PHPs) are increasingly relied upon to provide intensive mental health treatment for youth with acute and severely impairing mental health symptoms, yet very few interventions have been adapted to fit this unique delivery context. Transdiagnostic treatments hold promise for addressing the complex clinical presentations and workflow needs of PHP programs, but more work is needed to understand factors that influence successful implementation. We conducted a formative implementation process evaluation to identify barriers and facilitators of acceptability, appropriateness, and feasibility of implementing an evidence-based transdiagnostic intervention in a PHP setting and further targets for intervention and implementation adaptation. Seventeen PHP clinical providers completed a survey about the implementation of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A). Providers completed measures on the UP-C/A’s characteristics, acceptability, appropriateness, feasibility, leadership implementation support, and open-ended questions about the UP-C/A implementation. A mixed methods approach was used to analyze and integrate data. Ratings of acceptability, appropriateness, and feasibility were high. The most influential implementation facilitators were positive views of the innovation characteristics, while the most influential barriers were insufficient access to knowledge and information as well as limited processes for reflecting on implementation. Aspects of intervention design (e.g., low complexity, observability, adaptability) contributed to high levels of acceptability. Barriers to appropriateness and feasibility included perceived deficiencies in leadership and training supports and perceived needs of some intervention recipients not matching the intervention. Key adaptations included translating the UP-C/A, increasing interactive group components, providing additional supervision, and a process for receiving implementation feedback.