Panel Discussion 16 - Implementing Contextually Sensitive, Evidence-based Case Formulation at Scale

In the past several years, the field of clinical psychological science has been rethinking the one-size-fits-all paradigm of evidence-based treatments (EBTs). Although EBTs are effective on average, over half of people do not witness symptom improvement in efficacy trials (Cuijpers et al., 2023), EBT effectiveness is lower in community settings (Rudd et al., 2019), and over 60% of EBT implementation efforts fail (Alley et al., 2023). Given these findings, the field has increasingly focused on other important dimensions of evidence-based practice (e.g., patient-centered collaborative decision-making).

One dimension that has been less emphasized in implementation efforts is training clinicians in evidence-based case formulation – that is, the systematic development and testing of theoretically and empirically informed hypotheses about what “causes, cues, and maintains” (Jensen-Doss & McLeod, 2020) clinicians’ specific patients’ mental health challenges (Persons, 2012). Further, there is an urgent need to ensure that these case formulations incorporate patients’ cultural and contextual experiences to ensure that treatment is sufficiently personalized, affirmative, and culturally sensitive.

This panel, composed of clinical scientists with expertise in implementing evidence-based practices in community and training settings, will demonstrate that training clinicians in contextually sensitive, evidence-based case formulation is urgently necessary to reduce the research-to-practice gap and improve population mental health at scale. Each panelist will discuss their own efforts and experiences implementing contextually sensitive, evidence-based case formulations in community and training settings nationwide. All panelists will discuss promising results from their own implementation initiatives, suggesting that clinicians want, like, and need training in contextually sensitive, evidence-based case formulation and that such training improves clinical outcomes. We will also discuss the challenges related to these implementation efforts, and provide recommendations for future research and implementation efforts.