Organizational Culture, Absorptive Capacity, and the Change Process: Influences on the Fidelity of Implementation of Integrated Dual Disorder Treatment in Community-Based Mental Health Organizations
Community-based mental health organizations epitomize the diverse settings in which efforts are underway to understand the implementation of evidence-based practices. The organizational complexities associated with the implementation process make it challenging for agencies to adhere to fidelity protocols and requirements. Yet, the context in which implementation occurs requires exploration. Important dimensions of the context are organizational culture, absorptive capacity, and the change process. In light of the urgency to move empirically-based psychosocial mental health interventions into usual-care settings, it is necessary to understand the context in which such organizational dimensions influence fidelity to implementation. This exploratory study utilizes a mixed-methods research design to conduct a secondary analysis of a national study on the implementation of evidence-based practices. The study focused on 11 community-based mental health organizations that were involved in implementing the Integrated Dual Disorder Treatment (IDDT) protocol. The primary purpose of the research was to explore factors such as organizational culture, absorptive capacity, and the change process that influence the fidelity of implementation of the Integrated Dual Disorder Treatment Model.Findings show that a recovery vision is central to organizational culture in community-based mental health treatment. Important dimensions of the change process focus on leadership, organizational adaptability, and processes that foster knowledge transfer and supervision. There was no relationship between organizational culture typology and fidelity to implementation. Absorptive capacity indicated a moderate to strong relationship with fidelity. Leadership collaboration and a values-innovation fit with the Integrated Dual Disorder Treatment model were found to have a strong relationship to fidelity. The findings suggest understanding the contextual aspects of organizational culture and the change process are important to fidelity. This knowledge enhances a more effective implementation process for community-based mental health agencies to promote client outcomes based in recovery and rehabilitation.
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