Beliefs about evidence-based practices in addiction treatment: a survey of Veterans Administration program leaders

The purpose of this study was to determine Veterans Administration addiction treatment program leaders' familiarity with evidence-based practices, understanding of and attitudes toward existing VA treatment guidelines, the extent to which specific practices should be implemented, and perceived barriers to implementation. Two hundred and twenty surveys were mailed to program leaders between November 1999 and May 2000. One hundred and seventy-four (79%) were completed, representing 135 out of 162 (83%) facilities. Program leaders saw guidelines as educational tools that improved quality of care and could be implemented into existing programs. However, they also perceived staff resistance to implementation. The most strongly cited barriers to implementation were lack of administrative support, insufficient staff time, and lack of skills or knowledge. Several treatments were seen as strongly evidentiary, but were not widely implemented, suggesting possible foci for future translation studies.