Staff perception of barriers to behavior therapy at a psychiatric hospital

Behavior therapy has been found to be significantly effective in the treatment of psychiatric inpatients. Despite these findings, the frequency and quality of behavioral interventions in most hospital settings have been lacking. Several barriers have been thought to be impediments to the implementation of behavioral strategies in these settings, including administrative constraints, therapist biases, and limits of behavioral interventions themselves. To define these impediments more precisely, staff at Camarillo State Hospital were surveyed regarding their perceptions of barriers. A factor analysis of reported barriers uncovered five underlying factors: institutional constraints, insufficient collegial support, philosophical opposition, client dissatisfaction, and collateral interference. Further analyses found relationships between these factors and perceived job stress, characteristics of the treatment setting, and knowledge of behavior therapy. Identification of barriers to behavior therapy is a necessary first step in clinical services research that seeks to increase utilization of behavioral strategies.