Practical specification and application of implementation strategies to cognitive-behavioral research and practice

Cognitive-behavioral therapy (CBT) is a first-line intervention for anxiety and mood disorders, yet its reach has not been fully realized due to incomplete implementation in routine community practice. The field of implementation science has the potential to improve integration of CBT in the settings and populations that most stand to benefit. Numerous strategies have been proposed to improve implementation, but are not consistently specified in the research, particularly in CBT research and practice. The present narrative review is intended to demonstrate to mental health clinicians, researchers, and policy-makers the ways in which implementation strategies can be utilized and specified to improve implementation of CBT, using a previously developed implementation strategy classification scheme as a guide. We describe the categories of strategies, provide exemplars of their use in CBT research and implementation efforts, and summarize the implications of each category type for CBT practice and research. We conclude with a hypothetical implementation study illustrating optimal use and specification of these strategies targeting implementation of CBT for OCD.