Considerations for Implementing Evidence-Based Practices for Youth Anxiety in an Acute Psychiatric Care Setting

Adolescent partial hospitalization programs (PHP) provide specialized, intensive, interdisciplinary day treatment for youth with significant psychopathology warranting a higher level of care than outpatient therapy, but less intensive than admission to an inpatient unit. Although partial hospital programs are becoming increasingly utilized for youth with severe psychiatric disorders (Del Conte et al., 2016; Leffler et al., 2017), there is scarce research on the effectiveness of these programs and little is known about the extent to which evidence-based practices (EBPs) for youth are typically provided through these programs. Shortened lengths of stay, fluctuating patient acuity, diagnostic heterogeneity, and clinical complexity are significant and enduring barriers to successful implementation of EBPs in acute care facilities. As such, process descriptions of initiatives to implement EBPs in acute care settings are limited in the literature. Consequently, it is of importance to the field to elucidate the challenges of adapting EBPs for acute care contexts, strategies for managing these hurdles, strengths from which to build upon, and specific examples of what facilitates successful implementation. This article focuses on the lessons learned through a team's efforts using an implementation science framework to implement EBPs for youth anxiety in an adolescent partial hospitalization program in the context of a large academic medical center situated in a metropolitan area of the northeast. Reflecting on steps and missteps, the article offers seven considerations that may be informative for teams preparing to integrate EBPs into acute psychiatric care settings.