Providers' receptivity and perceived barriers to implement written exposure therapy for PTSD: Qualitative provider and leader interviews across six civilian health care systems.

OBJECTIVE

This investigation utilized qualitative interview data to evaluate an implementation model to understand mental health providers' receptivity and perceived barriers to training and implementing written exposure therapy, an evidence-based psychotherapy for posttraumatic stress disorder, in six, large, diverse, civilian health care systems across the United States.

METHOD: Semistructured qualitative interviews were conducted with 156 mental health providers and clinical leaders. Data were analyzed using thematic content analysis within the Consolidated Framework for Implementation Research framework.

RESULTS

Providers demonstrated high enthusiasm for written exposure therapy, citing its brevity and reduced patient burden as key advantages over other evidence-based psychotherapies for posttraumatic stress disorder. Primary barriers included organizational constraints (e.g., heavy caseloads, scheduling difficulties) and perceived patient-specific factors (e.g., writing limitations).

CONCLUSIONS

Findings highlight the complex interplay between intervention characteristics, organizational factors, and adopter attitudes in determining implementation success. While written exposure therapy's brevity and compatibility with existing beliefs and practices facilitate adoption, organizational restructuring and leadership support were essential to overcome structural barriers and sustain implementation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).