Initial Clinician Reports of the Bottom-Up Dissemination of an Evidence-Based Intervention for Early Childhood Trauma

Background: Bottom-up dissemination (BUD) of evidence based treatments (EBT), entailing the spread of an intervention through a peer network in a decentralized manner, is an under-reported phenomenon in the professional literature. Objective: This paper presents findings from a study researching the feasibility of BUD of an evidence-based intervention for young, traumatized children and their families—Child–Parent Psychotherapy (CPP). The research objective was to obtain information regarding whether, how, and where CPP clinicians are using the intervention after training, in a BUD plan. Methods: The research design entailed a post-training survey. Seventy-seven (90.5%) graduates from four cohorts of CPP training completed a questionnaire regarding their use of CPP. Descriptive statistics report how many CPP cases they are treating, their use of supervision, whether they are maintaining fidelity, and if or where they are disseminating CPP onward. Additional qualitative data was obtained from open-ended questions. Results: Clinicians reported using CPP as an entire intervention, and incorporating elements of it in general practice. They also reported spreading knowledge of the intervention, through teaching and supervising, in their workplaces and in other agencies. While clinicians reported a reasonable level of CPP fidelity, few were receiving regular supervision, and both supervisors and supervisees reported low use of fidelity measures in supervision. Conclusion: BUD may produce a dual outcome, disseminating both the EBT and elements of the intervention. The training agent’s role in providing support, as well as the possible contribution of “champions”, may be particularly important when other institutional supports are lacking.