Table 2.

Perceived predictors of CPT and PE implementation

Sub-construct	Definition	Sample quotation
Presence
Compatibility	Innovations’ consistency with existing values, experiences, and needs of adopter and system	“When we first did it [CPT] I thought that it was a good fit for us. It looked right immediately… because it was really consistent with a lot of the things we were already doing”
Relative advantage	Degree to which the innovation is considered superior to existing practices	“I think it’s extremely valuable in the residential program. We’ve had a number of vets who had gone through the program three to 10 years ago who heard about CPT in the PTSD outpatient groups they’re in and they want to come back just because they heard that it’s much more valuable”
Observability	Innovations’ results are observable to others	“Seeing that your patients get better is important. If you are successfully able to use the protocols and see that people do improve then that becomes reinforcing and you want to keep utilizing it”
Social networks	Structure and quality of social network, both formal and informal	“I think, quite realistically, the best support that one can have in implementing these protocols is to have other clinicians in the clinic who utilize them”
Dedicated time and resources	Availability of means needed to implement an innovation (e.g., funding, time, access, administrative support, etc.)	“I mean this system is fully in support of EBTs. It’s certainly not an issue within clinics or divisions of having managerial or support from directors and scheduling staff or time built into schedules for conference calls. That’s not an issue”
Leadership and vision	Style of leadership and presence of identified and articulated trajectory with guided direction toward implementation	“But when I got here you know they [Leadership] said you got to do it [PE] this way, but we’re going to support you. We’re going to give you the time. You’re going to have the credit to do it the way it’s supposed to be done. So there was full backing behind it and that was really, really a breath of fresh air”
Absence
Dedicated time and resources	Availability of means needed to implement an innovation (e.g., funding, time, access, administrative support, etc.)	“I think the most difficult one though is the resource intensity of PE and that’s been real difficult. It’s been real difficult for staff to have enough… You can’t carry a lot of those people on your caseload because you just don’t have the available time to see them at the frequency and intensity that they need admissions”