Table 2.

Key attitude-related themes, percentage of interviews/focus groups in which theme/subtheme was mentioned, and examples of a definition of evidence-based treatment from 21 interviews and 10 focus groups with clinicians serving American Indian and Alaska Native populations

Attitude-related themes and subthemes	Referenced in Interviews (n=21)	Referenced in Focus Groups (n=10)	Exemplary Quote
	n (%a)	n (%b)
Not culturally relevant	6 (28.6)	3 (30.0)	…my only concern about Evidence-Based practices (is) that they’re not typically researched using minority populations. They’re almost exclusively Caucasian. So I don’t think there’s recognition of cultural differences in clients and in populations.
External mandate	2 (9.5)	2 (20.0)	It had to be out of that book and that’s how we had to do it.
Western standard	3 (14.3)	2 (20.0)	They want to dictate how we should be doing it, you know, from their vaulted ivory tower down there. I just…Oh God, it makes me mad.
Client-centered	2 (9.5)	3 (30.0)	Asking a client what they feel they need.
Resource Drain	3 (14.3)	0	Evidence-based is all of that stuff that we just don’t have the money or the staff to do.
Maintaining sobriety	0	2 (20.0)	We can show that after sixty days, ninety days, one year … for a fact that we know this person has maintained sobriety.

^aPercentage refers to the percent of Key Informants who referenced the theme

^bPercentage refers to the percent of Focus Groups in which the theme was referenced