Table 4.

Blueprint for implementation

Importance	Goal	Responsible	Feasibility	Impact	Implementation category	Action step
H	1, 2, 3	B	H	3	Train and educate stakeholders/provide interactive assistance	Beck/IU training/supervision
H	1, 2, 3	IT	L	2	Develop stakeholder interrelationships	Hold cross-staff clinical meetings
H	1, 3	B/IT	H	2	Adapt and tailor to context	Facilitate, structure, and promote adaptability (Beck to work with IT to modify CBT to fit the sites)
H	2	B	L	3	Train and educate stakeholders	Conduct educational outreach visits
H	3	IT	L	3	Utilize financial strategies	Shift resources (ensure strategy for monitoring outcomes)
H	2	IT	H	1	Develop stakeholder interrelationships	Identify early adopters (have person shadowed, talk in clinical meetings about overcoming barriers)
H	2	B	L	3	Provide interactive assistance	Provide clinical supervision––include IT on calls
H	1, 2	B/IT	L	3	Train and educate stakeholders	Use train-the-trainers strategies
H	2, 3	IT	L	3	Change infrastructure	Increase demand––present data to courts and state level
H	2	IT	H	2	Support clinicians	Change performance evaluations, change professional roles
M	2	B/IT	H	1	Use evaluative and iterative strategies	Develop and institute self-assessment of competency
M	2, 3	IT	H	2	Develop stakeholder interrelationships	Capture and share local knowledge
M	2	IT	H	1	Support clinicians	Remind clinicians
L	3	B/IT	L	2	Train and educate stakeholders	Prep CBT client handouts (Beck to provide examples)
L	1, 2	B/IT	L	2	Utilize financial strategies	Alter incentives (certification, vacation, salary)
L	1, 3	B/IT	L	2	Support clinicians	Facilitate relay of clinical data to providers (data parties)
L	1, 2	IT	L	2	Support clinicians	Modify context to prompt new behaviors
L	1, 2, 3	IT	L	2	Train and educate stakeholders	Shadow other experts
L	1, 2, 3	IT	L	2	Use evaluative and iterative strategies	Obtain and use consumer and family feedback (exit interviews and surveys)

“Importance” contains “H” for “High” (i.e., strategy must be enacted because it targets a highly important barrier), “M” for “Moderate” (i.e., the strategy should be prioritized if resources are available), or an “L” for “Low” (i.e., strategy should only be enacted if time and resources are available). “Goal” contains a 1, 2, or 3 to indicate which of the top 3 goals the strategy would primarily target. “Responsible” reflects whether the strategy should be enacted by the “IT” (i.e., Implementation Team at Wolverine Human Services) or “B” (i.e., Beck Institute or other external experts). “Feasibility” contains either “H” for “High” or “L” for “Low” in terms of the ease with which a given strategy could be enacted. “Impact” contains a score from 1 to 3 to reflect the degree to which the strategy would likely impact the fidelity with which CBT would be delivered. “Implementation Category” is derived from an expert-engaged concept mapping exercise in which nine conceptually distinct categories emerged: adapt and tailor to the context, change infrastructure, develop stakeholder interrelationships, engage consumers, provide interactive assistance, support clinicians, train and educate stakeholders, utilize financial strategies, and use evaluative and iterative strategies. Implementation strategy contains the name of the strategy to be enacted. Timeline: 3 years total; 3–5 day training every 6 months

Note. Goals: 1 continue to enhance climate, teamwork, communication, attitudes, and satisfaction; 2 increase CBT knowledge, skill––integrate into care; 3 demonstrate benefit to youth