Table 1.

Barriers to MFG Implementation

	Context (Agency culture/policies, billing restrictions)	Intervention (Qualities/components of the practice itself)	Practitioner (Knowledge, priorities, personality, schedule)	Recipient (Cultural factors, interest, personality, access)
Barriers (What has gotten in the way?)	Billing/Reimbursement challenges (k=3) Clinic location (e.g., parking, accessibility; k=2) Little time for staff to plan and coordinate Lack of agency buy-in Lack of staffing, staff attrition, and new staff onboarding Lack of trained staff	Duration of intervention too long (k=3) Lengthy zpsychoeducation/workshop (k=2) Too strong focus on psychotic disorders rather than transdiagnostic Emphasis on biological model for psychoeducation Two staff members required per group Discordant with established model of FEP care Joining sessions seem redundant for long-standing clients (i.e., re-reviewing info)	Limited time/scheduling (k=2) Leaders do not speak same language as those served (k=2) Need more consistent supervision and focus on specific sessions Leaders unable to engage most families Racial/ethnic background of facilitators do not match those served (e.g., Facilitators are White)	Time constraint/Availability (e.g., due to work schedules; k=4) Already engaged in program/Receiving full battery of services (k=2) Resources (e.g., financial, childcare; k=2) Transportation (k=2) No family involvement Dynamics of family + kid Age variance mid 20-late 30s Families not wanting to engage with other families due to stigma Do not find problem-solving helpful and prefer “process” group

Note. Bolded were endorsed by two or more clinics. K refers to the number of clinics.