Uncovering Determinants of Perceived Feasibility of TF-CBT through Coincidence Analysis

Abstract

A mental health provider’s perception of how well an intervention can be carried out in their context (i.e., feasibility) is an important implementation outcome. This study aims to identify determinants of feasibility of trauma-focused cognitive behavioral therapy (TF-CBT) through a case-based causal approach. Data come from an implementation-effectiveness study in which lay counselors (teachers and community health volunteers) implemented a culturally-adapted TF-CBT in western Kenya. We identified combinations of determinants that led to feasibility among teacher- and community health volunteer-counselors through coincidence analysis. Among teacher-counselors, organizational-level factors (implementation climate, implementation leadership) determined moderate and high levels of feasibility. Among community health volunteer-counselors, a strong relationship between a clinical supervisor and the supervisee was the most influential determinant of feasibility. Findings from this paper support the development of implementation strategies for the study context and the methodology presented can guide the assessment of determinants in other contexts.