Implementing brief and low-intensity psychological interventions for children and young people with internalizing disorders: a rapid realist review

INTRODUCTION: Many children fail to receive the mental health treatments they need, despite strong evidence demonstrating efficacy of brief and low-intensity psychological interventions. This review identifies the barriers and facilitators to their implementation. SOURCES OF DATA: PsycInfo, EMBASE and Medline were searched and a systematic approach to data extraction using Normalization Process Theory highlighted key mechanisms and contextual factors. AREAS OF AGREEMENT: Ten interventions from 9 papers, including 371 young people, were included. Studies identified organizational demands, lack of implementation strategy and stigma as barriers to implementation, and clear training and plans for implementation as facilitators. AREAS OF CONTROVERSY: No standardized implementation outcomes were used across papers so meta-analysis was not possible. GROWING POINTS: Barriers and facilitators have been clearly identified across different settings. AREAS TIMELY FOR DEVELOPING RESEARCH: Longitudinal studies can identify methods and processes for enhancing long-term implementation and considers ways to monitor and evaluate uptake into routine practice.