Barriers and Facilitators to Implementing Attachment‐based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation
Open accessAbstract
Child welfare systems (CWS s) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (EST s) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers’ experiences of implementing attachment‐based family therapy (ABFT) in home‐based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home‐based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers’ belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of EST s into CWS settings, various barriers at multiple systemic levels need to be addressed.
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Multiple studies have shown high acceptability and feasibility of ABFT for both adolescents and emerging adults.
“Multiple studies have shown high acceptability and feasibility of ABFT for both adolescents and emerging adults [20, 24–27].”
Pilot studies indicated the acceptability and feasibility of ABFT in the Netherlands and Belgium and also for the young adult population.
“Our pilot studies indicated the acceptability and feasibility of ABFT in the Netherlands and Belgium [20, 25, 27] and also for the young adult population.”
Evidence of the feasibility and acceptability of ABFT with families in the child welfare system demonstrates that the treatment model also works well with families with complex histories and chronic, cross-generationally dysfunctional family dynamics.
“Evidence of the feasibility and acceptability of ABFT with families in the child welfare system demonstrates that the treatment model also works well with families with complex histories and chronic, cross-generationally dysfunctional family dynamics (73).”
From Combining attachment-based family therapy and cognitive behavioral therapy to improve outcomes for adolescents with anxiety (2023) · cites this paper as [73]
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- Authors
- Santens, T., Hannes, K., Levy, S., Diamond, G., & Bosmans, G.
- Affiliations
- KU Leuven (BE)
- Drexel University (US)
- Corresponding author
- Santens, Tara
- Venue
- Family Process
- Publisher
- Wiley
- Published
- 2019-12-10
- Volume
- 59
- Issue
- 4
- Pages
- 1483-1497
- ISSN
- 0014-7370 (ISSN-L)
- 1545-5300
- OpenAlex
- W2996264372
- Cited by
- 12
- References
- 38
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 2 · 2021: 3
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- Locations
- Family Process (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion, other-oa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Public Administration › Social Work Education and Practice
- Keywords
- attachment-based family therapy, child welfare, implementation barriers and facilitators, empirically supported treatments, home-based services, child and youth care, provider experiences, organizational fit, referral coordination, policy support, Consolidated Framework for Implementation Research
- MeSH terms
- Belgium, Child, Child Welfare, Family Therapy, Female, Health Plan Implementation, Humans, Male, Object Attachment, Systems Analysis, Process Assessment, Health Care, Qualitative Research
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