Improving psychologists' adherence to evidence-based practice guidelines for treating musculoskeletal injuries: A feasibility study

Objectives: The New South Wales personal injury compensation schemes have produced evidence-based practice (EBP) treatment guidelines for the management of functional disability following musculoskeletal injury. Psychologists' adherence with these guidelines is suboptimal, therefore the aim of this study was to elicit recommendations from field experts to overcome barriers to adherence and determine feasibility of their application by psychologists working within these schemes. Methods: A mixed methods design was used, consisting of a focus group and individual interviews (n = 8) of field experts followed by an online survey of psychologists (n = 150). The qualitative data were imported into QSR NVivo software and analysed using thematic analysis. The survey data were analysed using descriptive statistics in SPSS, and the narrative data were subjected to content analysis. Results: Five recommendations were made by experts and endorsed by majority of surveyed psychologists; however, some practical issues impacting application were identified. The recommendations included: mandatory training and continuing professional development; use of independent consultants for expert advice; completion of outcome measures prior to the first session and again in the eighth and final sessions; completion of the treatment plan in-session with the injured person. From the narrative comments of surveyed psychologists two key reasons for not endorsing the recommendations emerged: time and cost burden of compliance; and a perceived low efficacy for enhancing clinical practice. Conclusion: Overall, the recommendations proposed by field experts to increase adherence with EBP treatment guidelines were endorsed by the wider community of psychologists working under State Insurance Regulatory Authority insurance schemes.