From Theory to Implementation in Practice: A Qualitative Case Study of the Implementation of Virtual Reality in Mental Healthcare

Abstract

While virtual reality (VR) shows much promise for treatment of psychiatric disorders, it is not widely used in practice. Models as the Consolidated Framework for Implementation Research (CFIR) can be used to guide implementation, but not much is known about how to translate these models into concrete implementation processes. To identify relevant implementation factors, accompanying objectives and strategies, and points of improvement for the implementation of VR in mental healthcare. This case study took place at two organizations for mental healthcare. In Phase 1, an implementation plan with factors, objectives and strategies was developed based on the CFIR, previous research, and experiences from practice. In Phase 2, therapists’ experiences with the implementation process were identified via interviews. Deductive coding with the previously identified factors was used to investigate if and how the factors were experienced and to identify points of improvement regarding the accompanying objectives and strategies. Implementation factors, objectives, and strategies were identified for five domains: characteristics of therapists, patients, the intervention, inner setting and outer setting. In the interviews, few factors related to patients and the outer setting were identified. Points of improvement were related to available time for using VR, suitable skills training, and integration in treatment protocols and organizational structures. Our study showed that most formulated implementation factors were experienced by participants, but that there was room for improvement. Our findings underline the need for systematic and iterative development of multi-level implementation interventions, inspired by theories and framework from behavioural sciences.