To summarize, while there are multiple barriers to dissemination of evidence based treatments as well as research/practice gaps in multiple fields outside the addictions (Institute of Medicine, 2001; Rogers, 1995), the relative complexity of CBT, the demand placed on clinicians and patients alike in terms of complexity of ideas and need for structure, as well as the need for ongoing supervision to support fidelity, are particular challenges for the dissemination of CBT and constrain the implementation of standardized, high quality CBT in clinical practice.
