{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:28:26Z","timestamp":1787164106087,"version":"build-2736575974"},"reference-count":63,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the implementation of evidence\u2010based psychotherapy across international healthcare contexts and identify barriers to clinical delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an international, cross\u2010sectional, web\u2010based survey of psychiatrists from October 2024 to March 2025. The questionnaire assessed familiarity with 10 evidence\u2010based psychotherapy modalities, frequency of use, delivery confidence, perceived barriers, and clinical workload. Responses from 16 countries were analyzed across five geographic regions using chi\u2010squared tests and effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 424 respondents, 201 (47.4%) demonstrated low composite familiarity with evidence\u2010based psychotherapies. Cognitive behavior therapy maintained moderate familiarity across regions, while other modalities remained largely unfamiliar. Japan exhibited the most constrained practice environment, with 48.3% reporting consultations under 10 min compared to 15.1% in other regions, and 30.0% seeing 40 or more patients daily. Major time constraints were reported by 63.3% of Japanese psychiatrists, significantly higher than other regions (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.015). Frequent use of evidence\u2010based psychotherapy was lowest in Japan (20.0%) and highest in the Middle East (60.0%). Despite these challenges, 77.4% of all respondents rated these approaches as highly important. Respondents identified improved postgraduate training (54.0%), continuing education access (38.2%), and enhanced supervision (36.0%) as priorities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation varies across healthcare contexts, with Japan exemplifying system\u2010level constraints where brief consultations and high patient volumes override practitioner knowledge and motivation. While psychiatrists value evidence\u2010based approaches and seek to implement them, organizational barriers ultimately determine actual practice patterns. Findings indicate that training initiatives without concurrent structural reforms cannot bridge implementation gaps. Effective integration requires alignment of education, healthcare delivery structures, and payment systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70024","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T14:51:05Z","timestamp":1768229465000},"page":"308-316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Barriers to evidence\u2010based psychotherapy implementation: An international survey of workload, training, and clinical practice"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1704-6411","authenticated-orcid":false,"given":"Naoki","family":"Takamatsu","sequence":"first","affiliation":[{"name":"Department of Neuropsychiatry University of Tokyo Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3056-251X","authenticated-orcid":false,"given":"Ekachaeryanti","family":"Zain","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Niigata University Graduate School of Medical and Dental Sciences  Niigata Japan"},{"name":"Department of Psychiatry, Faculty of Medicine Mulawarman University  Samarinda Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Ying Heidi","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polona Rus","family":"Prelog","sequence":"additional","affiliation":[{"name":"Centre for Clinical Psychiatry University Psychiatric Clinic Ljubljana  Ljubljana Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4434-3526","authenticated-orcid":false,"given":"Roxanne C.","family":"Keynejad","sequence":"additional","affiliation":[{"name":"Health Service and Population Research Department, Institute of Psychiatry, Psychology &amp; Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedar","family":"Andress","sequence":"additional","affiliation":[{"name":"Northern Ireland Medical and Dental Training Agency  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahtab","family":"Motamed","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Shamspour","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Shahid Beheshti Hospital, Afzalipour Faculty of Medicine  Kerman Iran"},{"name":"Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Sharmie C.","family":"Quezon\u2010Santos","sequence":"additional","affiliation":[{"name":"Philippine Psychiatric Association  Quezon City Philippines"},{"name":"College of Medicine, Bataan Peninsula State University  Balanga City Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4297-8974","authenticated-orcid":false,"given":"Joanna","family":"Smolarczyk","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medical Sciences in Zabrze Medical University of Silesia  Zabrze Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Truett","sequence":"additional","affiliation":[{"name":"Lyra Health  Burlingame California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan Lun","family":"Huang","sequence":"additional","affiliation":[{"name":"Tsaotun Psychiatric Center, Ministry of Health and Welfare  Nantou Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kateryna","family":"Shyliuk","sequence":"additional","affiliation":[{"name":"Main Medical Clinical Center of the Ministry of Internal Affairs of Ukraine  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenny Wai Kwong","family":"Lim","sequence":"additional","affiliation":[{"name":"Institute of Mental Health  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2873-4025","authenticated-orcid":false,"given":"Tomohiro","family":"Shirasaka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Teine Keijinkai Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.61.4.271"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-017-0549-4"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20941"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21203"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21069"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20860"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00004"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20906"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20235"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000376584"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.110.082776"},{"key":"e_1_2_11_13_1","volume-title":"Mental Health Atlas 2020 [Internet]","author":"World Health Organization","year":"2021"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2167702612463566"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2013.06.001"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2013.04.006"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2009.07.003"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-50"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2025.2488019"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-016-0723-8"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-033365"},{"key":"e_1_2_11_23_1","first-page":"37","article-title":"A systematic review of studies on consultation length in Japan","volume":"35","author":"Kisa K","year":"2012","journal-title":"Jpn. 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