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Leadership and implementation of evidence‐based practices

Robert Holmberg (Department of Psychology, Lund University, Lund, Sweden)
Mats Fridell (Department of Psychology, Lund University, Lund, Sweden)
Patrick Arnesson (Department of Psychology, Lund University, Lund, Sweden)
Mia Bäckvall (Department of Psychology, Lund University, Lund, Sweden)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 18 July 2008




This paper seeks to investigate the role of leadership styles in the implementation of evidence‐based treatment methods (EBP) for drug abuse and criminal behaviour.


The paper employs a triangulation approach through mail questionnaires to 112 treatment personnel (49 per cent response rate), interviews with 65 employees and managers, observations and feedback workshops.


Responses from treatment personnel involved in the implementation of EBP indicated that their views on their immediate superior's leadership behaviour was significantly related to the perceptions of organisational innovative climate, job satisfaction and work output. Problems with workload, lack of collegial and managerial support and a low priority given to the programmes and treatment integrity were the most common barriers to implementation of the programmes. Effective managers were providing space, time and opportunity for the staff to perform their treatment‐related tasks and to be creative during the implementation process. This functional space had to be continually protected, both vertically from demands from higher levels of the organisation and horizontally from non‐helpful colleagues.

Research limitations/implications

The correlational design used in this study does not permit conclusions about causality.

Practical implications

Implementation of evidence‐based treatment programmes in clinical settings should pay attention to the impact of leadership styles on the experiences of treatment staff (climate, job‐satisfaction, burnout) and programme outcome. These variables should also be considered in the evaluation of treatment effects. The process of implementation can be seen as a route for learning and innovation, and managers should pay attention to the facilitation of these processes.


The role of leadership in implementation concerns not only production and structure but also learning, creativity and persistency during the process. The triangulation approach in this study also sheds light on the limitations of questionnaires in capturing the dynamics of leadership in human service organisations.



Holmberg, R., Fridell, M., Arnesson, P. and Bäckvall, M. (2008), "Leadership and implementation of evidence‐based practices", Leadership in Health Services, Vol. 21 No. 3, pp. 168-184.



Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited

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