Skip to main content

Table 2 Major Themes

From: Implementation of the CALM intervention for anxiety disorders: a qualitative study

Major Theme


Barriers to Implementation

Provider attitudes/behaviors

Uneven physician "buy in"


Enthusiasm could wane without continued intervention


Feeling that prevalence of anxiety was low in their clinic

Clinic structure

Part-time primary care providers harder to reach


Space concerns for ACS

Intervention characteristics

Part-time ACS


Communication with ACSs sometime unsatisfactory


Some nurses felt "out of the loop" and not consistent targets for education and marketing

Patient characteristics

Challenges of Low SES patients


Hispanic patients resistant to CALM


Drop-outs weaken enthusiasm among providers and staff

Facilitators to Implementation


Provider attitudes/behaviors

Interest in mental health increases uptake


Buy-in/support from nurses/staff

Clinic structure

Presence of MH professional


Reliable and appropriate space for ACS

Intervention characteristics

ACS in clinic full time (or close)


"Face-time" with providers/relationships


CALM not overly burdensome


Providers appreciated referral source and additional care


Positive feedback from/about patients


Providers very positive about ACS

Patient Characteristics

Prefer coming to primary care

Barriers to Sustaining CALM


Clinic structure

Paying for ACS service


Space for ACS and doing therapy

Facilitators to Sustaining CALM


   -Provider attitudes

Providers high value of CALM

   -Clinic structure

Already doing CC for other disorders


Presence of MH person who could adopt

  1. MH = mental health; ACS = anxiety clinical specialist; PCP = primary care physician; CALM = Coordinated Anxiety Learning and Management; SES = socioeconomic status; CBT = cognitive behavioral therapy; CC = collaborative care.