To get providers to uptake, if you will, these changes that we hope to make in the field will take some doing, and that's where dissemination is so important. Dissemination and implementation research, where we can then take that out there and show folks how to do it with efficiency and economy of course. That's always, for agencies that are pressed for time and resources and staff you can't give them a huge set of things and then tell them use it and you have to use it this way. They have to, they need some mobility and some room to work with the interventions.

In my own field, some of the work I did a few years ago was on interventions with depressed pregnant and post-partum women, so post-partum depression, and our research and many other people's research showed that really it's not so much the intervention that matters. Whether it's 8 sessions, 9 sessions, 10 sessions, whether it's delivered by home visitors, paraprofessionals, lay visitors, community people, or PhDs or MDs, the idea is that an intervention is provided and attention is given.

We learned that very quickly. We also learned that in a post-partum period for poor women, if you're trying to give them a 12-session intervention you're going to lose them. They can't come to the clinic. So we have to then adapt the intervention so that they can, so it makes sense. So if it's a 12-session intervention that we have in mind, maybe we need to think about it being able to do it in 4 sessions or in 5 at the most.

And that's where the clinicians' clinical judgment and we hope our own research will help clinicians make those adjustments to the therapies according to what's needed in the community but also through some kind of sound thinking that goes on.