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Abstract
This study examined organizational factors associated with the adoption and fidelity of cognitive behavioral therapy (CBT) in substance abuse treatment centers. Using data from 268 centers and their counselors, two outcomes were analyzed: CBT adoption and implementation fidelity. Adoption was higher in organizations that provided more training for new counselors, used medications in treatment, and had counselors who viewed CBT as an acceptable approach. Fidelity of CBT implementation was associated with specific training elements, including the use of TIPS and TAPS tools and greater staff familiarity with CBT. Findings highlight key organizational supports that promote evidence‑based practice.