Using data from a larger study investigating the eff ectiveness of a structured clinical protocol to manage individuals in residential facilities who experience behavioral and psychological symptoms of dementia (BPSD), the current study investigated whether external clinical support in using the protocol with specifi c residents increased compliance in its use, over and above only providing a generic workshop about the protocol and management of BPSD. Results indicated that provision of the workshop, in addition to clinical support, was associated with signifi cantly higher compliance. However, compliance was only found to be related to positive outcomes when staff received the generic workshop and not clinical support. When clinical support was provided, compliance was not related to outcomes or worse outcomes. These fi ndings, when considered in the context of the results of the larger trial, suggest that the relationship among clinical support, compliance with BPSD protocols, and clinical outcomes for residents and staff is complex and needs further investigation.