BackgroundEvidence-based treatments (EBTs) are available for treating childhood behavioral health challenges. Despite EBTs’ potential to help children and families, they have primarily remained in university settings. Little empirical evidence exists regarding how specific, commonly used training and quality control models are effective in changing practice, achieving full implementation, and supporting positive client outcomes.Methods/designThis study (NIMH RO1 MH095750; ClinicalTrials.gov Identifier: NCT02543359), which is currently in progress, will evaluate the effectiveness of three training models (Learning Collaborative (LC), Cascading Model (CM), and Distance Education (DE)) to implement a well-established EBT , Parent-Child Interaction Therapy, in real-world, community settings. The three models differ in their costs, skill training, quality control methods, and capacity to address broader implementation challenges. The project is guided by three specific aims: (1) to build knowledge about training outcomes, (2) to build knowledge about implementation outcomes, and (3) to test the differential impact of training clinicians using LC, CM, and DE models on key client outcomes. Fifty (50) licensed psychiatric clinics across Pennsylvania were randomized to one of the three training conditions: (1) LC, (2) CM, or (3) DE. The impact of training on practice skills (clinician level) and implementation/sustainment outcomes (clinic level) are being evaluated at four timepoints coinciding with the training schedule: baseline, 6 (mid), 12 (post), and 24 months (1 year follow-up). Immediately after training begins, parent–child dyads (client level) are recruited from the caseloads of participating clinicians. Client outcomes are being assessed at four timepoints (pre-treatment, 1, 6, and 12 months after the pre-treatment).DiscussionThis proposal builds on an ongoing initiative to implement an EBT statewide. A team of diverse stakeholders including state policy makers, payers, consumers, service providers, and academics from different, but complementary areas (e.g., public health, social work, psychiatry), has been assembled to guide the research plan by incorporating input from multidimensional perspective.Trial registrationClinicalTrials.gov: NCT02543359

Children’s emotion dysregulation, children’s appraisals, maternal psychological functioning, and harsh discipline were investigated as potential mediators in the putative link between exposure to intimate partner violence and poor child outcomes. Participants included 132 children ages 6–8 and their mothers who had been enrolled in a longitudinal study of parenting and children’s social development. The mothers were receiving some form of government-based economic assistance or other social services, and were currently involved in a romantic relationship. Results of structural equation modeling indicated children’s emotion dysregulation mediated the links between exposure to IPV and both internalizing and externalizing problems. Harsh discipline mediated the link between exposure to IPV and externalizing, but not internalizing, symptoms. Child appraisals and maternal psychological functioning mediated the link between exposure to IPV and internalizing, but not externalizing, symptoms.

BackgroundIn recent decades, evidence-based practices (EBPs) have been broadly promoted in community behavioural health systems in the United States of America, yet reported EBP penetration rates remain low. Determining how to systematically sustain EBPs in complex, multi-level service systems has important implications for public health. This study examined factors impacting the sustainability of parent-child interaction therapy (PCIT) in large-scale initiatives in order to identify potential predictors of sustainment.MethodsA mixed-methods approach to data collection was used. Qualitative interviews and quantitative surveys examining sustainability processes and outcomes were completed by participants from 12 large-scale initiatives.ResultsSustainment strategies fell into nine categories, including infrastructure, training, marketing, integration and building partnerships. Strategies involving integration of PCIT into existing practices and quality monitoring predicted sustainment, while financing also emerged as a key factor.ConclusionsThe reported factors and strategies impacting sustainability varied across initiatives; however, integration into existing practices, monitoring quality and financing appear central to high levels of sustainability of PCIT in community-based systems. More detailed examination of the progression of specific activities related to these strategies may aide in identifying priorities to include in strategic planning of future large-scale initiatives.Trial registrationClinicalTrials.gov ID NCT02543359; Protocol number PRO12060529.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-017-0230-8) contains supplementary material, which is available to authorized users.

Objective: Problematic maternal alcohol use confers risk for child maltreatment, though the effect on specific aspects of parenting is unclear. This study examined concurrent and prospective links among maternal alcohol use history, care neglect, supervisory neglect, and harsh or inconsistent discipline. Method: Multimethod multisource data were utilized to assess deficient parenting in 311 economically disadvantaged mothers at high risk of child maltreatment. Structural equation modeling was used to test hypothesized relations. Results: Maternal history of alcohol use was associated with more inconsistent discipline and higher levels of subsequent supervisory neglect. Secondary analyses among two-parent families found that paternal substance misuse was associated with maternal care neglect and poor supervision. Conclusions: Among low socioeconomic status families, maternal alcohol use increases the risk of inconsistent discipline and inadequate supervision. Inconsistent discipline may also lead to punitive parenting practices. Given the potential effect of paternal substance use on maternal parenting, findings highlight the importance of screening all caregivers for substance use in child welfare and research contexts to clarify when and how to intervene most effectively.

Angeles (UCLA) Psychology Clinic and associate adjunct professor of psychology at UCLA. Her research and teaching focus on evidence-based practices in supervision and training. DANIELLE DUNN, MA, is currently a research coordinator in Dr. Bryce McLeod's laboratory at Virginia Commonwealth University. Her research interests center on strategies to increase access and engagement in evidencebased practices (EBPs), and the implementation and sustainment of EBPs in community settings. JACQUELINE HERSH, PhD, is an assistant professor and director of the psychology clinic at Appalachian State University. Her research and professional interests include adapting and tailoring evidence-based treatments, examining factors that may influence manifestation of symptoms and treatment outcomes, as well as supporting underserved populations and student/trainee development. KAREN K. SAULES, PhD, is professor of psychology and director of the psychology training clinic at Eastern Michigan University. Her research interests include the intersection of eating and addictive behaviors, including those related to bariatric surgery outcomes and weight stigma. STEPHANIE R. GRAHAM, PhD, is a clinical professor in the Department of Counseling Psychology at the University of Wisconsin-Madison where she directs the program's training clinic and is also the director of clinical training for the doctoral program. Her research and professional interests include supervision and training in professional psychology and increasing access to mental health services for underserved undergraduate students. DEBORA J. BELL, PhD, is chair of psychological sciences at the University of Missouri. Her research and professional interests include social-cognitive and emotion regulation aspects of youth internalizing adjustment and professional issues in health service psychology education and training. JENNIFER L. HAMES, PhD, is an assistant clinical professor in clinical science at the University of Notre Dame, where she also directs the program's training clinic, the Notre Dame Psychological Services Center. Her research and professional interests include suicidal behavior, evidence-based treatment, and professional issues in health service psychology education and training.