Evidence-based practice implementation and staff emotional exhaustion in children's services

Abstract

Understanding the implementation of evidence-based practice (EBP) in community service settings is critical for the successful translation of research to practice. However, we have limited research evidence about the impact of EBP implementation on the mental health and social service workforce.In a previous study we demonstrated reduced staff turnover where an EBP was implemented with fidelity monitoring in the form of supportive ongoing supervision and consultation. Other research has shown that staff burnout and emotional exhaustion in particular is associated with poor quality of care and increased staff turnover intentions and turnover. Current research, however, has focused less on the effects that EBP implementation may have on staff emotional exhaustion. The present study investigates the association of EBP implementation and fidelity monitoring with staff emotional exhaustion in a statewide EBP implementation study. The 21 case management teams in this study were randomized in a 2 (EBP vs. services as usual [SAU]) by 2 (monitoring vs. no monitoring) design. The EBP in this study was SafeCare®, a home-based intervention that aims to reduce child neglect in at-risk families. SafeCare was developed from a behavior analysis approach and is based in cognitive behavioral principles. In keeping with our previous research, we hypothesized that providers implementing SafeCare with monitoring would have the lowest levels of emotional exhaustion and those receiving additional monitoring not in the context of EBP implementation would have higher emotional exhaustion relative to the other groups. Results supported our hypotheses in that we found lower emotional exhaustion for staff implementing the EBP but higher emotional exhaustion for staff receiving only fidelity monitoring and providing SAU. Together, these results suggest a potential staff and organizational benefit to EBP implementation and we discuss implications of the findings relative to EBPs and to fidelity monitoring.

A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings

“…Prior intervention research has even noted lower levels of stress in organizations that have successfully implemented a new EBP with a fidelity monitoring protocol, compared to treatment as usual programs with a new fidelity monitoring protocol (Aarons, Fettes, Flores, & Sornmerfeld, 2009). In the current study, we found that individual-level reports of morale had small to moderate significant positive correlations with three out of our four dependent variables, and that these associations were no longer significant after accounting for multiple constructs in a multivariate model.…”

How Intervention and Implementation Characteristics Relate to Community Therapists’ Attitudes Toward Evidence-Based Practices: A Mixed Methods Study

“…Emotional exhaustion, or feelings of being emotionally overextended and exhausted by one’s work, is a component of workplace burnout (Maslach & Jackson, 1981) linked to turnover intentions and poor job performance (Cropanzano, Rupp, & Byrne, 2003). Encouragingly, child welfare providers who received training and consultation in an EBP had lower rates of emotional exhaustion compared to providers who provided services as usual (Aarons, Fettes, Flores, & Sommerfield, 2009). Aarons and colleagues (2009) attributed these findings to the structure provided by the EBP protocol and the instrumental and emotional support received from consultants on the job.…”

“…Encouragingly, child welfare providers who received training and consultation in an EBP had lower rates of emotional exhaustion compared to providers who provided services as usual (Aarons, Fettes, Flores, & Sommerfield, 2009). Aarons and colleagues (2009) attributed these findings to the structure provided by the EBP protocol and the instrumental and emotional support received from consultants on the job. However, these hypotheses were not empirically tested.…”

Providers’ Attitudes Toward Evidence-Based Practices: Is it Just About Providers, or Do Practices Matter, Too?

“…In addition to yielding superior client outcomes relative to alternative treatments, the uptake of EBPs has been associated with better workforce outcomes, such as reduced burnout, among community providers (Aarons, Fettes, Flores Jr., & Sommerfeld, 2009). A Delphi poll of psychotherapy experts in 2000 predicted that evidence-based psychotherapies would become mandated and, by extension, widely implemented by 2010 (Norcross, Hedges, & Prochaska, 2002).…”