The Role of Staff Turnover in the Implementation of Evidence-Based Practices in Mental Health Care

Woltmann, Emily M.; Whitley, Rob; McHugo, Gregory J.; Brunette, Mary F.; Torrey, William C.; Daras, Laura Coots; Lynde, David; Drake, Robert E.

doi:10.1176/appi.ps.59.7.732

Cited by 135 publications

(121 citation statements)

References 28 publications

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“…The Delphi approach used by Beehler and colleagues (2013) is an example of mixed methods to achieve development and elaboration. Woltmann et al (2008) used qualitative data obtained through interviews with staff, clinic directors and consultant trainers to create categories of staff turnover and designations of positive, negative and mixed influence of turnover on implementation outcomes. These categories were then quantitatively compared with implementation outcomes via simple tabulations of fidelity and penetration means for each category.…”

Section: Mixed Methodsmentioning

confidence: 99%

Qualitative and Mixed Methods in Mental Health Services and Implementation Research

Palinkas

2014

Journal of Clinical Child & Adolescent Psychology

236

202

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Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research.

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Section: Mixed Methodsmentioning

confidence: 99%

Qualitative and Mixed Methods in Mental Health Services and Implementation Research

Palinkas

2014

Journal of Clinical Child & Adolescent Psychology

236

202

View full text Add to dashboard Cite

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“…Funding levels for most community programs that serve maltreated children do not allow for the costs typically incurred in adopting and adapting a new intervention, including costs associated with lost productivity during training, consultation from trainers, regular model-based supervision, and monitoring of fidelity. Supervisors trained in child trauma EBTs are in short supply and high staff turnover rates can make it difficult to sustain these practices due to the burden of constantly needing to train new staff in a complex intervention (Woltmann et al 2008). Historically underfunded, child abuse service settings may face financial disincentives to adopting EBT since reimbursement is still often determined by the quantity not the quality of services delivered.…”

Section: Introductionmentioning

confidence: 99%

Use of the Breakthrough Series Collaborative to Support Broad and Sustained Use of Evidence-Based Trauma Treatment for Children in Community Practice Settings

Ebert

Amaya-Jackson

Markiewicz

et al. 2011

Adm Policy Ment Health

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Empirically supported treatments for posttraumatic stress reactions in children are not widely available. This observational study evaluates the feasibility and utility of adapting the Institute for Healthcare's Breakthrough Series Collaborative (BSC) to support the broad implementation and sustained use of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in community practice settings. Study findings indicated that agency staff in diverse roles viewed the BSC methodology as a valuable and practicable approach for facilitating skillful delivery of TF-CBT with fidelity. Use of TF-CBT increased over the course of the collaborative and findings from a survey conducted one year later indicated that participating agencies were able to sustain and spread the practice.

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“…These included, for example, implementation strategies , client outcome monitoring ), fidelity Bond et al 2008), and staffing issues (Woltmann et al 2008).…”

Section: Introductionmentioning

confidence: 99%

The Sustainability of Evidence-Based Practices in Routine Mental Health Agencies

Swain

Whitley

McHugo

et al. 2009

Community Ment Health J

167

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The research presented here reports on sustainability of the practices within the National Implementing Evidence Based Practices Project for people with serious mental illness. Forty-nine sites completed the initial 2-year implementation phase and were the focus of our study. Our aims were to discern the number of sites that sustained practices 2 years after implementation, the reasons for sustaining or not sustaining, differences in characteristics between the two groups, and the extent and nature of practice adaptations. We used a mixed-methods approach, based on a telephone survey that gathered qualitative and quantitative data from site representatives and others familiar with the sites and practices during the follow-up period. We found that 80% of sites sustained their practices for 2 years post-implementation, that sustainers differed from non-sustainers in several domains: financing, training, fidelity and agency leadership, and that most sites adapted practices moderately to meet state and local needs.

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The Role of Staff Turnover in the Implementation of Evidence-Based Practices in Mental Health Care

Cited by 135 publications

References 28 publications

Qualitative and Mixed Methods in Mental Health Services and Implementation Research

Qualitative and Mixed Methods in Mental Health Services and Implementation Research

Use of the Breakthrough Series Collaborative to Support Broad and Sustained Use of Evidence-Based Trauma Treatment for Children in Community Practice Settings

The Sustainability of Evidence-Based Practices in Routine Mental Health Agencies

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