Therapists’ Attitudes Toward Evidence-Based Practices and Implementation of Parent–Child Interaction Therapy

Abstract

Child abuse and neglect affects many families each year, but evidence-based parent training programs can be instrumental in reducing maltreatment. Parent-Child Interaction Therapy, a parent training program developed for treatment of disruptive child behavior, has demonstrated effectiveness with families at risk of or exposed to child maltreatment. However, methods for disseminating this evidence-based intervention in community settings are not well understood. This study examined the association between community-based therapists' attitudes toward evidence-based practices (EBPs) and their participation in an implementation research project in which they received two forms of consultation. Results showed that therapists' self-reported unwillingness to diverge from EBPs was positively associated with their use of phone consultation and satisfaction with consultation. The degree to which therapists found EBPs appealing was positively associated with satisfaction as well. Open therapist attitudes toward EBPs were associated with greater attendance for online consultation. The next step in this line of research is to examine how therapists' attitudes toward EBPs can be improved, if changing attitudes affects therapist acquisition of treatment skills, and if such improvements enhance implementation efforts.

Factors Associated with Clinician Participation in TF-CBT Post-workshop Training Components

“…Another attitudinal factor, attitudes toward EBTs, has received mixed results. Shapiro et al (2012), for example, found that these attitudes did not predict intervention use following training, but Nelson et al (2012) found that more positive attitudes did predict increased participation in post-training consultation activities. In terms of more practical considerations, Aarons et al (2009) found that stakeholders listed the potential for EBT training to count toward clinicians' licensure and continuing education credits as an advantage of implementing such treatments, suggesting that this may serve as a facilitator.…”

“…Furthermore, with the exception of Nelson et al (2012) and Fritz et al (2013), few have examined the impact of barriers and facilitators on providers' participation in monitoring activities, which are important in supporting fidelity. The current study addressed these areas by utilizing objective measures of participation in post-workshop training activities aimed at assisting with and monitoring implementation among clinicians who treat children exposed to trauma.…”

“…Monitoring techniques include video or audio session review (Baer et al 2007), session rating sheets or checklists (Schoenwald et al 2000), telephone consultation calls (Simons et al 2010), live remote supervision (Funderburk et al 2008), and in-person learning collaborative activities (Cohen and Mannarino 2008). While all of these techniques have evidence demonstrating that they aid in implementation monitoring, not all trainees choose to participate in such post-training activities (Nelson et al 2012). …”

“…Second, we hypothesized that attitudes toward EBTs and perceptions of barriers would have the strongest predictive effects. This prediction was based on the Nelson et al (2012) and Fritz et al (2013) studies cited above, which focused on post-workshop activities and were thus the most closely related to our investigation. Specifically, Nelson et al found that positive EBT attitudes predicted greater participation in post-workshop consultation activities, and Fritz et al found that barriers such as productivity requirements were the most commonly cited reasons for non-participation in consultation calls.…”

“…Despite the existence of a variety of evidence-based treatments (EBTs) for children's mental health challenges (e.g., Compton et al 2002;Eyberg et al 2008), children and families rarely receive these treatments as part of usual care in the community (Chaffin and Friedrich 2004;Zima et al 2005). In response to this gap, researchers and community agencies have undertaken initiatives to disseminate EBTs into community settings (Aarons et al 2012), which frequently involves training mental health professionals (MHPs) through a face-to-face workshop conducted by a treatment expert (e.g., Cohen and Mannarino 2008;Nelson et al 2012). A one-time training, however, is likely to have only a minimal effect on behavior (Beidas and Kendall 2010;Forsetlund et al 2009;Herschell et al 2010).…”