Using evidence-based treatments: The experiences of youth providers working under a mandate.

Abstract

Whether as clinicians, administrators, or evaluators, psychologists are increasingly involved in efforts to implement evidence-based treatments (EBTs) within clinical practice settings. The state of Texas has undertaken what may be the largest EBT implementation effort to-date. A survey was conducted to understand the experiences of 197 children's service providers working within this effort. Providers' own attitudes toward the EBTs and their perceptions of their colleagues' support for the EBTs were somewhat negative, although they gave positive ratings of the quality of their EBT training and of their agencies' support for the EBTs. Significant, independent predictors of providers' attitudes toward the EBTs included provider views of their colleagues' and their agencies' support for the EBTs, their opinions of the quality of their training in the EBTs, and their perceptions of institutional barriers to EBT use (all ps Ͻ .05). These data suggest that successful implementation may require efforts to obtain buy-in at all organization levels and to provide adequate resources for training in and use of EBTs.

Effects of Workshop Training for Providers Under Mandated Use of an Evidence-Based Practice

“…Indeed, a prior study of RDM providers found that clinicians felt that their clients did not like the EBP protocols (Jensen-Doss et al 2009). The current training did include some focus on engagement strategies, but the amount of attention paid to this domain may not have been sufficient to fully impact client motivation.…”

“…Five content-derived scales assess the following constructs: Provider Attitudes toward EBPs, Colleague Attitudes toward EBPs, Agency Support for Implementation, Barriers to Implementation, and Quality of Training. Internal consistency ranged from a = .69 for Barriers to Implementation to a = .87 for Provider Attitudes toward EBPs in the previous study (Jensen-Doss et al 2009), and ranged from a = .62 to a = .81 in the current study.…”

“…Texas Survey of Provider Characteristics and Attitudes Providers completed the Texas Survey of Provider Characteristics and Attitudes (TX-CHAT), developed for a previous study of RDM clinicians (Jensen-Doss et al 2009). The TX-CHAT measures demographics, current job roles, and previous training.…”

Knowledge of and Attitudes Towards Evidence-Based Practices in Community Child Mental Health Practitioners

“…On the other hand, several studies have not found differences in practitioner attitudes based on level of clinical experience (Brookman-Frazee et al 2009;Nelson and Steele 2008;Stewart and Chambless 2007). Further, with regard to years of training, these researchers found no differences in attitudes whereas in a recent study of practitioners who were mandated to use EBPs for children and adolescents by the state of Texas, Jensen-Doss et al (2009) found that those who are less educated have more favorable attitudes towards EBPs. Jensen-Doss et al (2009) hypothesized that clinicians who have less prior training, knowledge or theoretical orientations upon which to draw might be more open to efforts to implement EBPs.…”

Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth?

“…But the evidence base for treatment guidelines mainly is generated from specific diagnostic and symptom profiles, not the context in which individuals live. There is widespread acceptance of the importance of knowing about, and adopting, evidence-based practices, yet in day-today practice, under pressure from insurance companies and mental health organizations, clinicians must make rapid decisions about what treatment is likely to be most effective for a given client (Jensen-Doss et al 2009;Raghavan et al 2008); limited treatment research has been conducted in everyday practice settings to provide needed guidance for practitioners in the field (Weisz et al 2013). To date, there is little understanding of how clinicians make judgments about treatment effectiveness, and whether they use information beyond diagnostic symptoms to decide on the best treatment strategies.…”