11 research outputs found
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The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study.
UnlabelledABSTBACKGROUND: Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States.MethodsIn-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics.ResultsWe found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice.ConclusionsThe findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes
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Whose Outcomes Come Out? Patterns of Caregiver- and Youth-reported Outcomes Based on Caregiver-youth Baseline Discrepancies
Discrepancies between caregiver and youth reports of emotional and behavioral symptoms are well-documented, with cross-informant correlations often falling in the low to moderate range. Studies have shown that caregiver-youth (dis)agreement in reporting of youth symptoms is related to treatment outcomes. However, commonly used methods for exploring reporter discrepancies (e.g., difference scores) are limited by their inability to assess discrepancies across multiple symptom domains simultaneously, and thus these previous findings do not explore multiple patterns of (dis)agreement.
We used latent profile analysis (LPA) to identify subgroups of clinically referred youths based on patterns of caregiver- and youth-reported internalizing and externalizing symptoms for 174 caregiver-youth dyads. Longitudinal multilevel models were used to examine changes in weekly caregiver- and youth-reported internalizing symptoms, externalizing symptoms, and top problems for identified subgroups.
The LPA identified four latent subgroups: (a) Caregiver Internalizing (9%), (b) Caregiver Internalizing-Externalizing (45%), (c) Youth Internalizing (7%), and (d) Caregiver-Youth Internalizing-Externalizing (39%). Clinical outcomes varied across informants and subgroups. Significant improvements in caregiver- and youth-reported outcome measures were documented within the Caregiver Internalizing, Caregiver Internalizing-Externalizing, and Caregiver-Youth Internalizing-Externalizing subgroups. However, only youth-reported improvements were detected in the Youth Internalizing subgroup. The results show differences in treatment outcomes across caregiver-youth informant subgroups.
These findings suggest how youth and caregiver baseline data could provide guidance for clinicians in interpreting discrepant reporting and its relevance to change during treatment
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Effects of Standard and Modular Psychotherapies in the Treatment of Youth With Severe Irritability
Objective: To examine the preliminary effectiveness of a modular, transdiagnostic, behavioral/cognitive-behavioral intervention (MATCH) compared with standard manualized treatments (SMT) and usual care (UC) for treating youth with severe irritability. Method: We analyzed data from an effectiveness trial in which treatment-referred youths (N = 174; M-age = 10.6 years; 70% boys) were randomized to receive MATCH, SMT, or UC (ns = 53-62). Masked assessments of irritability, diagnoses, impairment, and internalizing, externalizing, total, and top problems were collected from caregivers and youths at pre- and posttreatment, weekly during treatment, and quarterly through 2-year follow-up. Baseline measures of irritability and impairment were used to identify a subsample characterized by severe irritability and mood dysregulation (SIMD; n = 81; M-age = 10.2 years; 69% boys; to = 24-31 across conditions). Longitudinal multilevel models and ANOVAs were estimated to examine numerous clinical outcomes within and between conditions. Results: Among youth with SIMD, MATCH produced faster improvements than UC and SMT, with medium or large effect sizes in two thirds of all comparisons tested (Mdn ES = 0.60). Although SIMD youths in all conditions showed reductions in DSM diagnoses, only MATCH predicted significantly fewer posttreatment diagnoses than UC (averaging 1.0 fewer; FS = 0.93). Finally, among the entire sample, MATCH and SMT equivalently outperformed UC in reducing irritability (FS = 0.49) and the effects of each treatment condition on other outcomes were not moderated by baseline irritability. Conclusions: Extant behavioral/cognitive- behavioral psychotherapies-already well-established and widely used-may be helpful for treating youths with severe irritability. A transdiagnostic, modular format showed the most consistently favorable pattern of results across multiple outcomes, informants, and measurement schedules
The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study
Background
Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States. Methods
In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics. Results
We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice. Conclusions
The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes
Recommended from our members
The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study.
UnlabelledABSTBACKGROUND: Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States.MethodsIn-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics.ResultsWe found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice.ConclusionsThe findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes