Skip to main content
Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research 6/2019

26.07.2019 | Original Article

Interactions Between Clinician and Organizational Characteristics to Predict Cognitive-Behavioral and Psychodynamic Therapy Use

verfasst von: Emily M. Becker-Haimes, Nathaniel J. Williams, Kelsie H. Okamura, Rinad S. Beidas

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Conceptual models of implementation posit contextual factors and their associations with evidence-based practice (EBP) use at multiple levels and suggest these factors exhibit complex cross-level interactions. Little empirical work has examined these interactions, which is critical to advancing causal implementation theory and optimizing implementation strategy design. Mixed effects regression examined cross-level interactions between clinician (knowledge, attitudes) and organizational characteristics (culture, climate) to predict cognitive-behavioral and psychodynamic therapy use with youth (N = 247 clinicians across 28 agencies). Results indicated several interactions, highlighting the importance of attending to interactions between variables at multiple levels to advance multilevel implementation theory and strategies.
Fußnoten
1
As the high number of predictors and interactions may stretch the limits of the sample size and increases risk for multicollinearity, we also tested each interaction independently. Results were largely unchanged, suggesting we retain the overall models for parsimony. Inter-correlations between subscales of the EBPAS were small to moderate (all r < .33) further supporting the decision to retain the overall models. Inter-correlations between organizational proficiency and implementation climate were high (r = .50), suggesting each organizational variable be examined separately.
 
Literatur
Zurück zum Zitat Aarons, G. A., Ehrhart, M. G., Farahnak, L. R., & Hurlburt, M. S. (2015). Leadership and organizational change for implementation (LOCI): A randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation. Implementation Science, 10(1), 11. https://doi.org/10.1186/s13012-014-0192-y.CrossRefPubMed Aarons, G. A., Ehrhart, M. G., Farahnak, L. R., & Hurlburt, M. S. (2015). Leadership and organizational change for implementation (LOCI): A randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation. Implementation Science, 10(1), 11. https://​doi.​org/​10.​1186/​s13012-014-0192-y.CrossRefPubMed
Zurück zum Zitat Aarons, G. A., Glisson, C., Green, P. D., Hoagwood, K., Kelleher, K. J., & Landsverk, J. A. (2012). The organizational social context of mental health services and clinician attitudes toward evidence-based practice: A United States national study. Implementation Science, 7(1), 56. https://doi.org/10.1186/1748-5908-7-56.CrossRefPubMed Aarons, G. A., Glisson, C., Green, P. D., Hoagwood, K., Kelleher, K. J., & Landsverk, J. A. (2012). The organizational social context of mental health services and clinician attitudes toward evidence-based practice: A United States national study. Implementation Science, 7(1), 56. https://​doi.​org/​10.​1186/​1748-5908-7-56.CrossRefPubMed
Zurück zum Zitat Beidas, R. S., Williams, N. J., Green, P. D., Aarons, G. A., Becker-Haimes, E. M., Evans, A. C., … & Marcus, S. C. (2018). Concordance between administrator and clinician ratings of organizational culture and climate. Administration and Policy in Mental Health and Mental Health Services Research, 45(1), 142-151. https://doi.org/10.1007/s10488-016-0776-8 CrossRef Beidas, R. S., Williams, N. J., Green, P. D., Aarons, G. A., Becker-Haimes, E. M., Evans, A. C., … & Marcus, S. C. (2018). Concordance between administrator and clinician ratings of organizational culture and climate. Administration and Policy in Mental Health and Mental Health Services Research45(1), 142-151. https://​doi.​org/​10.​1007/​s10488-016-0776-8 CrossRef
Zurück zum Zitat Benjamin Wolk, C., Marcus, S. C., Weersing, V. R., Hawley, K. M., Evans, A. C., Hurford, M. O., et al. (2016). Therapist-and client-level predictors of use of therapy techniques during implementation in a large public mental health system. Psychiatric Services, 67(5), 551–557.CrossRef Benjamin Wolk, C., Marcus, S. C., Weersing, V. R., Hawley, K. M., Evans, A. C., Hurford, M. O., et al. (2016). Therapist-and client-level predictors of use of therapy techniques during implementation in a large public mental health system. Psychiatric Services, 67(5), 551–557.CrossRef
Zurück zum Zitat Brookman-Frazee, L., Haine, R. A., Baker-Ericzén, M., Zoffness, R., & Garland, A. F. (2010). Factors associated with use of evidence-based practice strategies in usual care youth psychotherapy. Administration and Policy in Mental Health and Mental Health Services Research, 37(3), 254–269. https://doi.org/10.1007/s10488-009-0244-9.CrossRefPubMed Brookman-Frazee, L., Haine, R. A., Baker-Ericzén, M., Zoffness, R., & Garland, A. F. (2010). Factors associated with use of evidence-based practice strategies in usual care youth psychotherapy. Administration and Policy in Mental Health and Mental Health Services Research, 37(3), 254–269. https://​doi.​org/​10.​1007/​s10488-009-0244-9.CrossRefPubMed
Zurück zum Zitat Creed, T. A., Wolk, C. B., Feinberg, B., Evans, A. C., & Beck, A. T. (2016). Beyond the label: Relationship between community therapists’ self-report of a cognitive behavioral therapy orientation and observed skills. Administration and Policy in Mental Health and Mental Health Services Research, 43(1), 36–43. https://doi.org/10.1007/s10488-014-0618-5.CrossRefPubMed Creed, T. A., Wolk, C. B., Feinberg, B., Evans, A. C., & Beck, A. T. (2016). Beyond the label: Relationship between community therapists’ self-report of a cognitive behavioral therapy orientation and observed skills. Administration and Policy in Mental Health and Mental Health Services Research, 43(1), 36–43. https://​doi.​org/​10.​1007/​s10488-014-0618-5.CrossRefPubMed
Zurück zum Zitat Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), 50. https://doi.org/10.1186/1748-5908-4-50.CrossRefPubMed Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), 50. https://​doi.​org/​10.​1186/​1748-5908-4-50.CrossRefPubMed
Zurück zum Zitat Egger, N., Konnopka, A., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., … & Wiltink, J. (2016). Long‐term cost‐effectiveness of cognitive behavioral therapy versus psychodynamic therapy in social anxiety disorder. Depression and Anxiety, 33(12), 1114-1122. https://doi.org/10.1002/da.22540 CrossRef Egger, N., Konnopka, A., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., … & Wiltink, J. (2016). Long‐term cost‐effectiveness of cognitive behavioral therapy versus psychodynamic therapy in social anxiety disorder. Depression and Anxiety33(12), 1114-1122. https://​doi.​org/​10.​1002/​da.​22540 CrossRef
Zurück zum Zitat Glisson, C., Landsverk, J., Schoenwald, S., Kelleher, K., Hoagwood, K. E., Mayberg, S., et al. (2008). Assessing the organizational social context (OSC) of mental health services: Implications for research and practice. Administration and Policy in Mental Health and Mental Health Services Research, 35(1–2), 98. https://doi.org/10.1007/s10488-007-0148-5.CrossRefPubMed Glisson, C., Landsverk, J., Schoenwald, S., Kelleher, K., Hoagwood, K. E., Mayberg, S., et al. (2008). Assessing the organizational social context (OSC) of mental health services: Implications for research and practice. Administration and Policy in Mental Health and Mental Health Services Research, 35(1–2), 98. https://​doi.​org/​10.​1007/​s10488-007-0148-5.CrossRefPubMed
Zurück zum Zitat Kolko, D. J., Cohen, J. A., Mannarino, A. P., Baumann, B. L., & Knudsen, K. (2009). Community treatment of child sexual abuse: A survey of practitioners in the National Child Traumatic Stress Network. Administration and Policy in Mental Health and Mental Health Services Research, 36(1), 37–49. https://doi.org/10.1007/s10488-008-0180-0.CrossRefPubMed Kolko, D. J., Cohen, J. A., Mannarino, A. P., Baumann, B. L., & Knudsen, K. (2009). Community treatment of child sexual abuse: A survey of practitioners in the National Child Traumatic Stress Network. Administration and Policy in Mental Health and Mental Health Services Research, 36(1), 37–49. https://​doi.​org/​10.​1007/​s10488-008-0180-0.CrossRefPubMed
Zurück zum Zitat Lyon, A. R., Ludwig, K., Romano, E., Leonard, S., Vander Stoep, A., & McCauley, E. (2013). “If it’s worth my time, I will make the time”: School-based providers’ decision-making about participating in an evidence-based psychotherapy consultation program. Administration and Policy in Mental Health and Mental Health Services Research, 40(6), 467–481. https://doi.org/10.1007/s10488-013-0494-4.CrossRefPubMed Lyon, A. R., Ludwig, K., Romano, E., Leonard, S., Vander Stoep, A., & McCauley, E. (2013). “If it’s worth my time, I will make the time”: School-based providers’ decision-making about participating in an evidence-based psychotherapy consultation program. Administration and Policy in Mental Health and Mental Health Services Research, 40(6), 467–481. https://​doi.​org/​10.​1007/​s10488-013-0494-4.CrossRefPubMed
Zurück zum Zitat Olin, S. S., Williams, N., Pollock, M., Armusewicz, K., Kutash, K., Glisson, C., et al. (2014). Quality indicators for family support services and their relationship to organizational social context. Administration and Policy in Mental Health and Mental Health Services Research, 41(1), 43–54. https://doi.org/10.1007/s10488-013-0499-z.CrossRefPubMed Olin, S. S., Williams, N., Pollock, M., Armusewicz, K., Kutash, K., Glisson, C., et al. (2014). Quality indicators for family support services and their relationship to organizational social context. Administration and Policy in Mental Health and Mental Health Services Research, 41(1), 43–54. https://​doi.​org/​10.​1007/​s10488-013-0499-z.CrossRefPubMed
Zurück zum Zitat Powell, B. J., Beidas, R. S., Rubin, R. M., Stewart, R. E., Wolk, C. B., Matlin, S. L., et al. (2016). Applying the policy ecology framework to Philadelphia’s behavioral health transformation efforts. Administration and Policy in Mental Health and Mental Health Services Research, 43(6), 909–926. https://doi.org/10.1007/s10488-016-0733-6.CrossRefPubMed Powell, B. J., Beidas, R. S., Rubin, R. M., Stewart, R. E., Wolk, C. B., Matlin, S. L., et al. (2016). Applying the policy ecology framework to Philadelphia’s behavioral health transformation efforts. Administration and Policy in Mental Health and Mental Health Services Research, 43(6), 909–926. https://​doi.​org/​10.​1007/​s10488-016-0733-6.CrossRefPubMed
Zurück zum Zitat Powell, B. J., Mandell, D. S., Hadley, T. R., Rubin, R. M., Evans, A. C., Hurford, M. O., et al. (2017). Are general and strategic measures of organizational context and leadership associated with knowledge and attitudes toward evidence-based practices in public behavioral health settings? A cross-sectional observational study. Implementation Science, 12(1), 64. https://doi.org/10.1186/s13012-017-0593-9.CrossRefPubMed Powell, B. J., Mandell, D. S., Hadley, T. R., Rubin, R. M., Evans, A. C., Hurford, M. O., et al. (2017). Are general and strategic measures of organizational context and leadership associated with knowledge and attitudes toward evidence-based practices in public behavioral health settings? A cross-sectional observational study. Implementation Science, 12(1), 64. https://​doi.​org/​10.​1186/​s13012-017-0593-9.CrossRefPubMed
Zurück zum Zitat Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., et al. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76. https://doi.org/10.1007/s10488-010-0319-7.CrossRefPubMed Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., et al. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76. https://​doi.​org/​10.​1007/​s10488-010-0319-7.CrossRefPubMed
Zurück zum Zitat Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, L., … Saul, J. (2008). Bridging the gap between prevention research and practice: The interactive systems framework for dissemination and implementation. American Journal of Community Psychology, 41(3-4), 171-181. https://doi.org/10.1007/s10464-008-9174-z CrossRef Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, L., … Saul, J. (2008). Bridging the gap between prevention research and practice: The interactive systems framework for dissemination and implementation. American Journal of Community Psychology, 41(3-4), 171-181. https://​doi.​org/​10.​1007/​s10464-008-9174-z CrossRef
Zurück zum Zitat Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., … & Weersing, V. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice. American Psychologist, 72(2), 79. https://doi.org/10.1037/a0040360 CrossRef Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., … & Weersing, V. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice. American Psychologist, 72(2), 79. https://​doi.​org/​10.​1037/​a0040360 CrossRef
Zurück zum Zitat Whetten, D. A. (1989). What constitutes a theoretical contribution? Academy of Management Review, 14(4), 490–495.CrossRef Whetten, D. A. (1989). What constitutes a theoretical contribution? Academy of Management Review, 14(4), 490–495.CrossRef
Zurück zum Zitat Williams, N. J., Ehrhart, M. G., Aarons, G. A., Marcus, S. C., & Beidas, R. S. (2018). Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: Cross-sectional and lagged analyses from a 2-year observational study. Implementation Science, 13(1), 85.CrossRef Williams, N. J., Ehrhart, M. G., Aarons, G. A., Marcus, S. C., & Beidas, R. S. (2018). Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: Cross-sectional and lagged analyses from a 2-year observational study. Implementation Science, 13(1), 85.CrossRef
Zurück zum Zitat Williams, N. J., & Glisson, C. (2014a). The role of organizational culture and climate in the dissemination and implementation of empirically supported treatments for youth. In R. Beidas & P. Kendall (Eds.), Dissemination and implementation of evidence based practices in child and adolescent mental health (pp. 61–81). New York: Oxford University Press. Williams, N. J., & Glisson, C. (2014a). The role of organizational culture and climate in the dissemination and implementation of empirically supported treatments for youth. In R. Beidas & P. Kendall (Eds.), Dissemination and implementation of evidence based practices in child and adolescent mental health (pp. 61–81). New York: Oxford University Press.
Zurück zum Zitat Williams, N. J., Glisson, C., Hemmelgarn, A., & Green, P. (2017). Mechanisms of change in the ARC organizational strategy: Increasing mental health clinicians’ EBP adoption through improved organizational culture and capacity. Administration and Policy in Mental Health and Mental Health Services Research, 44(2), 269–283. https://doi.org/10.1007/s10488-016-0742-5.CrossRefPubMed Williams, N. J., Glisson, C., Hemmelgarn, A., & Green, P. (2017). Mechanisms of change in the ARC organizational strategy: Increasing mental health clinicians’ EBP adoption through improved organizational culture and capacity. Administration and Policy in Mental Health and Mental Health Services Research, 44(2), 269–283. https://​doi.​org/​10.​1007/​s10488-016-0742-5.CrossRefPubMed
Zurück zum Zitat Zyzanski, S. J., Flocke, S. A., & Dickinson, L. M. (2004). On the nature and analysis of clustered data. The Annals of Family Medicine, 2(3), 199–200.CrossRef Zyzanski, S. J., Flocke, S. A., & Dickinson, L. M. (2004). On the nature and analysis of clustered data. The Annals of Family Medicine, 2(3), 199–200.CrossRef
Metadaten
Titel
Interactions Between Clinician and Organizational Characteristics to Predict Cognitive-Behavioral and Psychodynamic Therapy Use
verfasst von
Emily M. Becker-Haimes
Nathaniel J. Williams
Kelsie H. Okamura
Rinad S. Beidas
Publikationsdatum
26.07.2019
Verlag
Springer US
Erschienen in
Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 6/2019
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-019-00959-6

Weitere Artikel der Ausgabe 6/2019

Administration and Policy in Mental Health and Mental Health Services Research 6/2019 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.