Category: Dissemination / Implementation

Symposium

Therapist, Client, and Session Process Characteristics Associated with Evidence-Based Practice Concordant Care

Saturday, November 18
3:45 PM - 5:15 PM
Location: Aqua Salon A & B, Level 3, Aqua Level

Keywords: Implementation | Community-Based Assessment / Intervention | Evidence-Based Practice
Presentation Type: Symposium

There are increasing large-scale endeavors to implement evidence-based practices (EBPs) in publicly-funded service sectors (McHugh & Barlow, 2010). One such effort is the Los Angeles County Department of Mental Health (LACDMH) Prevention Early Intervention (PEI) Transformation, a system-driven initiative in which implementation support was provided for six practices to address a range of child MH problems. Identifying predictors of therapist practice delivery is essential, particularly within large systems of care that are implementing multiple EBPs.


This study examined therapist, client, and session process characteristics as predictors of the extent to which therapists report delivering strategies considered essential to EBPs for a given clinical program using the Bimonthly Therapist Report EBP Concordant Care Assessment (ECCA). The ECCA has 34 items that represent four EBP Target Composites: 1) Trauma 2) Conduct 3) Anxiety 4) Depression. Participants were 668 therapists (88% female; 43% Hispanic; 86% Master’s level) delivering care through the LACDMH PEI Transformation and completed the ECCA about their service delivery with a client over two months.


Multilevel models revealed that therapist, client, and session process factors were significantly associated with EBP concordant care for Trauma and Conduct cases after accounting for agency-level variance. Specifically, more fully carrying out session activities as intended, more in-session expressed client barriers (e.g., expressing concerns), and favorable perceptions of Trauma and Conduct EBPs were associated with greater Trauma and Conduct concordant care. Additionally, training in a fewer number of practices, more disengaged client barriers (e.g., avoiding participation), Latino therapists, and caregiver involvement related to higher Trauma concordant care. Lastly, therapists who had clients younger than 12 years reported greater Conduct concordant care.


Results suggest that therapist delivery of EBP concordant care is impacted by some shared therapy process features but also unique client and therapist characteristics depending on the MH target that is the focus of practice delivery. 

Nicole Stadnick

Assistant Project Scientist
University of California, San Diego

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