Mental Health Provider Reach and Engagement in a Countywide Training Initiative.

Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports. MH providers were offered free 1) formal EBP workshops, 2) a biweekly learning community, 3) individual case consultation, and 4) confidential online clinical feedback system. To register, interested providers (N = 698) completed a web-based assessment measuring clinical practice information, organizational implementation climate, and EBP knowledge, attitudes, and practices. Thirteen providers, selected via purposeful sampling stratified by level of participation, completed semi-structured qualitative interviews. While the training initiative achieved high reach (66% of county agencies had a provider register), far fewer providers engaged substantially in training. Quantitative results indicated that providers whose professional discipline was not psychology, had higher baseline EBP knowledge, more extensive use of common evidence-based strategies, and less extensive use of other therapy strategies, engaged in more training. Rapid qualitative analysis of interviews expanded upon these findings and illuminated provider, organizational, system, practical, and training activity-specific barriers and facilitators to engagement. Findings suggest the importance of identifying strategies for improving provider engagement in training activities beyond workshops. Implications for future research and training initiatives are discussed.

Evidence-Based Treatment Strategies in Youth Mental Health Services: Results from a National Survey of Providers.

Previous surveys indicate infrequent use of evidence-based treatment (EBT) manuals in usual care youth mental health, but the extent to which providers use core and common EBT strategies and what contextual factors impact EBT strategy implementation need further study. In a national, multidisciplinary survey of 1092 youth-serving providers, providers reported regular use of many EBT strategies. Provider learning theory orientation, more recent degree, more standardized and ongoing assessment use, more positive attitudes toward innovation and evidence, fewer low-income clients, and perceptions that their agency valued quality care and provided fewer training resources predicted more frequent EBT strategy use.

Characterizing supervision-as-usual: Findings from two provider surveys.

Although clinical supervision is widely seen as critical for professional training and for safeguarding and promoting client well-being in mental health care, it is understudied, particularly in publicly funded services. In surveys of two large samples of youth mental health service providers (a state sample of providers billing Medicaid [N = 1,057] and a national sample of professional guild members [N = 1,720]), we examined the amount of time providers reported spending in supervision and consultation in a typical workweek and its covariation with characteristics of providers' caseloads and work settings. Across both samples, providers reported spending an average of 2-3 hr per week in supervision. Serving higher percentages of low-income clients was associated with significantly more supervision time. Working in private practice was associated with less supervision, while community mental health and residential facilities were each associated with more supervision time. The national survey also measured providers' perceptions of their current supervision. On average, providers endorsed feeling comfortable with the amount of supervision received and supported by their supervisors. However, working with more low-income clients was associated with greater need for supervisor approval and oversight and with less comfort in the amount of supervision received. Those working with more low-income clientele may benefit from additional supervision time or more focused supervision coverage of the specific needs of clients with low-income. More in-depth research on critical processes and content in supervision is a much-needed future direction for supervision research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).