Abstract
Implementation initiatives and technology-based resources aim to address barriers to Evidence-Based Practice (EBP) use by creating generalizable techniques that can be used for a variety of youth-serving agencies. However, research has not carefully examined unique differences between agency types or individual programs in readiness to use such technologies and implementation strategies. The current study explored differences between community mental health clinics and child advocacy centers on organizational cultural factors (e.g., ability to change and commitment for change) to implement a novel technology-based toolkit to support delivery of Trauma Focused Cognitive Behavioral Therapy (TF-CBT). Results indicated that TF-CBT providers from child advocacy centers reported greater commitment to change and more support to use the technology-based system than those from community mental health centers. Findings suggest that implementation initiatives should address the needs of individual agencies and service settings and adaptations should be explored to best meet the needs of these settings.
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Aarons, G. A., Green, A. E., Trott, E., Willging, C. E., Torres, E. M., Ehrhart, M. G., & Roesch, S. C. (2016). The roles of system and organizational leadership in system-wide evidence-based intervention sustainment: A mixed-method study. Administration and Policy in Mental Health and Mental Health Services Research, 43(6), 991–1008.
Aarons, Sommerfeld, D. H., & Willging, C. E. (2011). The soft underbelly of system change: the role of leadership and organizational climate in turnover during statewide behavioral health reform. Psychological Services, 8(4), 269–281. https://doi.org/10.1037/a0026196
Aarons, & Sawitzky, A. C. (2006). Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychological Services, 3(1), 61–72. https://doi.org/10.1037/1541-1559.3.1.61
American Psychological Association (2021). Policy statement on evidence-based practice in psychology. Professional practice Guidelines. Retrieved from: https://www.apa.org/practice/guidelines/evidence-based-statement
Anderson, M. (2015). Racial and ethnic differences in how people use mobile technology. Pew Research Center. Retrieved from: https://www.pewresearch.org/fact-tank/2015/04/30/racial-and-ethnic-differences-in-how-people-use-mobile-technology/
Anton, M. T., Ridings, L. E., Hanson, R., Davidson, T., Saunders, B., Price, M., Kmett Danielson, C., Chu, B., Dismuke, C. E., Adams, Z. W., & Ruggiero, K. J. (2020). Hybrid type 1 randomized controlled trial of a tablet-based application to improve quality of care in child mental health treatment. Contemporary clinical trials, 94, 106010. https://doi.org/10.1016/j.cct.2020.106010
ArmenakisHarris, S. G., & Mossholder, K. W. (1993). Creating readiness for organizational change. Human Relations (New York), 46(6), 681–703. https://doi.org/10.1177/001872679304600601
Arthur, Christofides, N., & Nelson, G. (2020). Educators’ perceptions of organisational readiness for implementation of a pre-adolescent transdisciplinary school health intervention for inter-generational outcomes. PLoS ONE, 15(1), e0227519. https://doi.org/10.1371/journal.pone.0227519
Beidas, R. S., Marcus, S., Aarons, G. A., Hoagwood, K. E., Schoenwald, S., Evans, A. C., & Mandell, D. S. (2015). Predictors of community therapists’ use of therapy techniques in a large public mental health system. JAMA Pediatrics, 169(4), 374–382.
Beidas, Williams, N. J., Green, P. D., Aarons, G. A., Becker-Haimes, E. M., Evans, A. C., Rubin, R., Adams, D. R., & Marcus, S. C. (2016). 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
Chambless, & Ollendick, T. H. (2001). Empirically supported psychological interventions: controversies and evidence. Annual Review of Psychology, 52(1), 685–716. https://doi.org/10.1146/annurev.psych.52.1.685
Cheung, & Snowden, lR. (1990). Community mental health and ethnic minority populations. Community Mental Health Journal, 26(3), 277–291. https://doi.org/10.1007/BF00752778
Chorpita, R., Daleiden, E. L., Ebesutani, C., Young, J., Becker, K. D., Nakamura, B. J., Phillips, L., Ward, A., Lynch, R., Trent, L., Smith, R. L., Okamura, K., & Starace, N. (2011). Evidence-based treatments for children and adolescents: an updated review of indicators of efficacy and effectiveness. Clinical Psychology (New York, NY), 18(2), 154–172. https://doi.org/10.1111/j.1468-2850.2011.01247.x
Cohen, M. B., & McWilliams, J. (2020). Overcoming resistance to change. The Palgrave Handbook of Organizational Change Thinkers. https://doi.org/10.1007/978-3-319-49820-1_6-1
Cohen, & Mannarino, A. P. (2016). Evidence based intervention: trauma-focused cognitive behavioral therapy for children and families. Parenting and Family Processes in Child Maltreatment and Intervention. https://doi.org/10.1007/978-3-319-40920-7_6
Cohen, Mannarino, A. P., Perel, J. M., & Staron, V. (2007). A pilot randomized controlled trial of combined trauma-focused cbt and sertraline for childhood ptsd symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 46(7), 811–819. https://doi.org/10.1097/chi.0b013e3180547105
Collyer, Eisler, I., & Woolgar, M. (2019). Systematic literature review and meta-analysis of the relationship between adherence, competence and outcome in psychotherapy for children and adolescents. European Child & Adolescent Psychiatry, 29(4), 417–431. https://doi.org/10.1007/s00787-018-1265-2
Cooke, R.A., & Lafferty, J.C. (1989). Organizational culture inventory. Plymouth, MI: Human Synergistics.
Cooke, & Szumal, J. L. (1993). Measuring normative beliefs and shared behavioral expectations in organizations: the reliability and validity of the organizational culture inventory. Psychological Reports, 72(3_suppl), 1299–1330. https://doi.org/10.2466/pr0.1993.72.3c.1299
Donker, Petrie, K., Proudfoot, J., Clarke, J., Birch, M.-R., & Christensen, H. (2013). Smartphones for smarter delivery of mental health programs: a systematic review. Journal of Medical Internet Research, 15(11), e247–e247. https://doi.org/10.2196/jmir.2791
Farahnak, L. R., Ehrhart, M. G., Torres, E. M., & Aarons, G. A. (2019). The influence of transformational leadership and leader attitudes on subordinate attitudes and implementation success. Journal of Leadership & Organizational Studies, 27(1), 98–111. https://doi.org/10.1177/1548051818824529
Feldman, S. P. (1993). How organizational culture can affect innovation. In L. Hirschhorn & C. K. E. Barnett (Eds.), The psychodynamics of organizations: Labor and social change (pp. 85–97). Temple University Press.
Glisson, C., & James, L. R. (2002). The cross-level effects of culture and climate in human service teams. Journal of Organizational Behavior, 23(6), 767–794. https://doi.org/10.1002/job.162
Glisson, C., & Williams, N. J. (2015). Assessing and changing organizational social contexts for effective mental health services. Annual Review of Public Health, 36(1), 507–523.
Hanson, R. F., Saunders, B. E., Peer, S. O., Ralston, E., Moreland, A. D., Schoenwald, S. K., & Chapman, J. (2018). Community-based learning collaboratives and participant reports of interprofessional collaboration, barriers to and utilization of child trauma services. Child & Youth Services Review, 94, 206–314. https://doi.org/10.1016/j.childyouth.2081.09.038
Hanson, R. F., Schoenwald, S., Saunders, B. E., Chapman, J., Palinkas, L. A., Moreland, A. D., & Dopp, A. (2016). Testing the community-based learning collaborative (CBLC) implementation model: A study protocol. International Journal of Mental Health Systems. https://doi.org/10.1186/s13033-016-0084-4
Hantsoo, Criniti, S., Khan, A., Moseley, M., Kincler, N., Faherty, L. J., Epperson, C. N., & Bennett, I. M. (2018). A mobile application for monitoring and management of depressed mood in a vulnerable pregnant population. Psychiatric Services (Washington, DC), 69(1), 104–107. https://doi.org/10.1176/appi.ps.201600582
Heck, N. C., Saunders, B. E., & Smith, D. W. (2015). Web-based training for an evidence-supported treatment: Training completion and knowledge acquisition in a global sample of learners. Child Maltreatment, 20(3), 183–192.
Helseth, S. A., Peer, S. O., Are, F., Korell, A. M., Saunders, S. K., Chapman, J. E., & Hanson, R. F. (2020). Sustainment of trauma-focused and evidence-based practices following learning collaborative implementation. Administration and Policy in Mental Health and Mental Health Services Research. https://doi.org/10.1007/s10488-020-01024-3
Herbert, Walsh, W., & Bromfield, L. (2018). A national survey of characteristics of child advocacy centers in the United States: Do the flagship models match those in broader practice? Child Abuse & Neglect, 76, 583–595. https://doi.org/10.1016/j.chiabu.2017.09.030
Kazdin, A. E. (2018). Annual research review: Expanding mental health services through novel models of intervention delivery. Journal of Child Psychology and Psychiatry, 60(4), 455–472. https://doi.org/10.1111/jcpp.12937
NCA’s standards for accredited members. (2021). National Children’s Alliance. https://www.nationalchildrensalliance.org/ncas-standards-for-accredited-members/
Powell, Beidas, R. S., Lewis, C. C., Aarons, G. A., McMillen, J. C., Proctor, E. K., & Mandell, D. S. (2015). Methods to improve the selection and tailoring of implementation strategies. The Journal of Behavioral Health Services & Research, 44(2), 177–194. https://doi.org/10.1007/s11414-015-9475-6
Powell, Fernandez, M. E., Williams, N. J., Aarons, G. A., Beidas, R. S., Lewis, C. C., McHugh, S. M., & Weiner, B. J. (2019). Enhancing the impact of implementation strategies in healthcare: a research agenda. Frontiers in Public Health, 7, 3–3. https://doi.org/10.3389/fpubh.2019.00003
Rosenbaum, Piers, A. D., Schumacher, L. M., Kase, C. A., & Butryn, M. L. (2017). Racial and ethnic minority enrollment in randomized clinical trials of behavioural weight loss utilizing technology: a systematic review. Obesity Reviews, 18(7), 808–817. https://doi.org/10.1111/obr.12545
Ruggiero, Saunders, B. E., Davidson, T. M., Lewsky Cook, D., & Hanson, R. (2017). Leveraging technology to address the quality chasm in children’s evidence-based psychotherapy. Psychiatric Services (Washington, DC), 68(7), 650–652. https://doi.org/10.1176/appi.ps.201600548
Sashkin, M., & Flumer, R. (1985). Pillars of excellence: Organizational beliefs questionnaire. Organizational Design and Development, Bryn Mawr, PA.
Shea, C. M., Jacobs, S. R., Esserman, D. A., Bruce, K., & Weiner, B. J. (2014). Organizational readiness for implementing change: A psychometric assessment of a new measure. Implementation Science. https://doi.org/10.1186/1748-5908-9-7
Spring, B. (2007). Evidence-based practice in clinical psychology: What it is, why it matters; what you need to know. Journal of Clinical Psychology, 63(7), 611–631. https://doi.org/10.1002/jclp.20373
US Center for Mental Health Services. (2011). The comprehensive community mental health services for children and their families program: evaluation findings; Annual report to Congress, Retrieved from: https://store.samhsa.gov/system/ files/pep13-cmhi2011.pdf
Weisel, Fuhrmann, L. M., Berking, M., Baumeister, H., Cuijpers, P., & Ebert, D. D. (2019). Standalone smartphone apps for mental health—a systematic review and meta-analysis. NPJ Digital Medicine, 2(1), 1–10. https://doi.org/10.1038/s41746-019-0188-8
Xenikou, & Furnham, A. (1996). A correlational and factor analytic study of four questionnaire measures of organizational culture. Human Relations (New York), 49(3), 349–371. https://doi.org/10.1177/001872679604900305
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This study was supported by National Institute of Mental Health (NIMH) Grant R01 MH110620-01A1 (PI: Ruggiero). Views expressed herein are those of the authors and do not necessarily reflect those of NIMH or respective institutions.
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Shanholtz, C.E., Ridings, L.E., Espeleta, H.C. et al. A Comparison of the Readiness of Youth Service Agencies to Implement a Technology-Based Toolkit to Support Treatment Delivery. Community Ment Health J 59, 1163–1171 (2023). https://doi.org/10.1007/s10597-023-01099-w
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DOI: https://doi.org/10.1007/s10597-023-01099-w