Therapists’ perceptions toward evidence-based practices (EBPs) are important in implementation efforts, however little is known about characteristics of EBPs associated with more positive attitudes. This mixed-methods study examined how intervention and implementation characteristics of six EBPs related to therapist attitudes. Quantitative analysis of 793 cross-sectional surveys revealed that therapists endorsed more positive attitudes toward EBPs with (1) prescribed session content and order and (2) required consultation. Associations between these intervention and implementation characteristics and attitudes were not moderated by therapist experience or emotional exhaustion. Qualitative analyses complemented quantitative findings, indicating that “structure” was appealing for interventions and that therapists felt supported by consultation.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Practices have been de-identified in order to maintain a neutral presentation of data.
Aarons, G. A. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The evidence-based practice attitude scale (EBPAS). Mental Health Services Research, 6, 61–74.
Aarons, G. A., Cafri, G., Lugo, L., & Sawitzky, A. (2012). Expanding the domains of attitudes towards evidence-based practice: the evidence based practice attitude scale-50. Administration and Policy in Mental Health and Mental Health Services Research, 39, 331–340. doi:10.1007/s10488-010-0302-3.
Aarons, G. A., Fettes, D. L., Flores, L. E., & Sommerfeld, D. H. (2009a). Evidence-based practice implementation and staff emotional exhaustion in children’s services. Behaviour Research and Therapy, 47, 954–960. doi:10.1016/j.brat.2009.07.006.
Addis, M. E., Wade, W. A., & Hatgis, C. (1999). Barriers to dissemination of evidence—based practices: Addressing practitioners’ concerns about manual—based psychotherapies. Clinical Psychology: Science and Practice, 6, 430–441.
Addis, M. E., & Krasnow, A. D. (2000). A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. Journal of Consulting and Clinical Psychology, 68, 331–339. doi:10.1037//0022-006X.68.2.331.
Bearman, S. K., Weisz, J. R., Chorpita, B. F., Hoagwood, K., Ward, A., Ugueto, A. M., & Bernstein, A. (2013). More practice, less preach? The role of supervision processes and therapist characteristics in EBP implementation. Administration and Policy in Mental Health, 40, 518–529. http://doi.org/10.1007/s10488-013-0485-5.
Beidas, R. S., Edmunds, J. M., Cannuscio, C. C., Gallagher, M., Downey, M. M., & Kendall, P. C. (2013). Therapists’ perspectives on the effective elements of consultation following training. Administration and Policy in Mental Health, 40, 507–517. doi:10.1007/s10488-013-0475-7.
Beidas, R. S., Edmunds, J., Ditty, M., Watkins, J., Walsh, L., Marcus, S., & Kendall, P. (2014). Are inner context factors related to implementation outcomes in cognitive-behavioral therapy for youth anxiety? Administration and Policy in Mental Health and Mental Health Services Research, 41, 788–799. doi:10.1007/s10488-013-0529-x.
Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: A Publication of the Division of Clinical Psychology of the American Psychological Association, 17, 1–30. doi:10.1111/j.1468-2850.2009.01187.x.
Borntrager, C. F., Chorpita, B. F., Higa-McMillan, C., & Weisz, J. R. (2009). Provider attitudes toward evidence-based practices: Are the concerns with the evidence or with the manuals?. Psychiatric Services, 60, 677–688.
Brookman-Frazee, L., Garland, A. F., Taylor, R., & Zoffness, R. (2009). Therapists’ attitudes towards psychotherapeutic strategies in community-based psychotherapy with children with disruptive behavior problems. Administration and Policy in Mental Health, 36, 1–12. doi:10.1007/s10488-008-0195-6.
Brookman-Frazee, L., Stadnick, N., Roesch, S., Regan, J., Barnett, M., Bando, L., ... & Lau, A (2016). Measuring sustainment of multiple practices fiscally mandated in children’s mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 43, 1009–1022. doi:10.1007/s10488-016-0731-8.
Brookman-Frazee, L. I., Drahota, A., & Stadnick, N. (2012). Training community mental health therapists to deliver a package of evidence-based practice strategies for school-age children with autism spectrum disorders: A pilot study. Journal of Autism and Developmental Disorders, 42, 1651–1661. doi:10.1007/s10803-011-1406-7.
Burgess, A. M., Okamura, K. H., Izmirian, S. C., Higa-McMillan, C. K., Shimabukuro, S., & Nakamura, B. J. (2016). Therapist attitudes towards evidence-based practice: A joint factor analysis. The Journal of Behavioral Health Services & Research, doi:10.1007/s11414-016-9517-8.
Cashel, M. L. (2002). Child and adolescent psychological assessment: Current clinical practices and the impact of managed care. Professional Psychology: Research and Practice, 33, 446–453.
Chorpita, B. F., & Daleiden, E. L. (2009). Mapping evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments from 322 randomized trials. Journal of Consulting and Clinical Psychology, 77, 566–579. doi:10.1037/a0014565.
Chorpita, B. F., Bernstein, A., & Daleiden, E. L. (2011). Empirically guided coordination of multiple evidence-based treatments: An illustration of relevance mapping in children’s mental health services. Journal of Consulting and Clinical Psychology, 79, 470–480. doi:10.1037/a0023982.
Chorpita, B. F., Daleiden, E. L., & Collins, K. S. (2014). Managing and adapting practice: A system for applying evidence in clinical care with youth and families. Clinical Social Work Journal, 42, 134–142. doi:10.1007/s10615-013-0460-3.
Chorpita, B. F., Park, A., Tsai, K., Korathu-Larson, P., Higa-McMillan, C. K., Nakamura, B. J., & Krull, J. (2015). Balancing effectiveness with responsiveness: Therapist satisfaction across different treatment designs in the child STEPs randomized effectiveness trial. Journal of Consulting and Clinical Psychology, 83, 709–718. doi:10.1037/a0039301.
Christian, A. S., Niec, L. N., Acevedo-Polakovich, I. D., & Kassab, V. A. (2014). Dissemination of an evidence-based parenting program: Clinician perspectives on training and implementation. Children and Youth Services Review, 43, 8–17. doi:10.1016/j.childyouth.2014.04.005.
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006).Treating trauma and traumatic grief in children and adolescents. New York, NY: The Guilford Press.
Cook, J. M., Thompson, R., & Schnurr, P. P. (2015). Perceived characteristics of intervention scale development and psychometric properties. Assessment, 22, 704–714. doi:10.1177/1073191114561254.
Cropanzano, R., Rupp, D. E., & Byrne, Z. S. (2003). The relationship of emotional exhaustion to work attitudes, job performance, and organizational citizenship behaviors. Journal of Applied Psychology, 88, 160–169. doi:10.1037/0021-9010.88.1.160.
Edmunds, J. M., Read, K. L., Ringle, V. A., Brodman, D. M., Kendall, P. C., & Beidas, R. S. (2014). Sustaining clinician penetration, attitudes and knowledge in cognitive-behavioral therapy for youth anxiety. Implementation Science, 9, 1–12. doi:10.1186/s13012-014-0089-9.
Funderburk, B. W., Ware, L. M., Altshuler, E., & Chaffin, M. (2008). Use and feasibility of telemedicine technology in the dissemination of parent-child interaction therapy. Child Maltreatment, 13, 377–382. doi:10.1177/1077559508321483.
Glisson, C., Green, P., & Williams, N. J. (2012). Assessing the organizational social context (OSC) of child welfare systems: implications for research and practice. Child Abuse & Neglect, 36, 621–632. doi:10.1016/j.chiabu.2012.06.002.
Glisson, C., Landsverk, J., Schoenwald, S., Kelleher, K., Hoagwood, K. E., Mayberg, S.,. & Research Network on Youth Mental Health. (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, 98–113. doi:10.1007/s10488-007-0148-5.
Godley, S. H., White, W. L., Diamond, G., Passetti, L., & Titus, J. C. (2001). Therapist reactions to manual-guided therapies for the treatment of adolescent marijuana users. Clinical Psychology: Science and Practice, 8, 405–417. doi:10.1093/clipsy.8.4.405.
Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Quarterly, 82, 581–629. doi:10.1111/j.0887-378X.2004.00325.x.
Hamilton, A. (2013). Qualitative methods in rapid turn-around health services research. Retrieved 19 August, 2016 from http://www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/780-notes.pdf. .
Hawley, K. M., Cook, J. R., & Jensen-Doss, A. (2009). Do noncontingent incentives increase survey response rates among mental health providers? A randomized trial comparison. Administration and Policy in Mental Health and Mental Health Services Research, 36, 343–348. doi:10.1007/s10488-009-0225-z.
Hayes, A. F. (2006). A primer on multilevel modeling. Human Communication Research, 32, 385–410. doi:10.1111/j.1468-2958.2006.00281.x.
Herschell, A. D., Kolko, D. J., Baumann, B. L., & Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations. Clinical Psychology Review, 30, 448–466. doi:10.1016/j.cpr.2010.02.005.
Jaycox, L. H. (2003). CBITS: Cognitive behavioral intervention for trauma in schools. Dallas, TX: Sopris West.
Jensen-Doss, A., Hawley, K. M., Lopez, M., & Osterberg, L. D. (2009). Using evidence-based treatments: The experiences of youth providers working under a mandate. Professional Psychology: Research and Practice, 40, 417–424. doi:10.1037/a0014690.
Lau, A. S., & Brookman-Frazee, L. (2016). The 4KEEPS study: Identifying predictors of sustainment of multiple practices fiscally mandated in children’s mental health services. Implementation Science. doi:10.1186/s13012-016-0388-4.
Lieberman, A. F., & Van Horn, P. (2005). Don’t hit my mommy!: A manual for child-parent psychotherapy with young witnesses of family violence. Washington, DC: Zero to Three.
Lim, A., Nakamura, B. J., Higa-McMillan, C. K., Shimabukuro, S., & Slavin, L. (2012). Effects of workshop trainings on evidence-based practice knowledge and attitudes among youth community mental health providers. Behaviour Research and Therapy, 50, 397–406. doi:10.1016/j.brat.2012.03.008.
Los Angeles County Department of Mental Health (2010a). CBITS implementation planning. Retrieved 19 August, 2016 from http://file.lacounty.gov/dmh/cms1_159573.pdf.
Los Angeles County Department of Mental Health (2010b). CPP implementation planning. Retrieved 19 August, 2016 from http://file.lacounty.gov/dmh/cms1_159574.pdf.
Los Angeles County Department of Mental Health (2010c). MAP kickoff meeting: Training and implementation. Retrieved 19 August, 2016 from http://file.lacounty.gov/dmh/cms1_160228.pdf.
Los Angeles County Department of Mental Health (2010d). TF-CBT implementation planning. Retrieved 19 August, 2016 from http://file.lacounty.gov/dmh/cms1_160204.pdf.
Los Angeles County Department of Mental Health (2010e). Triple P implementation planning. Retrieved 19 August, 2016 from http://file.lacounty.gov/dmh/cms1_160228.pdf.
Lyon, A. R., Ludwig, K., Romano, E., Leonard, S., Stoep, A. V., & 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, 40, 467–481. doi:10.1007/s10488-013-0494-4.
Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2, 99–113. doi:10.1002/job.4030020205.
Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. Sage.
Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health, 39, 341–352. doi:10.1007/s10488-011-0352-1.
Nadeem, E., Gleacher, A., & Beidas, R. S. (2013). Consultation as an implementation strategy for evidence-based practices across multiple contexts: Unpacking the black box. Administration and Policy in Mental Health, 40, 439–450. doi:10.1007/s10488-013-0502-8.
Najavits, L. M. (2002). Seeking safety: A treatment manual for PTSD and substance abuse. Guilford Press.
Nakamura, B. J., Higa-McMillan, C. K., Okamura, K. H., & Shimabukuro, S. (2011). Knowledge of and attitudes towards evidence-based practices in community child mental health practitioners. Administration and Policy in Mental Health and Mental Health Services Research, 38, 287–300. doi:10.1007/s10488-011-0351-2.
Nelson, M. M., Shanley, J. R., Funderburk, B. W., & Bard, E. (2012). Therapists’ attitudes toward evidence-based practices and implementation of parent–child interaction therapy. Child Maltreatment, 17, 47–55. doi:10.1177/1077559512436674.
Nelson, T. D., & Steele, R. G. (2007). Predictors of practitioner self-reported use of evidence-based practices: Practitioner training, clinical setting, and attitudes toward research. Administration and Policy in Mental Health and Mental Health Services Research, 34, 319–330. doi:10.1007/s10488-006-0111-x.
Nelson, T. D., Steele, R. G., & Mize, J. A. (2006). Practitioner attitudes toward evidence-based practice: Themes and challenges. Administration and Policy in Mental Health and Mental Health Services Research, 33, 398–409. doi:10.1007/s10488-006-0044-4.
Palinkas, L. A., Aarons, G. A., Horwitz, S., Chamberlain, P., Hurlburt, M., & Landsverk, J. (2011). Mixed method designs in implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 38, 44–53. doi:10.1007/s10488-010-0314-z.
Pemberton, J. R., Conners-Burrow, N. A., Sigel, B. A., Sievers, C. M., Stokes, L. D., & Kramer, T. L. (2015). Factors associated with clinician participation in TF-CBT post-workshop training components. Administration and Policy in Mental Health and Mental Health Services Research, 1–10, doi:10.1007/s10488-015-0677-2.
Piotrowski, C., & Keller, J. W. (1989). Psychological testing in outpatient mental health facilities: A national study. Professional Psychology: Research and Practice, 20, 423.
Reding, M. E., Chorpita, B. F., Lau, A. S., & Innes-Gomberg, D. (2014). Providers’ attitudes toward evidence-based practices: is it just about providers, or do practices matter, too? Administration and Policy in Mental Health and Mental Health Services Research, 41, 767–776. doi:10.1007/s10488-013-0525-1.
Rogers, E. M. (1962). Diffusion of innovations. New York, NY: Free Press.
Rogers, E. M. (2003). Diffusion of innovations (5th edn.). New York, NY: Free Press.
Rosenberg, R. P., & Beck, S. (1986). Preferred assessment methods and treatment modalities for hyperactive children among clinical child and school psychologists. Journal of Clinical Child Psychology, 15, 142–147.
Spradley, J. (1979). The ethnographic interview. New York: Holt, Rinehart and Winston.
Turner, K. M., Markie-Dadds, C., & Sanders, M. R. (2002). Facilitator’s manual for group Triple P (2nd ed. revised). Milton, QLD: Triple P International Pty. Ltd.
Funding supported by NIMH(R01MH100134).
Conflict of interest
Miya Barnett, Lauren Brookman-Frazee, Jennifer Regan, Dana Saifan, Nicole Stadnick, and Anna Lau declare that they have no conflict of interest.
It was obtained from all individual participants included in the study.
Research Involving Human and Animal Participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
About this article
Cite this article
Barnett, M., Brookman-Frazee, L., Regan, J. et al. How Intervention and Implementation Characteristics Relate to Community Therapists’ Attitudes Toward Evidence-Based Practices: A Mixed Methods Study. Adm Policy Ment Health 44, 824–837 (2017). https://doi.org/10.1007/s10488-017-0795-0
- EBP attitudes
- Intervention characteristics
- Implementation characteristics