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Administration and Policy in Mental Health and Mental Health Services Research

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01-11-2019 | Original Article

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

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

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 6/2019

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.

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.

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Title: Interactions Between Clinician and Organizational Characteristics to Predict Cognitive-Behavioral and Psychodynamic Therapy Use
Authors: Emily M. Becker-Haimes
Nathaniel J. Williams
Kelsie H. Okamura
Rinad S. Beidas
Publication date: 01-11-2019
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 6/2019
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-019-00959-6

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

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