Top

Published in:

Open Access 01-12-2019 | Psychotherapy | Research

A repeated cross-sectional study of clinicians’ use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia

Authors: Rinad S. Beidas, Nathaniel J. Williams, Emily M. Becker-Haimes, Gregory A. Aarons, Frances K. Barg, Arthur C. Evans, Kamilah Jackson, David Jones, Trevor Hadley, Kimberly Hoagwood, Steven C. Marcus, Geoffrey Neimark, Ronnie M. Rubin, Sonja K. Schoenwald, Danielle R. Adams, Lucia M. Walsh, Kelly Zentgraf, David S. Mandell

Published in: Implementation Science | Issue 1/2019

Abstract

Background

Little work investigates the effect of behavioral health system efforts to increase use of evidence-based practices or how organizational characteristics moderate the effect of these efforts. The objective of this study was to investigate clinician practice change in a system encouraging implementation of evidence-based practices over 5 years and how organizational characteristics moderate this effect. We hypothesized that evidence-based techniques would increase over time, whereas use of non-evidence-based techniques would remain static.

Method

Using a repeated cross-sectional design, data were collected three times from 2013 to 2017 in Philadelphia’s public behavioral health system. Clinicians from 20 behavioral health outpatient clinics serving youth were surveyed three times over 5 years (n = 340; overall response rate = 60%). All organizations and clinicians were exposed to system-level support provided by the Evidence-based Practice Innovation Center from 2013 to 2017. Additionally, approximately half of the clinicians participated in city-funded evidence-based practice training initiatives. The main outcome included clinician self-reported use of cognitive-behavioral and psychodynamic techniques measured by the Therapy Procedures Checklist-Family Revised.

Results

Clinicians were 80% female and averaged 37.52 years of age (SD = 11.40); there were no significant differences in clinician characteristics across waves (all ps > .05). Controlling for organizational and clinician covariates, average use of CBT techniques increased by 6% from wave 1 (M = 3.18) to wave 3 (M = 3.37, p = .021, d = .29), compared to no change in psychodynamic techniques (p = .570). Each evidence-based practice training initiative in which clinicians participated predicted a 3% increase in CBT use (p = .019) but no change in psychodynamic technique use (p = .709). In organizations with more proficient cultures at baseline, clinicians exhibited greater increases in CBT use compared to organizations with less proficient cultures (8% increase vs. 2% decrease, p = .048).

Conclusions

System implementation of evidence-based practices is associated with modest changes in clinician practice; these effects are moderated by organizational characteristics. Findings identify preliminary targets to improve implementation.

Hoagwood KE, Olin SS, Horwitz S, McKay M, Cleek A, Gleacher A, et al. Scaling up evidence-based practices for children and families in New York state: toward evidence-based policies on implementation for state mental health systems. J Clin Child Adolesc Psychol. 2014;43(2):145–57. https://doi.org/10.1080/15374416.2013.869749.CrossRefPubMedPubMedCentral

Bruns EJ, Kerns SE, Pullmann MD, Hensley SW, Lutterman T, Hoagwood KE. Research, data, and evidence-based treatment use in state behavioral health systems, 2001–2012. Psychiatr Serv. 2015;67(5):496–503. https://doi.org/10.1176/appi.ps.201500014.CrossRefPubMedPubMedCentral

Rubin RM, Hurford MO, Hadley T, Matlin SL, Weaver S, Evans AC. Synchronizing watches: the challenge of aligning implementation science and public systems. Admin Pol Ment Health. 2016;43(6):1023–8. https://doi.org/10.1007/s10488-016-0759-9.CrossRef

Regan J, Lau AS, Barnett M, Stadnick N, Hamilton A, Pesanti K, et al. Agency responses to a system-driven implementation of multiple evidence-based practices in children’s mental health services. BMC Health Serv Res. 2017;17(1):671. https://doi.org/10.1186/s12913-017-2613-5.CrossRefPubMedPubMedCentral

Walker SC, Lyon AR, Aos S, Trupin EW. The consistencies and vagaries of the Washington state inventory of evidence-based practice: the definition of “evidence-based” in a policy context. Admin Pol Ment Health. 2017;44(1):42–54. https://doi.org/10.1007/s10488-015-0652-y.CrossRef

Mark DD, Rene’e WL, White JP, Bransford D, Johnson KG, Song VL. Hawaii's statewide evidence-based practice program. Nurs Clin. 2014;49(3):275–90. https://doi.org/10.1016/j.cnur.2014.05.002.CrossRef

Cristofalo MA. Implementation of health and mental health evidence-based practices in safety net settings. Soc Work Health Care. 2013;52(8):728–40. https://doi.org/10.1080/00981389.2013.813003.CrossRefPubMed

Hemmelgarn AL, Glisson C, James LR. Organizational culture and climate: implications for services and interventions research. Clin Psychol. 2006;13(1):73–89. https://doi.org/10.1111/j.1468-2850.2006.00008.x.CrossRef

Okamura KH, Wolk B, Courtney L, Kang-Yi CD, Stewart R, Rubin RM, et al. The price per prospective consumer of providing therapist training and consultation in seven evidence-based treatments within a large public behavioral health system: an example cost-analysis metric. Front Public Health. 2018;5:356. https://doi.org/10.3389/fpubh.2017.00356.CrossRefPubMedPubMedCentral

10.

Powell BJ, Beidas RS, Rubin RM, Stewart RE, Wolk CB, Matlin SL, et al. Applying the policy ecology framework to Philadelphia’s behavioral health transformation efforts. Admin Pol Ment Health. 2016;43(6):909–26. https://doi.org/10.1007/s10488-016-0733-6.CrossRef

11.

Stewart RE, Marcus SC, Hadley TR, Hepburn BM, Mandell DS. State adoption of incentives to promote evidence-based practices in behavioral health systems. Psychiatr Serv. 2018;69(6):685–8. https://doi.org/10.1176/appi.ps.201700508.CrossRefPubMed

12.

Brown CH, Curran G, Palinkas LA, Aarons GA, Wells KB, Jones L, et al. An overview of research and evaluation designs for dissemination and implementation. Annu Rev Public Health. 2017;38:1–22. https://doi.org/10.1146/annurev-publhealth-031816-044215.CrossRefPubMedPubMedCentral

13.

Starin AC, Atkins MS, Wehrmann KC, Mehta T, Hesson-McInnis MS, Marinez-Lora A, et al. Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative. J Clin Child Adolesc Psychol. 2014;43(2):169–78. https://doi.org/10.1080/15374416.2013.848772.CrossRefPubMed

14.

Beidas RS, Aarons GA, Barg F, Evans AC, Hadley T, Hoagwood KE, et al. Policy to implementation: evidence-based practice in community mental health–study protocol. Implement Sci. 2013;8(1):38. https://doi.org/10.1186/1748-5908-8-38.CrossRefPubMedPubMedCentral

15.

Brookman-Frazee L, Stadnick N, Roesch S, Regan J, Barnett M, Bando L, et al. Measuring sustainment of multiple practices fiscally mandated in children’s mental health services. Admin Pol Ment Health. 2016;43(6):1009–22. https://doi.org/10.1007/s10488-016-0731-8.CrossRef

16.

Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Admin Pol Ment Health. 2011;38(1):4–23. https://doi.org/10.1007/s10488-010-0327-7.CrossRef

17.

Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci. 2015;10(1):53. https://doi.org/10.1186/s13012-015-0242-0.CrossRefPubMedPubMedCentral

18.

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4(1):50. https://doi.org/10.1186/1748-5908-4-50.CrossRefPubMedPubMedCentral

19.

Aarons GA, Ehrhart MG, Farahnak LR, Sklar M. Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation. Annu Rev Public Health. 2014;35:255–74. https://doi.org/10.1146/annurev-publhealth-032013-182447.CrossRefPubMedPubMedCentral

20.

Cameron KS, Quinn RE. Diagnosing and changing organizational culture: based on the competing values framework. San Francisco: Wiley; 2011.

21.

Hartnell CA, Ou AY, Kinicki A. Organizational culture and organizational effectiveness: a meta-analytic investigation of the competing values framework's theoretical suppositions. J Appl Psychol. 2011;96(4):677. https://doi.org/10.1037/a0021987.CrossRefPubMed

22.

Brownson RC, Royer C, Ewing R, McBride TD. Researchers and policymakers: travelers in parallel universes. Am J Prev Med. 2006;30(2):164–72. https://doi.org/10.1016/j.amepre.2005.10.004.CrossRefPubMed

23.

Beidas RS, Marcus S, Aarons GA, Hoagwood KE, Schoenwald S, Evans AC, et al. Predictors of community therapists’ use of therapy techniques in a large public mental health system. JAMA Pediatr. 2015;169(4):374–82. https://doi.org/10.1001/jamapediatrics.2014.3736.CrossRefPubMedPubMedCentral

24.

Locke J, Lawson GM, Beidas RS, Aarons GA, Xie M, Lyon AR, et al. Individual and organizational factors that affect implementation of evidence-based practices for children with autism in public schools: a cross-sectional observational study. Implement Sci. 2019;14(1):29. https://doi.org/10.1186/s13012-019-0877-3.CrossRefPubMedPubMedCentral

25.

Guerrero EG, Fenwick K, Kong Y. Advancing theory development: exploring the leadership–climate relationship as a mechanism of the implementation of cultural competence. Implement Sci. 2017;12(1):133. https://doi.org/10.1186/s13012-017-0666-9.CrossRefPubMedPubMedCentral

26.

Williams NJ, Glisson C, Hemmelgarn A, Green P. Mechanisms of change in the ARC organizational strategy: increasing mental health clinicians’ EBP adoption through improved organizational culture and capacity. Admin Pol Ment Health. 2017;44(2):269–83. https://doi.org/10.1007/s10488-016-0742-5.CrossRef

27.

Saldana L, Chamberlain P, Wang W, Brown CH. Predicting program start-up using the stages of implementation measure. Admin Pol Ment Health. 2012;39(6):419–25. https://doi.org/10.1007/s10488-011-0363-y.CrossRef

28.

Lewis CC, Klasnja P, Powell BJ, Tuzzio L, Jones S, Walsh-Bailey C, et al. From classification to causality: advancing understanding of mechanisms of change in implementation science. Front Public Health. 2018;6:136. https://doi.org/10.3389/fpubh.2018.00136.CrossRefPubMedPubMedCentral

29.

Powell BJ, Fernandez ME, Williams NJ, Aarons GA, Beidas RS, Lewis CC, et al. Enhancing the impact of implementation strategies in healthcare: a research agenda. Front Public Health. 2019;7:3. https://doi.org/10.1097/HCO.0000000000000067.CrossRefPubMedPubMedCentral

30.

Williams NJ, Beidas RS. Annual research review: the state of implementation science in child psychology and psychiatry: a review and suggestions to advance the field. J Child Psychol Psychiatry. 2018; https://doi.org/10.1111/jcpp.12960.CrossRef

31.

Chambless DL, Ollendick TH. Empirically supported psychological interventions: controversies and evidence. Annu Rev Psychol. 2001;52(1):685–716. https://doi.org/10.1146/annurev.psych.52.1.685.CrossRefPubMed

32.

Garland AF, Brookman-Frazee L, Hurlburt MS, Accurso EC, Zoffness RJ, Haine-Schlagel R, et al. Mental health care for children with disruptive behavior problems: a view inside therapists' offices. Psychiatr Serv. 2010;61(8):788–95. https://doi.org/10.1176/ps.2010.61.8.788.CrossRefPubMedPubMedCentral

33.

Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognit Ther Res. 2012;36(5):427–40. https://doi.org/10.1007/s10608-012-9476-1.CrossRefPubMedPubMedCentral

34.

Weisz JR, Kuppens S, Ng MY, Eckshtain D, Ugueto AM, Vaughn-Coaxum R, et al. What five decades of research tells us about the effects of youth psychological therapy: a multilevel meta-analysis and implications for science and practice. Am Psychol. 2017;72(2) https://doi.org/10.1037/a0040360.CrossRef

35.

Zhou X, Hetrick SE, Cuijpers P, Qin B, Barth J, Whittington CJ, et al. Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: a systematic review and network meta-analysis. World Psychiatry. 2015;14(2):207–22. https://doi.org/10.1002/wps.20217.CrossRefPubMedPubMedCentral

36.

Abbass AA, Rabung S, Leichsenring F, Refseth JS, Midgley N. Psychodynamic psychotherapy for children and adolescents: a meta-analysis of short-term psychodynamic models. J Am Acad Child Adolesc Psychiatry. 2013;52(8):863–75. https://doi.org/10.1016/j.jaac.2013.05.014.CrossRefPubMed

37.

De Nadai AS, Storch EA. Design considerations related to short-term psychodynamic psychotherapy. J Am Acad Child Adolesc Psychiatry. 2013;52(11):1213–4. https://doi.org/10.1016/j.jaac.2013.08.012.CrossRefPubMed

38.

Steel D. Repeated cross-sectional design. In: Encyclopedia of survery research methods. Edited by Layrakas PJ, vol. 2. Thousand Oaks, CA: SAGE Publications; 2008. p. 714–6.

39.

Stirman SW, Buchhofer R, McLaulin JB, Evans AC, Beck AT. Public-academic partnerships: the Beck initiative: a partnership to implement cognitive therapy in a community behavioral health system. Psychiatr Serv. 2009;60(10):1302–4. https://doi.org/10.1176/ps.2009.60.10.1302.CrossRefPubMedPubMedCentral

40.

Foa EB, Hembree EA, Cahill SP, Rauch SA, Riggs DS, Feeny NC, et al. Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. J Consult Clin Psychol. 2005;73(5):953. https://doi.org/10.1037/0022-006X.73.5.953.CrossRefPubMed

41.

Beidas RS, Adams DR, Kratz HE, Jackson K, Berkowitz S, Zinny A, et al. Lessons learned while building a trauma-informed public behavioral health system in the city of Philadelphia. Eval Program Plann. 2016;59:21–32. https://doi.org/10.1016/j.evalprogplan.2016.07.004.CrossRefPubMedPubMedCentral

42.

Linehan M. DBT skills training manual. New York: Guilford Publications; 2014.

43.

Eyberg S. Parent-child interaction therapy: integration of traditional and behavioral concerns. Child Fam Behav Ther. 1988;10(1):33–46. https://doi.org/10.1300/J019v10n01_04.CrossRef

44.

Skriner LC, Wolk CB, Stewart RE, Adams DR, Rubin RM, Evans AC, et al. Therapist and organizational factors associated with participation in evidence-based practice initiatives in a large urban publicly-funded mental health system. J Behav Health Serv Res. 2017;45(2):174–86. https://doi.org/10.1007/s11414-017-9552-0.CrossRef

45.

Benjamin Wolk C, Marcus SC, Weersing VR, Hawley KM, Evans AC, Hurford MO, et al. Therapist-and client-level predictors of use of therapy techniques during implementation in a large public mental health system. Psychiatr Serv. 2016;67(5):551–7. https://doi.org/10.1176/appi.ps.201500022.CrossRefPubMed

46.

Babbar S, Adams DR, Becker-Haimes EM, Skriner LC, Kratz HE, Cliggitt L, et al. Therapist turnover and client non-attendance. Child Youth Serv Rev. 2018;93:12–6. https://doi.org/10.1016/j.childyouth.2018.06.026.CrossRef

47.

Weersing VR, Weisz JR, Donenberg GR. Development of the therapy procedures checklist: a therapist-report measure of technique use in child and adolescent treatment. J Clin Child Adolesc Psychol. 2002;31(2):168–80. https://doi.org/10.1207/S15374424JCCP3102_03.CrossRefPubMed

48.

Kolko DJ, Cohen JA, Mannarino AP, Baumann BL, Knudsen K. Community treatment of child sexual abuse: a survey of practitioners in the National Child Traumatic Stress Network. Admin Pol Ment Health. 2009;36(1):37–49. https://doi.org/10.1007/s10488-008-0180-0.CrossRef

49.

Do M, Warnick E, Weersing V. Examination of the psychometric properties of the Therapy Procedures Checklist-Family Revised. In: Poster presented at the annual meeting of the Association for Behavioral and Cognitive Therapies (ABCT). MD: National Harbor; 2012.

50.

James LR, Demaree RG, Wolf G. Estimating within-group interrater reliability with and without response bias. J Appl Psychol. 1984;69(1):85. https://doi.org/10.1037/0021-9010.69.1.85.CrossRef

51.

Brown RD, Hauenstein NM. Interrater agreement reconsidered: an alternative to the rwg indices. Organ Res Methods. 2005;8(2):165–84. https://doi.org/10.1177/1094428105275376.CrossRef

52.

Bliese PD. Within-group agreement, non-independence, and reliability: implications for data aggregation and analysis. In: Klein KJ, SWJ K, editors. Multilevel theory, research, and methods in organizations: foundations, extensions, and new directions. San Francisco: Jossey-Bass; 2000. p. 349–81.

53.

Glisson C, Landsverk J, Schoenwald SK, Kelleher K, Hoagwood KE, Mayberg S, et al. Assessing the organizational social context (OSC) of mental health services: implications for research and practice. Admin Pol Ment Health. 2008;35:98–113. https://doi.org/10.1007/s10488-007-0148-5.CrossRef

54.

Williams NJ, Glisson C. Testing a theory of organizational culture, climate and youth outcomes in child welfare systems: a United States national study. Child Abuse Negl. 2014;38(4):757–67. https://doi.org/10.1016/j.chiabu.2013.09.003.CrossRefPubMed

55.

Aarons GA, Glisson C, Green PD, Hoagwood KE, Kelleher KJ, Landsverk JA. The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study. Implement Sci. 2012;7(1):56. https://doi.org/10.1186/1748-5908-7-56.CrossRefPubMedPubMedCentral

56.

Olin SS, Williams NJ, Pollock M, Armusewicz K, Kutash K, Glisson C, et al. Quality indicators for family support services and their relationship to organizational social context. Admin Pol Ment Health. 2014;41(1):43–54. https://doi.org/10.1007/s10488-013-0499-z.CrossRef

57.

Aarons GA, Ehrhart MG, Farahnak LR. The implementation leadership scale (ILS): development of a brief measure of unit level implementation leadership. Implement Sci. 2014;9(1):45. https://doi.org/10.1186/1748-5908-9-45.CrossRefPubMedPubMedCentral

58.

Ehrhart MG, Aarons GA, Farahnak LR. Assessing the organizational context for EBP implementation: the development and validity testing of the implementation climate scale (ICS). Implement Sci. 2014;9(1):157. https://doi.org/10.1186/s13012-014-0157-1.CrossRefPubMedPubMedCentral

59.

Beidas RS, Stewart RE, Adams DR, Fernandez T, Lustbader S, Powell BJ, et al. A multi-level examination of stakeholder perspectives of implementation of evidence-based practices in a large urban publicly-funded mental health system. Admin Pol Ment Health. 2015; https://doi.org/10.1007/s10488-015-0705-2.CrossRef

60.

Beidas RS, Skriner L, Adams D, Wolk CB, Stewart RE, Becker-Haimes E, et al. The relationship between consumer, clinician, and organizational characteristics and use of evidence-based and non-evidence-based therapy strategies in a public mental health system. Behav Res Ther. 2017;99:1–10. https://doi.org/10.1016/j.brat.2017.08.011.CrossRefPubMedPubMedCentral

61.

Aarons GA, Glisson C, Hoagwood KE, Kelleher K, Landsverk J, Cafri G. Psychometric properties and US national norms of the evidence-based practice attitude scale (EBPAS). Psychol Assess. 2010;22(2):356. https://doi.org/10.1037/a0019188.CrossRefPubMed

62.

Garner BR, Godley SH, Bair CM. The impact of pay-for-performance on therapists' intentions to deliver high-quality treatment. J Subst Abus Treat. 2011;41(1):97–103. https://doi.org/10.1016/j.jsat.2011.01.012.CrossRef

63.

Henggeler SW, Chapman JE, Rowland MD, Halliday-Boykins CA, Randall J, Shackelford J, et al. Statewide adoption and initial implementation of contingency management for substance-abusing adolescents. J Consult Clin Psychol. 2008;76(4):556–67. https://doi.org/10.1037/0022-006X.76.4.556.CrossRefPubMedPubMedCentral

64.

Jensen-Doss A, Hawley KM, Lopez M, Osterberg LD. Using evidence-based treatments: the experiences of youth providers working under a mandate. Prof Psychol Res Pr. 2009;40(4):417. https://doi.org/10.1037/a0014690.CrossRef

65.

Williams JR, Williams WO, Dusablon T, Blais MP, Tregear SJ, Banks D. Evaluation of a randomized intervention to increase adoption of comparative effectiveness research by community health organizations. J Behav Health Serv Res. 2014;41(3):308–23. https://doi.org/10.1007/s11414-013-9369-4.CrossRefPubMed

66.

Enders CK. Applied missing data analysis. New York: Guildford Press; 2010.

67.

Raudenbush SW, Bryk AS. Hierarchical linear models: applications and data analysis methods, vol. 1. Thousand Oaks, CA: Sage Publications; 2002.

68.

Raudenbush SW, Bryk AS, Congdon R. HLM 6 for windows. In., 6.08 edn. Lincolnwood: Scientific software international, Inc.; 2004.

69.

Raftery AE. Bayesian model selection in social research. Sociol Methodol. 1995;25:111–64. https://doi.org/10.2307/271063.CrossRef

70.

Rothman K: No adjustments are needed for multiple comparisons. 1990; 1:43–46.

71.

Michels K, Rosner B. Data trawling: to fish or not to fish. Lancet. 1996;348:1152–3. https://doi.org/10.1016/S0140-6736(96)05418-9.CrossRefPubMed

72.

Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B Methodol. 1995;57(1):289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x.CrossRef

73.

Salsberg E, Quigley L, Mehfoud N, Acquaviva KD, Wyche K, Silwa S: Profile of the social work workforce. The George Washington University; 2017. https://www.cswe.org/Centers-Initiatives/Initiatives/National-Workforce-Initiative/SW-Workforce-Book-FINAL-11-08-2017.aspx. Accessed: April 23, 2019.

74.

Williams NJ. Multilevel mechanisms of implementation strategies in mental health: integrating theory, research, and practice. Admin Pol Ment Health. 2016;43(5):783–98. https://doi.org/10.1007/s10488-015-0693-2.CrossRef

75.

Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50(3):217–26. https://doi.org/10.1097/MLR.0b013e3182408812.CrossRefPubMedPubMedCentral

76.

Glisson C, Schoenwald SK, Kelleher K, Landsverk J, Hoagwood KE, Mayberg S, et al. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Admin Pol Ment Health. 2008;35(1–2):124–33. https://doi.org/10.1007/s10488-007-0152-9.CrossRef

77.

Glisson C, Hemmelgarn A, Green P, Williams NJ. Randomized trial of the availability, responsiveness and continuity (ARC) organizational intervention for improving youth outcomes in community mental health programs. J Am Acad Child Adolesc Psychiatry. 2013;52(5):493–500. https://doi.org/10.1016/j.jaac.2012.05.010. CrossRefPubMed

78.

Glisson C. Assessing and changing organizational culture and climate for effective services. Res Soc Work Pract. 2007;17(6):736–47. https://doi.org/10.1177/1049731507301659.CrossRef

79.

Wang V, Maciejewski ML, Helfrich CD, Weiner BJ. Working smarter not harder: coupling implementation to de-implementation. Healthcare. 2018;6:104–7. https://doi.org/10.1016/j.hjdsi.2017.12.004.CrossRefPubMed

80.

McKay VR, Morshed AB, Brownson RC, Proctor EK, Prusaczyk B. Letting go: conceptualizing intervention de-implementation in public health and social service settings. Am J Community Psychol. 2018;62:189–202. https://doi.org/10.1002/ajcp.12258.CrossRefPubMedPubMedCentral

81.

Podsakoff N. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003;88(5):879–903. https://doi.org/10.1037/0021-9010.88.5.879.CrossRefPubMed

82.

Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH behavior change consortium. Health Psychol. 2004;23(5):443–51. https://doi.org/10.1037/0278-6133.23.5.443.CrossRefPubMed

83.

Hogue A, Dauber S, Lichvar E, Bobek M, Henderson CE. Validity of therapist self-report ratings of fidelity to evidence-based practices for adolescent behavior problems: correspondence between therapists and observers. Admin Pol Ment Health. 2015;42(2):229–43. https://doi.org/10.1007/s10488-014-0548-2.CrossRef

84.

Hurlburt MS, Garland AF, Nguyen K, Brookman-Frazee L. Child and family therapy process: concordance of therapist and observational perspectives. Admin Pol Ment Health. 2010;37(3):230–44. https://doi.org/10.1007/s10488-009-0251-x.CrossRef

85.

McHugh RK, Barlow DH. The dissemination and implementation of evidence-based psychological treatments: a review of current efforts. Am Psychol. 2010;65(2):73–84. https://doi.org/10.1037/a0018121.CrossRefPubMed

86.

Aarons GA, Ehrhart MG, Farahnak LR, Hurlburt MS. Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation. Implement Sci. 2015;10(1):11. https://doi.org/10.1186/s13012-014-0192-y.CrossRefPubMedPubMedCentral

Title: A repeated cross-sectional study of clinicians’ use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia
Authors: Rinad S. Beidas
Nathaniel J. Williams
Emily M. Becker-Haimes
Gregory A. Aarons
Frances K. Barg
Arthur C. Evans
Kamilah Jackson
David Jones
Trevor Hadley
Kimberly Hoagwood
Steven C. Marcus
Geoffrey Neimark
Ronnie M. Rubin
Sonja K. Schoenwald
Danielle R. Adams
Lucia M. Walsh
Kelly Zentgraf
David S. Mandell
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Psychotherapy
Published in: Implementation Science / Issue 1/2019
Electronic ISSN: 1748-5908
DOI: https://doi.org/10.1186/s13012-019-0912-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A repeated cross-sectional study of clinicians’ use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia

Abstract

Background

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

The impact of basic vs. enhanced Go NAPSACC on child care centers’ healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory

Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions

Elucidating the influence of supervisors’ roles on implementation climate

Exploring the effect of implementation and context on a stepped-wedge randomised controlled trial of a vital sign triage device in routine maternity care in low-resource settings

Longitudinal assessment of the association between implementation strategy use and the uptake of hepatitis C treatment: Year 2