An Examination of Provider Characteristics and Views about Evidence-Based Practices

Background and Purpose: A significant barrier to accessing child mental health treatment is the low rate of the adoption and implementation of Evidence-Based practices (EBP) in outpatient mental health settings. With providers being instrumental in the adoption and implementation of EBPs, it is evident in the literature that many mental health settings struggle.  Data suggest that demographic factors of clients (e.g., age, number of years in the field, license type, and level of education) and provider attitudes about EBPs are associated with utilization of EBPs. The gap between provider knowledge and practice impacts quality of care for youth and families in public mental health settings. This study aims to examine the relationships between provider demographic characteristics, attitudes towards EBPs, organizational readiness for change, and adoption of EBPs in outpatient mental health clinics in New York City.

Methods: Participants included 77 providers to date involved in a NIMH-funded study of a Multiple Family Group (MFG) model within a population of 134 New York State Offices of Mental Health-licensed clinics located within the five boroughs of New York City. MFG is an evidence-informed, family centered, group delivered, manualized intervention that targets known family processes that are associated with the onset and perpetuation of behavior problems in youth. Demographic characteristics of providers were collected by a demographic questionnaire, attitudes towards EBPs by the Evidence-Based Practice Attitude Scale (EBPAS), and organizational readiness for change and training exposure and utilization by the Texas Christian University Organizational Readiness for Change (TCU-ORC). Univariate and bivariate statistics were examined using Independent Samples T-Tests and Chi-Square tests in SPSS 24. 

Results: The majority of providers used EBPs were younger, had a masters, graduate, or nursing degree (83%), a LCSW or LMSW (61%), were paid a salary (66%), and identified as a therapist or clinician (81%).  There were significant differences in the proportions of those who did and did not use EBPs currently in practice and provider age, education, payment type, and role in clinic. Further, providers who reported current use of an EBP endorsed more positive attitudes towards EBPs than those who did not currently use an EBP (t(85)- -2.43, p < .05).  Providers who reported current use of an EBP endorsed greater training exposure and utilization (t(51)= -3.69, p < .01) and self-efficacy within their agency (t(44)= -2.41, p < .05) independently as compared to those who did not use an EBP.

Conclusions and Implications:  Findings pointed towards the implication that provider attitudes about EBPs, self-efficacy in implementation, and agency support of training exposure and utilization independently play roles in the uptake of EBPs in practice.  Continued research on factors that facilitate the adoption and implementation of EBPs in public mental health settings is greatly needed to inform policymakers, administrators, and providers to ultimately improve care.  Furthermore, a better understating of adoption in mental health settings will also contribute to future development of implementation strategies tailored specifically for mental health organizations as to provide best practices.