Examining Organizational Factors Fostering a Therapeutic Climate Supporting the Adoption and Use of Evidence-Based Practices for Outpatient Mental Health Clinics Serving Youth

Background: The benefits of incorporating evidence-based practice in mental health settings is well documented. However, many mental health settings continue not to adopt or implement evidence-based practices.  Despite the growing momentum to incorporate evidence-based practices in outpatient mental health settings, the actual adoption and implementation of these practices is slow. An improved understanding of these factors can potentially improve efforts to ensure effective adoption, implementation, and sustainment of evidence-based practices, and thus improve treatment for youth in mental health settings. Research focusing specifically on the factors that facilitate the adoption and implementation of evidence-based practices in mental health settings is greatly needed to inform policymakers, administrators, providers, and researchers about evidence-based success in order to improve care for families in need of services.  Furthermore, a better understanding of innovation adoption in mental health settings will not only lead to the increased adoption of innovation, but also to the greater development of implementation strategies tailored specifically for mental health organizations in the provision of  best practices. Purpose: This study aimed to explore the relationship between organizational climate and adoption of evidenced-based practices among outpatient mental health providers.  Methods: This exploratory cross-sectional study involves secondary analysis of data in a NIMH-funded study of behavioral parent training group intervention, entitled the 4Rs and 2Ss for Strengthening Families.  All participants (n=52) were providers of outpatient child mental health clinics in the New York Metropolitan Area. Organizational climate was measured by the Texas Christian University’s Organizational Readiness for Change (TCU ORC) scale and adoption of evidence-based practices by the Training Exposure and Utilization Scale (TCU).  Data were examined using Structural Equation Modeling (SEM) in Mplus. Results: Of the 52 participants in the sample, the mean age was 41.74 (± 15.18); the majority of the sample identified as White/Caucasian (54%) and non-Hispanic/Latino (56%) and eighty-eight percent held a graduate degree, 83% had a social work license (LSCW or LMSW). SEM findings indicated that a more supportive organizational climate and greater readiness for change related to increased adoption of evidence-based practices among providers.  No significant differences were found in EBP use by provider education, race, ethnicity, license type, employment, payment type, caseload and role. There were, however, significant differences found in EBP use by provider age and number of years in practice. Implications: This study provides important perspectives on the relationship between organizational climate and adoption of evidenced-based practices among outpatient mental health providers. This study conducted formative research that enriched the understanding of the factors influencing the adoption of evidence-based practices in outpatient mental health clinics serving youth.  The improved understanding of these factors can improve efforts to ensure effective adoption, implementation, and sustainment of evidence-based practices and thus improve treatment for youth in mental health settings. This study examined the way in which organizational factors (including organizational climate and organizational readiness for change) affect the adoption and implementation of evidence-based family strengthening approaches in mental health settings serving youth and found a significant relationship.