Effects of Modularized Workshop Trainings on Youth Clinical Progress in a Public Mental Health System

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2020
Authors
McLennan, Priya
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Nakamura, Brad J.
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Psychology
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While progress has been made for properly testing, identifying, and defining, evidence-based practices (EBPs) for specific disorders and populations, there continues to be challenges in bringing these practices into public sector mental health settings. One area that has indicated potential for furthering EBP adoption is expanding our scientific understanding of adapting evidence-based training processes to better suit large community mental health systems. Of particular interest, research has suggested that a modular approach to treatment and training may be a promising method for treatment delivery and useful for helping balance the dialectic between the prescriptive nature sometimes typical of standard EBP approaches and the flexibility often needed in real-world implementation. Given this potential, recent literature has started to examine such modular training effects on therapists’ practice behavior changes. In particular, one study by McLennan, Mueller, Heck, and Nakamura (2019) investigated the results of therapist’s modular training attendance on their use of the trained modular techniques. More explicitly, they found that the effects of training on specific technique implementation were impacted by a variety of factors, including not only traditionally studied therapist and youth factors, but also the type of problem area addressed at the training. Thus, the present investigation aimed to expand upon McLennan et al.’s (2019) findings by examining the extent to which youths’ clinical progress improved as a result of therapists’ attendance at modular workshop trainings. Longitudinal, archival data from community mental health providers (n = 48) who participated in a series of state-sponsored anxiety (ANX) and/or disruptive behavior (DBD) workshops in modular approaches to EBPs for youth in Hawai‘i was examined. A cross-classified multilevel model (level-1: effects of time, level-2: youth factors, and level-3: therapist factors) was used to examine youths’ clinical progress following their therapist’s workshop training attendance. Multiple time-varying, youth, and therapist variables were embedded within the analyses to better understand their potential effect on youth clinical progress. Results indicated that youths’ month in treatment, therapists’ training attendance, and therapists’ practice behaviors (i.e., therapists use of the specific trained techniques and therapists use of additional non-workshop techniques) influenced youths’ clinical progress. However, therapists’ knowledge of the specific trained techniques was not a significant moderator of youth outcomes. Results also demonstrated differential findings based on the problem area addressed at the training. Specifically, therapists’ use of the trained techniques improved youth progress ratings after both the ANX and DBD trainings. However, the rate at which the clients’ progress ratings improved over time was only significant for those therapists who attended the disruptive behavior training. These results suggest that public sector mental health therapists may require differential training and implementation efforts depending on the problem area being addressed in order to maintain trained skills and potentially positively enhance youth treatment outcomes. Study limitation and implications for EBP dissemination and implementation are further discussed.
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Clinical psychology, children’s mental health, clinical progress, dissemination, evidence-based training, implementation, practice element
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169 pages
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