IMPLEMENTING EVIDENCE-BASED PRACTICE IN CHILDREN’S MENTAL HEALTH IN RURAL SETTINGS: CLINICIAN AND AGENCY FACTORS

Author

Bethany Leraas, Southern Illinois University CarbondaleFollow

Date of Award

9-1-2020

Degree Name

Master of Arts

Department

Psychology

First Advisor

Fehr, Karla

Abstract

Evidence-based practice (EBP) in children’s mental health has the potential to treat childhood psychological concerns in a more effective and cost-efficient way. Despite the American Psychological Association’s commitment to EBP utilization, current efforts to disseminate and implement EBP into routine care have been slow. This slow uptake may adversely affect children and families by limiting their access to effective care. These consequences may be exacerbated in rural communities due to lack of qualified professionals and resources necessary to implement EBP. Previous research has identified several individual clinician factors and mental health agency characteristics that may influence the success of implementation efforts. These factors include clinician demographic variables (e.g., education level, theoretical orientation, discipline, years of clinical experience, caseload size), clinician attitudes toward EBP, clinician knowledge of EBP, agency characteristics (e.g., setting, size, supervision method, available funding), organizational culture, and organizational climate. The current study investigated how these variables are associated and affect EBP implementation in rural areas. Fifty-five rural mental health providers who provide therapy services to children completed questionnaires assessing current use of EBP, attitudes toward and knowledge of EBP, and agency culture and implementation climate. Results indicated that rural clinicians possessed relatively positive attitudes toward EBP, perceived their organization’s culture and climate as conducive to EBP use, and were just as knowledgeable about EBP as clinicians from urban and mixed rural-urban samples. However, clinician knowledge of evidence-based therapy techniques was not related to EBP utilization. Results also indicated that organizational culture was negatively associated with EBP use and suggests that further research is needed to clarify how clinician and agency variables affect EBP utilization in rural areas. These findings have important implications for EBP training programs. Specifically, extended supervision and consultation models should be incorporated into continuing education workshops and content related to organizational factors (e.g., strategies for fostering an organizational culture and climate conductive to EBP use) should be included. Findings from this study also highlight the need for more effectiveness research to be conducted in rural settings to address the unique barriers experienced by rural clinicians.