Adolescent Client and Clinician Predictors of Measurement-Based Care Fidelity in Community Mental Health Settings.

Objective: Regularly administering outcome measures, measurement-based care (MBC), informs clinical decision-making and improves youth mental health. Understanding predictors of high-fidelity MBC delivery helps ensure all youth can benefit from this evidence-based practice. Research on client and clinician predictors of MBC fidelity has mixed findings.

Consultation Content and Techniques for measurement-Based Care Implementation in Youth Community Mental Health Settings.

Measurement-based care (MBC) is an evidence-based practice (EBP) focused on regularly administering outcome measures to clients to inform clinical decision making. While MBC shows promise for improving youth treatment outcomes, therapist adoption remains low. Clinical consultation is one strategy that improves MBC implementation, but our limited understanding of consultation hinders the ability to optimize its impact.

Provider Use of, Attitudes Towards, and Self-efficacy with Key Measurement-based Care Practices in Youth Mental Health Treatment: A Multi-site Examination.

Measurement-based care (MBC) is an underutilized evidence-based practice, and current implementation efforts demonstrate limited success in increasing MBC use. A better understanding of MBC implementation determinants is needed to improve these efforts, particularly from studies examining the full range of MBC practices and that span multiple samples of diverse providers using different MBC systems. This study addressed these limitations by conducting a multi-site survey examining MBC predictors and use in youth treatment.

Clinical Consultation During a Trauma-Focused Cognitive Behavioral Therapy Community-Based Learning Collaborative: Examination of Consultation Content, Consultative Strategies, and Provider Engagement.

Consultation following evidence-based practice (EBP) training enhances the uptake of EBPs. Yet, little is known about what occurs during consultation, and it is often difficult for providers to engage in consultation. This study examined provider engagement in consultation and the content and strategies used during consultation following training in Trauma-focused Cognitive Behavioral Therapy (TF-CBT) as part of a community-based learning collaborative (CBLC).

Consultation as an Implementation Strategy to Increase Fidelity of Measurement-Based Care Delivery in Community Mental Health Settings: An Observational Study.

Regularly administering outcome measures to clients to inform clinical decision making, referred to as measurement-based care (MBC), has the potential to improve mental health treatment due to its applicability across disorders and treatment settings. Given the utility of MBC, understanding predictors of high-fidelity MBC implementation is important. Training and consultation are widely used implementation strategies to increase the fidelity of evidence-based practice delivery but have rarely been studied with MBC.

Characterizing measurement-based care implementation using therapist report.

The effectiveness of measurement-based care (MBC), an evidence-based practice that uses regularly collected assessment data to guide clinical decision-making, is impacted by whether and how therapists use information from MBC tools in treatment. Improved characterization of how therapists use MBC in treatment sessions with youth is needed to guide implementation and understand variability in MBC effectiveness. To meet this need, this study examined therapists' sharing and discussion of MBC in treatment sessions.

External and Internal Validity Considerations in Youth Effectiveness Trials: Lessons Learned from the COMET Study.

Objective: Effectiveness trials aim to increase the generalizability and public health impact of interventions. However, challenges associated with this design present threats to external and internal validity. This paper illustrates these challenges using data from a two-site randomized effectiveness trial, the Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET) and presents recommendations for future research.

CBT+ Training Initiative in Washington State Community Mental Health: An Evaluation of Child Clinical Outcomes.

The Washington State CBT+  Initiative offers a flexible training and consultation approach for community mental health providers in evidence-based practices for four child mental health targets: cognitive behavioral therapy for depression, anxiety, trauma, and behavioral difficulties. As part of consultation, clinicians used an online system to track delivery of treatment components and clinical outcomes using standardized symptom measures. The current study used these clinician-input data to examine symptom change for children using paired sample t-tests.

Perspectives of Nonspecialists Delivering a Brief Depression Treatment in the United States: A Qualitative Investigation.

Background: Task sharing is an implementation strategy which increases access to services by training and supporting treatment delivery by nonspecialists. Such an approach has demonstrated effectiveness for depression and other mental health outcomes; however, few studies in high-income countries have examined nonspecialist providers' (NSPs) perspectives of the acceptability, feasibility, and appropriateness of delivering mental health interventions. We examine qualitative reports of NSPs experiences delivering a brief structured behavioral intervention for depression (called "Do More, Feel Better" [DMFB]) to adults aged 55 and older.

Stakeholder engagement to inform evidence-based treatment implementation for children's mental health: a scoping review.

Background: There is a pervasive mental health treatment gap for children across the globe. Engaging stakeholders in child mental health evidence-based treatment (EBT) implementation projects may increase the likelihood of successful EBT implementation, thereby better addressing the treatment gap. However, little is known about the extent of stakeholder engagement to inform the implementation of child mental health EBTs.

Transitioning to Telehealth for COVID-19 and Beyond: Perspectives of Community Mental Health Clinicians.

In response to COVID-19, mental health clinics transitioned to telehealth to maintain psychotherapy delivery. Community mental health (CMH) settings, which are often under-resourced, likely experienced many barriers. This study examined CMH clinicians' experiences transitioning to telehealth.

The relationship between first-level leadership and inner-context and implementation outcomes in behavioral health: a scoping review.

Background: First-level leadership is uniquely positioned to support evidence-based practice (EBP) implementation for behavioral health due to first-level leaders' access to and relationship with service providers. First-level leaders are individuals who directly supervise and manage frontline employees who do not manage others. However, first-level leadership is underrepresented in existing reviews of the impact of leadership on EBP implementation.

Application of Evidence-Based Treatment in Community Mental Health Settings: Examining EBT Delivery Duration and Client Discharge.

Characterizing community mental health (CMH) treatment duration and discharge is an important step toward understanding how to better meet client needs. This report describes patterns of treatment duration and discharge among clinicians participating in a state-funded evidence-based treatment (EBT) training initiative. After training and consultation, clinicians (N = 376) reported on treatment duration and discharge for their "most complete case.

The impact of implementation climate on community mental health clinicians' attitudes toward exposure: An evaluation of the effects of training and consultation.

Background: Most evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) and anxiety disorders include exposure; however, in community settings, the implementation of exposure lags behind other EBT components. Clinician-level determinants have been consistently implicated as barriers to exposure implementation, but few organizational determinants have been studied. The current study examines an organization-level determinant, implementation climate, and clinician-level determinants, clinician demographic and background factors, as predictors of attitudes toward exposure and changes in attitudes following training.

Lay Counselor Perspectives of Providing a Child-Focused Mental Health Intervention for Children: Task-Shifting in the Education and Health Sectors in Kenya.

The global mental health treatment gap has increasingly been addressed using task-shifting; however, very little research has focused on lay counselors' perspectives on the acceptability, feasibility, and appropriateness of mental health interventions in specific government-supported sectors that might scale up and sustain mental health care for children and adolescents. In western Kenya, these sectors include Education and Health. Data come from a large hybrid effectiveness-implementation study examining implementation practices and policies in either or both sectors that support successful implementation of a child-focused intervention, Trauma-focused Cognitive Behavioral Therapy (TF-CBT), for children and adolescents who had experienced parental death.

Implementing Mental Health Services for Children and Adolescents: Caregiver Involvement in School-Based Care.

Objective: This study compared clinician contact with clients' caregivers by service setting, specifically schools, which are the most common service setting for youths.

Methods: Data were from a state-funded cognitive-behavioral therapy training initiative. Clinicians (N=177) completed pretraining and postconsultation surveys including retrospective reports of caregiver contact and amount of school-based practice.