Bruce F Chorpita, Kimberly D Becker, Alayna L Park, Davielle Lakind, Karen Guan, Maya M Boustani, Meredith R Boyd, Wendy Chu, Eleanor G Wu, Kendra S Knudsen
{"title":"Cultivating evidence-based clinical reasoning and action in youth mental health care: The Reaching Families multisite randomized trial.","authors":"Bruce F Chorpita, Kimberly D Becker, Alayna L Park, Davielle Lakind, Karen Guan, Maya M Boustani, Meredith R Boyd, Wendy Chu, Eleanor G Wu, Kendra S Knudsen","doi":"10.1037/ccp0000939","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Despite decades of policy emphasizing the role of evidence in guiding services, few studies have sought to improve the degree to which evidence is used in supervision and treatment. This study reports supervisor and therapist outcomes from the Reaching Families multisite cluster-randomized controlled trial, which tested the effects of a coordinated knowledge system (CKS) against practice guidelines (PG) on the use of evidence in supervision and treatment targeting low treatment engagement in publicly funded youth community mental health organizations located in two geographically distinct, underresourced communities where service inequities are common.</p><p><strong>Method: </strong>The sample included 121 mental health professionals (92.6% female; 81.0% Black, Indigenous, and people of color1) randomly assigned to a CKS or PG control condition. We recorded, transcribed, and coded 430 supervision and 208 treatment sessions involving 221 youth (Mage = 13.1 years, 46.2% female; 78.7% Black, Indigenous, and people of color) and/or their caregivers who reported engagement concerns during therapy.</p><p><strong>Results: </strong>CKS dyads showed uniformly greater use of evidence focused on specific client needs relative to dyads in the PG condition, with large effect sizes and no differences in the effect of condition across the sites. Secondary analyses showed that tools in the CKS condition were perceived significantly more positively than those in the PG condition in terms of effort and effectiveness, and supervisory workload was the same across both conditions.</p><p><strong>Conclusions: </strong>In routine clinical care delivered within highly representative community settings, a strategically designed knowledge resource can improve evidence-based reasoning and action and be perceived as easy to use and useful without negatively impacting workload. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"93 2","pages":"65-82"},"PeriodicalIF":4.5000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of consulting and clinical psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/ccp0000939","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Despite decades of policy emphasizing the role of evidence in guiding services, few studies have sought to improve the degree to which evidence is used in supervision and treatment. This study reports supervisor and therapist outcomes from the Reaching Families multisite cluster-randomized controlled trial, which tested the effects of a coordinated knowledge system (CKS) against practice guidelines (PG) on the use of evidence in supervision and treatment targeting low treatment engagement in publicly funded youth community mental health organizations located in two geographically distinct, underresourced communities where service inequities are common.
Method: The sample included 121 mental health professionals (92.6% female; 81.0% Black, Indigenous, and people of color1) randomly assigned to a CKS or PG control condition. We recorded, transcribed, and coded 430 supervision and 208 treatment sessions involving 221 youth (Mage = 13.1 years, 46.2% female; 78.7% Black, Indigenous, and people of color) and/or their caregivers who reported engagement concerns during therapy.
Results: CKS dyads showed uniformly greater use of evidence focused on specific client needs relative to dyads in the PG condition, with large effect sizes and no differences in the effect of condition across the sites. Secondary analyses showed that tools in the CKS condition were perceived significantly more positively than those in the PG condition in terms of effort and effectiveness, and supervisory workload was the same across both conditions.
Conclusions: In routine clinical care delivered within highly representative community settings, a strategically designed knowledge resource can improve evidence-based reasoning and action and be perceived as easy to use and useful without negatively impacting workload. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
