Attitudes toward adoption of evidence-based practices: A comparison of autism early intervention providers and children’s mental health providers.

Across the country, states are reporting increases in the number of children with autistic spectrum disorders (ASDs) served each year in the early intervention system. Research examining factors impacting the successful dissemination and implementation of evidence-based practices (EBPs) into service systems for these children is limited. Preliminary information indicates that adoption of EBPs is variable. Provider attitudes toward the adoption of EBPs may be one factor that limits or facilitates implementation of efficacious treatments and these attitudes vary by organizational context and provider individual differences. The current study examines cross-context differences in provider attitudes toward EBPs by comparing the attitudes of 71 education-based early intervention providers working with children with ASD to the attitudes of 238 mental health providers in the public mental health system. This provides the first examination of ASD early intervention provider attitudes toward EBP. Results indicated that early intervention providers reported significantly more favorable attitudes toward adopting EBPs than did mental health providers. Early intervention providers with extended experience in the field perceived less divergence between their current practice and EBPs. Implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric properties and U.S. National norms of the Evidence-Based Practice Attitude Scale (EBPAS).

[Correction Notice: An erratum for this article was reported in Vol 22(3) of Psychological Assessment (see record 2010-18043-022). There were three errors in Table 1 on p. 360. In the last row, the row label should be “Overall EBPAS mean,” M = 2.73, and SD = 0.49. The revised Table 1 appears in the erratum.] The Evidence-Based Practice Attitude Scale (EBPAS) assesses mental health and social service provider attitudes toward adopting evidence-based practices. Scores on the EBPAS derive from 4 subscales (i.e., Appeal, Requirements, Openness, and Divergence) as well as the total scale, and preliminary studies have linked EBPAS scores to clinic structure and policies, organizational culture and climate, and first-level leadership. EBPAS scores are also related to service provider characteristics, including age, education level, and level of professional development. The present study examined the factor structure, reliability, and norms of EBPAS scores in a sample of 1,089 mental health service providers from a nationwide sample drawn from 100 service institutions in 26 states in the United States. The study also examined associations of provider demographic characteristics with EBPAS subscale and total scores. Confirmatory factor analysis supported a second-order factor model, and reliability coefficients for the subscales ranged from .91 to .67 (total scale = .74). The study establishes national norms for the EBPAS so that comparisons can be drawn for U.S. local as well as international studies of attitudes toward evidence-based practices. The results suggest that the factor structure and reliability are likely generalizable to a variety of service provider contexts and different service settings and that the EBPAS subscales are associated with provider characteristics. Directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Aarons et al. (2010).

Reports an error in "Psychometric properties and U.S. National norms of the Evidence-Based Practice Attitude Scale (EBPAS)" by Gregory A. Aarons, Charles Glisson, Kimberly Hoagwood, Kelly Kelleher, John Landsverk and Guy Cafri (Psychological Assessment, 2010[Jun], Vol 22[2], 356-365). There were three errors in Table 1 on p. 360. In the last row, the row label should be “Overall EBPAS mean,” M = 2.73, and SD = 0.49. The revised Table 1 appears in the erratum. (The following abstract of the original article appeared in record 2010-10892-016.) The Evidence-Based Practice Attitude Scale (EBPAS) assesses mental health and social service provider attitudes toward adopting evidence-based practices. Scores on the EBPAS derive from 4 subscales (i.e., Appeal, Requirements, Openness, and Divergence) as well as the total scale, and preliminary studies have linked EBPAS scores to clinic structure and policies, organizational culture and climate, and first-level leadership. EBPAS scores are also related to service provider characteristics, including age, education level, and level of professional development. The present study examined the factor structure, reliability, and norms of EBPAS scores in a sample of 1,089 mental health service providers from a nationwide sample drawn from 100 service institutions in 26 states in the United States. The study also examined associations of provider demographic characteristics with EBPAS subscale and total scores. Confirmatory factor analysis supported a second-order factor model, and reliability coefficients for the subscales ranged from .91 to .67 (total scale = .74). The study establishes national norms for the EBPAS so that comparisons can be drawn for U.S. local as well as international studies of attitudes toward evidence-based practices. The results suggest that the factor structure and reliability are likely generalizable to a variety of service provider contexts and different service settings and that the EBPAS subscales are associated with provider characteristics. Directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Servant leadership, procedural justice climate, service climate, employee attitudes, and organizational citizenship behavior: A cross-level investigation.

This study tests the influence of servant leadership on 2 group climates, employee attitudes, and organizational citizenship behavior. Results from a sample of 815 employees and 123 immediate supervisors revealed that commitment to the supervisor, self-efficacy, procedural justice climate, and service climate partially mediated the relationship between servant leadership and organizational citizenship behavior. Cross-level interaction results revealed that procedural justice climate and positive service climate amplified the influence of commitment to the supervisor on organizational citizenship behavior. Implications of these results for theory and practice and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A trickle-down model of organizational justice: Relating employees' and customers' perceptions of and reactions to fairness.

This study developed and tested a trickle-down model of organizational justice that hypothesized that employees' perceptions of fairness should affect their attitudes toward the organization, subsequently influencing their behaviors toward customers. In turn, customers should interpret these behaviors as signals of fair treatment, causing them to react positively to both the employee and the organization. The model was tested on a sample of 187 instructors and their students. The results revealed that instructors who perceived high distributive and procedural justice reported higher organizational commitment. In turn, their students reported higher levels of instructor effort, prosocial behaviors, and fairness, as well as more positive reactions to the instructor. Overall, the results imply that fair treatment of employees has important organizational consequences because of customers' attitudes and future intentions toward key service employees. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pursuing an evidence-based culture through contextualized feedback: Aligning youth outcomes and practices.

How can contextualized feedback on therapy practices and youth outcomes promote an evidence-based culture for adolescent mental health? Relative to other quality improvement tools, feedback and progress monitoring systems are generally underutilized. This article describes a feedback system collaboratively developed by the Hawai'i Department of Health Child and Adolescent Mental Health Division and private agency staff contracted to provide mental health services to youth. Feedback reports allow providers to monitor progress of their youth clients, compare their progress with youth receiving similar services, examine the extent they are using practices derived from evidence-based protocols, and compare these practice profiles to what other youth are receiving. Providers gather to discuss reports, share success stories, and offer suggestions to improve practices and outcomes based on data from the reports. The provider feedback system in Hawai'i has emphasized youth outcomes and has promoted an “evidence-based culture.” This article encourages direct providers and supervisors to consider how such a system might fit in their current practice and whether contextualized feedback might be one way to enhance services and outcomes for youth with mental health needs. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Receptivity and planned change: Community attitudes and deinstitutionalization.

An expectancy-value model was used to measure and explain receptivity attitudes (i.e., change climate) toward the implementation of deinstitutionalization programs. Questionnaires measuring values, expectancies, and behavioral intentions were mailed to community leaders and to members of community groups believed to be important in setting opinions and making decisions. Responses from 599 persons revealed that (a) the size of a proposed group home affected neither attitudes nor intentions of support, (b) group homes for mental health clients were viewed with less favorable attitudes and intentions than those for the retarded or the elderly, (c) members of various community groups held significantly different attitudes and intentions toward the programs, and (d) attitudes and intentions toward deinstitutionalization were more favorable than toward institutionalization. The application of this approach for assessing the implementation climate for planned change was discussed. (55 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of gender diversity management on perceptions of organizational attractiveness: The role of individual differences in attitudes and beliefs.

In this study, the authors examined how individual gender-related attitudes and beliefs affect the reactions of men and women to gender diversity management programs in organizations. They found that whereas there were no significant between-sex differences in the effects of gender diversity management on organizational attractiveness, there were strong within-sex differences based on individual attitudes and beliefs. Specifically, within the sexes, centrality of one's gender identity, attitudes toward affirmative action for women, and the belief that women are discriminated against in the workplace moderated the effects of gender diversity management on organizational attractiveness. The findings, combined with prior research, suggest that it is critical for organizations to incorporate efforts to manage perceptions of gender diversity management programs into their diversity management strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public attitudes about psychologists and mental health care: Research to guide the American Psychological Association public education campaign.

Focus groups and a random telephone survey were conducted to examine the public's attitudes toward mental health providers. The research showed that the public has very little understanding of the qualifications and credentials of psychologists and cannot tell one mental health provider from another. Respondents believed that their emotional health affects their physical health but were typically not willing to pay more for mental health insurance coverage. An information gap was also evident: A majority of respondents agreed that psychological health is important, but almost half said they wish they had more information about how and when to access psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statewide adoption and initial implementation of contingency management for substance-abusing adolescents.

Four hundred thirty-two public sector therapists attended a workshop in contingency management (CM) and were interviewed monthly for the following 6 months to assess their adoption and initial implementation of CM to treat substance-abusing adolescent clients. Results showed that 58% (n = 131) of the practitioners with at least one substance-abusing adolescent client (n = 225) adopted CM. Rates of adoption varied with therapist service sector (mental health vs. substance abuse), educational background, professional experience, and attitudes toward treatment manuals and evidence-based practices. Competing clinical priorities and client resistance were most often reported as barriers to adopting CM, whereas unfavorable attitudes toward and difficulty in implementing CM were rarely cited as barriers. The fidelity of initial CM implementation among adopters was predicted by organizational characteristics as well as by several demographic, professional experience, attitudinal, and service sector characteristics. Overall, the findings support the amenability of public sector practitioners to adopt evidence-based practices and suggest that the predictors of adoption and initial implementation are complex and multifaceted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

To use or not to use: Clinicians' perceptions of telemental health.

Equal access to mental health services is necessary for healthy individuals and communities. However, due to geographical distances and other barriers, some clients cannot easily access mental health professionals. Technologies such as videoconferencing for clinical purposes (i.e., telemental health) may help to bridge these gaps to connect clients and clinicians at geographically diverse locations. However, despite its potential utility, telemental health has not been widely adopted in Canada. This study is an exploratory investigation into mental health professionals' attitudes toward telemental health, factors that affect the frequency with which they use this technology, and their perceptions of individual characteristics that make clients more or less suitable candidates for telemental health. This study has a particular focus on remote and rural and Operational Stress Injury (OSI) contexts. One hundred sixty mental health workers across Canada participated in an online survey, and 25 mental health workers from Operational Stress Injury clinics across Canada participated in in-person interviews. The data were examined using qualitative and quantitative analysis methods. Findings suggest that mental health workers have overall positive attitudes toward the use of telemental health—particularly for clients in remote and rural locations. Additionally, receiving training in telemental health, being in the mental health field for longer, and perceiving the technology as easy to use are associated with more frequent use of telemental health. Finally, clinicians reported specific client characteristics that they perceive to make some clients unsuitable candidates for telemental health. Implications of these findings and directions for future research are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Attitudinal and contextual variables explaining teachers' leadership behavior.

Focused on identifying the way in which individual and organizational variables affect the classroom leadership behavior of teachers. Data gathered from a questionnaire designed for this study were collected from 147 teachers and 2,430 students in 10 community colleges. Results indicate that the openness of interpersonal relations among the teaching staff and the teachers' assessments of their students may have an effect on their leadership behavior. Additionally, a moderating effect of teachers' attitudes toward student control was identified; the leadership of teachers having participative attitudes may be affected more by both formal and perceived organizational participativeness than is the leadership of other teachers. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of job attitudes, training, and organization climate on performance of the hard-core unemployed.

Examined potential contributors toward the job performance and retention of 478 hard-core unemployed (hcu): (a) the hcu's biographic and demographic background, (b) attitudes toward work, (c) the organizational climate in which he is placed, and (d) the effect of a 2-wk training/orientation program. The sole correlate of the hcu's work effectiveness and behavior was the degree of supportiveness of the organizational climate in which he was placed. In addition, the hcu saw this climate as far less supportive than did his supervisor. Results indicate that programs geared primarily toward adapting the hcu's work attitudes to the predominant social structure in the organization are far less potent than those that also incorporate the adaptation of the organizational climate. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confrontations with aggression and mental health problems in police officers: The role of organizational stressors, life-events and previous mental health problems.

The extent to which the frequency of facing aggression incidents is associated with mental health problems among police officers when organizational stressors, life-events, and previous mental health problems are taken into account is unclear. To elucidate this data from a longitudinal study of police officers was analyzed (N = 473). Mental health problems (MHPs) are here defined as severe anxiety, depression, hostility, burnout symptoms, and/or sleeping problems according the SCL-90–R and MBI. All MHPs were assessed at baseline and 27 months later. Logistic regression showed that serious threat was statistically significant associated with MHPs at follow-up among officers without MHPs at baseline, but not among those with MHPs at baseline. However, stepwise logistic regression showed that serious threat and/or physical aggression were not independently associated with MHPs at follow-up. Organizational stressors, that is, problems with colleagues were independent predictors in all analyses. Among the total study sample, previous MHPs were the strongest independent predictors. These findings suggest superiors should attend to the mental health, organizational stressors and life-events of their officers regularly and not only following critical incidents at work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of public/private health care insurance parameters for independent psychological practice.

Managed care cost-cutting strategies are more prevalent in the private (employer provided) than public (Medicare/Medicaid) health care sectors. The main organizational managed care strategy pertaining to the independent practice of psychology has been the separation of the administration of mental from medical health care though behavioral health carve-outs. These organizations typically offer lower reimbursement rates and have greater preauthorization requirements than non-managed care public plans for the same psychological service. Dispute resolution in the private sector involves lawsuits and state consumer protection programs while public plans utilize internal review and are subject to investigations of provider billing fraud and abuse. Behavioral health carve-outs have reduced mental health care utilization rates with unknown effects upon outcome. There is some evidence that psychologists have chosen to limit practice within the private sector, but national data on the overall effect is lacking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The story of hardiness: Twenty years of theorizing, research, and practice.

Since 1979, the development of the hardiness approach to enhancing performance and health has been facilitated by continual cross-fertilization between theorizing, research, and practice. At first, hardiness emerged from individual differences research on stress reactions as the attitudes of commitment, control, and challenge. Since then, extensive theorizing and practice, combined with considerable additional research, has led to the supplementation of hardy attitudes with hardy skills concerning coping, social interaction, and self-care. Also, the mechanisms whereby hardy attitudes and skills enhance performance and health are better understood. The hardiness approach has also expanded from the individual to the organizational level. All these developments form an example of the value of combining theorizing, research, and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental illness stigma as a mediator of differences in Caucasian and South Asian college students' attitudes toward psychological counseling.

Previous research has established that Asian Americans use mental health services less frequently and hold poorer attitudes toward psychological counseling than Caucasians. The authors directly tested whether stigmatizing beliefs regarding mental illness might explain such differential attitudes toward counseling in a South Asian and Caucasian student sample. Using mediation analyses, the authors examined 2 aspects of stigma posited to affect help-seeking attitudes: personal stigmatizing views and perceptions of the public's stigmatizing views directed toward persons with mental illness. First, the authors found that Caucasian (n = 74) college students revealed more positive attitudes toward counseling than did South Asian (n = 54) students. Second, in terms of mediation, increased personal stigma, but not perceived stigma, expressed by South Asians partially mediated and accounted for 32% of the observed difference in attitudes toward counseling services. These findings support a long-standing conjecture in the literature regarding the increased significance of stigma processes on disparities in majority-minority help-seeking attitudes. They also suggest that efforts to reduce disparities in attitudes toward counseling for South Asian students specifically should incorporate interventions to reduce the increased stigma expressed by this community, particularly related to a desire for social distance from persons with a mental illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of proactive personality in job satisfaction and organizational citizenship behavior: A relational perspective.

Drawing from a relational approach, the authors conceptualize the quality of leader–member exchange as a mediator and procedural justice climate as a contextual moderator for understanding the role of proactive personality in job satisfaction and organizational citizenship behavior. Data from a sample of 200 Chinese employees within 54 work groups were used to examine the hypothesized models. Results show that having a proactive personality was associated with employees establishing a high-quality exchange relationship with their supervisors; in turn, the quality of leader–member exchange was associated with greater job satisfaction and more organizational citizenship behaviors. Additionally, the relationship between proactive personality and organizational citizenship behavior was positively moderated by procedural justice climate within the group. Implications for management theory and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical psychologist in the vanguard: Current attitudes toward mental illness.

To determine the current degree of acceptance of an antimedical approach to mental illness, a survey was conducted of attitudes toward mental illness among various mental health professionals (20 psychiatrists, 23 psychiatric nurses, 16 psychologists, and 25 social workers) and mental patients (41 outpatients with a history of psychiatric hospitalization and 20 outpatients with no similar history) in a community mental health center. Responding to 6 statements reflecting attitudes toward the traditional medical model, clinical psychologists showed greater acceptance of the antimedical paradigm than did psychiatrists, psychiatric social workers, psychiatric nurses, and psychiatric outpatients. Several explanations are offered as to why clinical psychologists appear to be in the vanguard of those adopting a critical, antimedical stance within the clinical arena. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interdisciplinary training and interdisciplinary functioning: a survey of attitudes and practices in community mental health

A survey of staff members and training-program directors suggests that inter-disciplinary functioning is the rule rather than the exception in community mental health centers, although there are significant differences by profession in time spent in interdisciplinary work and in attitudes toward it. Striking parallels are seen within each profession between attitudes of staff and of directors of training programs. Barriers to interdisciplinary functioning and training are identified and discussed.