title: Sustaining clinician penetration, attitudes and knowledge in cognitive-behavioral therapy for youth anxiety.
abstract: BACKGROUND
  Questions remain regarding the sustainment of evidence-based practices following implementation. The present study examined the sustainment of community clinicians' implementation (i.e., penetration) of cognitive-behavioral therapy, attitudes toward evidence-based practices, and knowledge of cognitive-behavioral therapy for youth anxiety two years following training and consultation in cognitive-behavioral therapy for youth anxiety.
  
  
  METHODS
  Of the original 115 participants, 50 individuals (43%) participated in the two-year follow-up. A t- test examined sustainment in penetration over time. Hierarchical linear modeling examined sustainment in knowledge and attitudes over time. Time spent in consultation sessions was examined as a potential moderator of the change in knowledge and attitudes.
  
  
  RESULTS
  Findings indicated sustained self-reported penetration of cognitive-behavioral therapy for anxious youth, with low fidelity to some key CBT components (i.e., exposure tasks). Follow-up knowledge was higher than at baseline but lower than it had been immediately following the consultation phase of the study. Belief in the utility of evidence-based practices was sustained. Willingness to implement an evidence-based practice if required to do so, appeal of evidence-based practices, and openness toward evidence-based practices were not sustained. Participation in consultation positively moderated changes in knowledge and some attitudes.
  
  
  CONCLUSIONS
  Sustainment varied depending on the outcome examined. Generally, greater participation in consultation predicted greater sustainment. Implications for future training include higher dosages of consultation.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Edmunds
authors.forename: Kendra L
authors.initials: KL
authors.lastname: Read
authors.forename: Vanesa A
authors.initials: VA
authors.lastname: Ringle
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Brodman
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000628:therapy*; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D015928:Cognitive Behavioral Therapy / Q000706:statistics & numerical data*; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires