title: Therapist- and Client-Level Predictors of Use of Therapy Techniques During Implementation in a Large Public Mental Health System.
abstract: Many youths receiving community mental health treatment do not receive evidence-based interventions. Research suggests that community mental health therapists use a broad range of therapeutic techniques at low intensities. This study examined the relationship between therapist- and client-level predictors of community-based therapists' report of cognitive, behavioral, psychodynamic, and family techniques within the context of implementation efforts.
  
  
  
  A total of 130 therapists participated from 23 organizations in an urban, publicly funded behavioral health system implementing evidence-based practices. Therapist-level predictors included age, gender, clinical experience, licensure status, and participation in evidence-based practice initiatives. Child-level predictors included therapist-reported child primary disorder (externalizing, internalizing, or other) and child age. Therapists completed the Therapist Procedures Checklist-Family Revised, a self-report measure of therapeutic techniques used.
  
  
  
  Unlicensed therapists were more likely than licensed therapists to report using psychodynamic and behavioral techniques. Therapists who did not participate in an evidence-based practice initiative were less likely to report use of cognitive techniques. Those with clients with externalizing disorders were more likely to report use of behavioral and family techniques. Therapists with the youngest clients (ages three to seven years) were most likely to report use of behavioral techniques and less likely to report use of cognitive and psychodynamic techniques.
  
  
  
  Results suggest that both therapist and client factors predict self-reported use of therapy techniques. Participating in an evidence-based practice initiative was associated with increased reports of using cognitive techniques. Therapists reported using behavioral and family techniques more than other techniques when working with youths with externalizing disorders and using fewer cognitive and psychodynamic techniques with young clients.
authors.affiliation: Dr. Benjamin Wolk and Dr. Beidas are with the Department of Psychiatry and Dr. Marcus is with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia (e-mail: cbenja@upenn.edu ). Dr. Weersing is with the Department of Psychiatry, San Diego State University, San Diego. Dr. Hawley is with the Department of Psychological Sciences, University of Missouri, Columbia. Dr. Evans and Dr. Hurford are with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia.
authors.forename: Courtney
authors.initials: C
authors.lastname: Benjamin Wolk
authors.affiliation: Dr. Benjamin Wolk and Dr. Beidas are with the Department of Psychiatry and Dr. Marcus is with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia (e-mail: cbenja@upenn.edu ). Dr. Weersing is with the Department of Psychiatry, San Diego State University, San Diego. Dr. Hawley is with the Department of Psychological Sciences, University of Missouri, Columbia. Dr. Evans and Dr. Hurford are with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Marcus
authors.affiliation: Dr. Benjamin Wolk and Dr. Beidas are with the Department of Psychiatry and Dr. Marcus is with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia (e-mail: cbenja@upenn.edu ). Dr. Weersing is with the Department of Psychiatry, San Diego State University, San Diego. Dr. Hawley is with the Department of Psychological Sciences, University of Missouri, Columbia. Dr. Evans and Dr. Hurford are with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia.
authors.forename: V Robin
authors.initials: VR
authors.lastname: Weersing
authors.affiliation: Dr. Benjamin Wolk and Dr. Beidas are with the Department of Psychiatry and Dr. Marcus is with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia (e-mail: cbenja@upenn.edu ). Dr. Weersing is with the Department of Psychiatry, San Diego State University, San Diego. Dr. Hawley is with the Department of Psychological Sciences, University of Missouri, Columbia. Dr. Evans and Dr. Hurford are with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Hawley
authors.affiliation: Dr. Benjamin Wolk and Dr. Beidas are with the Department of Psychiatry and Dr. Marcus is with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia (e-mail: cbenja@upenn.edu ). Dr. Weersing is with the Department of Psychiatry, San Diego State University, San Diego. Dr. Hawley is with the Department of Psychological Sciences, University of Missouri, Columbia. Dr. Evans and Dr. Hurford are with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia.
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Evans
authors.affiliation: Dr. Benjamin Wolk and Dr. Beidas are with the Department of Psychiatry and Dr. Marcus is with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia (e-mail: cbenja@upenn.edu ). Dr. Weersing is with the Department of Psychiatry, San Diego State University, San Diego. Dr. Hawley is with the Department of Psychological Sciences, University of Missouri, Columbia. Dr. Evans and Dr. Hurford are with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Hurford
authors.affiliation: Dr. Benjamin Wolk and Dr. Beidas are with the Department of Psychiatry and Dr. Marcus is with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia (e-mail: cbenja@upenn.edu ). Dr. Weersing is with the Department of Psychiatry, San Diego State University, San Diego. Dr. Hawley is with the Department of Psychological Sciences, University of Missouri, Columbia. Dr. Evans and Dr. Hurford are with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia.
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services; D055317:Evidence-Based Practice; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000628:therapy*; D015143:Philadelphia; D011369:Professional-Patient Relations; D011379:Prognosis; D057566:Self Report