(PS5-C69) Examination of Implementation Factors Reported by Community Therapists Working in Urban Schools during a Global Pandemic

Background: Schools are a critical de facto mental health services system for youth. This is especially true in times of crises when need for mental health care increases but access becomes more limited. Thus, recent policies aim to increase access to evidence-based practices (EBPs) in schools, especially in underserved communities. In response to a recent state-level mandate, Philadelphia’s school-based community mental health providers are now required to provide EBPs such as cognitive-behavioral therapy (CBT). Implementation climate and attitudes toward EBPs are important determinants of successful implementation, but little is known about the characteristics of community providers co-located in schools. This study sought to characterize and examine the relationship between CBT acceptability, appropriateness, feasibility, and agency implementation climate.

Methods: Participants were 114 newly co-located community therapists from 26 agencies. A little over half of therapists identified as Black/African American (52.6%), 36% as identified as White, and 11.4% identified as Other or American Indian; 79% were female. Prior to EBP training, participants completed the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure for CBT with values ranging from 1 to 5; and the Implementation Climate Scale which consists of 6 subscales with values ranging from 0 to 4. Across all measures, higher scores indicate more positive individual attitudes and organizational climate.

Results: Therapists endorsed relatively high CBT acceptability (M=4.3), appropriateness (M=4.2), and feasibility (M=4.2). Similarly, the implementation climate average of 3.5 indicated an overall positive implementation climate across agencies. Responses across the implementation climate subscales were similarly positive except for the Rewards for using EBPs subscale (Recognition for using EBPs M=3.5; Focus on EBPs M=4.3; Educational support for EBPs M=3.7; Selection of staff for openness M=4.1; Selection of staff for EBPs M=3.4; Rewards for using EBPs M=2.0). We did not find any significant correlations between CBT acceptability, appropriateness, and feasibility, and any of the implementation climate subscales.

 




Conclusions:  Findings point to overall positive individual CBT attitudes and implementation climates, suggesting that community therapists newly co-located in urban schools and their agencies value EBPs. The only implementation factor that was relatively low had to do with therapists’ impressions of receiving rewards for using EBPs at their agencies. Implications for CBT implementation in urban schools will be discussed, especially considering the context of a global pandemic.