University of Washington.
University of Washington.
Behav Ther. 2018 Jul;49(4):481-493. doi: 10.1016/j.beth.2017.12.007. Epub 2017 Dec 20.
The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the supervisor level and implementation climate was the only significant factor associated with EBT supervision intensity. While individual clinician and supervisor factors may play a role in EBT coverage in supervision, our results suggest that an implementation climate that supports EBT may be the most critical factor for improving intensity of EBT coverage. Thus, implementation efforts that address the extent to which EBTs are expected, rewarded, and supported within an organization may be needed to support greater coverage of EBT during workplace-based supervision.
本研究旨在探讨与特定循证治疗(EBT)——创伤焦点认知行为疗法(TF-CBT)在基于工作场所的临床督导中的 EBT 关注强度相关的临床医生、督导者和组织因素。来自华盛顿州各地心理健康机构的督导者(n=56)和临床医生(n=207)完成了在线自我报告问卷。多层线性模型(MLM)分析用于检验嵌套临床医生和督导者因素对督导中 EBT 关注强度的相对影响。我们发现,临床医生报告的 EBT 督导强度的 33%变异在督导者水平上聚类,而实施氛围是与 EBT 督导强度唯一显著相关的因素。虽然个体临床医生和督导者因素可能在督导中的 EBT 覆盖范围中发挥作用,但我们的结果表明,支持 EBT 的实施氛围可能是提高 EBT 覆盖范围强度的最关键因素。因此,可能需要实施旨在解决在组织内 EBT 被期望、奖励和支持的程度的努力,以支持在基于工作场所的督导中更广泛地使用 EBT。