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Symposia

Dissemination & Implementation Science

Understanding and Overcoming Barriers Within Evidence-based Practice Implementation in Youth Community and School-based Mental Health Services

2 - (SYM 110) Community Mental Health Provider Responses to Emergent Life Events During Modular Cognitive Behavioral Treatment for Youth

Saturday, November 16, 2024
4:30 PM – 6:00 PM EST
Location: Liberty C, Level 3, Downtown Marriott
Abstract Body


Background: Emergent life events (ELEs; unpredictable acute stressors) can interfere with the delivery of evidence-based treatment in community settings. Understanding when ELEs occur during treatment and how providers respond can inform strategies to improve clinical care. This study describes the occurrence of ELEs, provider delivery of therapeutic practices in response to ELEs, and provider adherence to modular cognitive behavioral treatment when treating youth experiencing ELEs in community settings.



Methods: This community-engaged study analyzed provider reports of session content collected by community mental health agencies throughout the United States. The sample included 329 providers serving 2435 clients across 26222 unique sessions of MATCH. MATCH contains 33 therapeutic practices for addressing anxiety, traumatic stress, depression, and behavioral problems. Provider-reported adherence to MATCH when addressing an ELE was measured considering content (whether the session covered MATCH content consistent with the client’s target problem), content and sequencing (whether the session covered MATCH content in the expected sequence for the client’s target problem), and content, sequencing, and participant (whether the session covered MATCH content in the expected sequence with the expected participant(s) for the client’s target problem). 



Results: Clients were predominately White (60%), female (48%) and school aged (M = 11 years old). ELEs occurred during 18% of sessions (N = 4647) and they occurred for 55% of clients (N = 1334). On average clients reported 1-2 total ELEs during treatment (M = 1.91, range = 0 – 38). Most clients (66%) experienced an ELE during the first three treatment sessions. During sessions that contained an ELE, 87% contained MATCH content, 51% contained MATCH content in the expected sequence, and 22% contained MATCH content in the expected sequence with the expected participants. The most commonly delivered MATCH practices in ELE sessions were development of a fear hierarchy (10%), psychoeducation about anxiety (10%), and psychoeducation about disruptive behavior (9%). 



Discussion: Findings indicate that most clients experience ELE early during treatment when few cognitive behavioral skills have been introduced. Providers commonly respond to ELEs using MATCH, but the type of MATCH practices delivered vary widely. The range of practices delivered will be presented to inform the development of clinical tools to support the use of evidence-based practices when treating complex cases.