Optimizing Implementation Coaching to Support Successful EBP Delivery

NCT05799794 | Completed DMC

• 2 other identifiers: STUDY000149691P50MH126219
• Study Type: interventional
• Target: 213
• Locations: 1 country
• Sites: 1

Brief Summary

This project engages community mental health center (CMHC) clinical supervisors in the development and examination of an optimized coaching strategy for psychotherapists utilizing Cognitive Behavioral Therapy (CBT) in Washington State. The optimized coaching strategy has the potential to enhance the adoption and fidelity of evidence-based practice (EBP).

Conditions

Anxiety Depression; Mental Health Issue

Outcome Measures

Primary Outcomes (1)

• CBT Fidelity

  Clinicians participating in the Initiative, and who participate in this study, routinely enter session and de-identified CBT client outcome data. The investigative team will code cases enrolled study clinicians enter into the de-identified Dashboard. Based on the CBT model the clinician specifies, investigators will code cases for delivery of "essential elements" of that CBT model for each of the mental health conditions of focus: Anxiety, Depression, Posttraumatic Stress, and Behavioral Problems. Essential element coding will produce a count and a "fidelity" ratio of sessions including essential CBT elements (vs. only other elements) for each client, specific to the CBT model they received. Higher scores represent higher CBT fidelity reflecting greater essential element delivery (content) and coverage (dose).

  through study completion, an average of 7 months

Secondary Outcomes (4)

• Externalizing Behavior Symptoms

  through study completion, an average of 7 months

• Posttraumatic Stress Symptoms

  through study completion, an average of 7 months

• Depressive Symptoms

  through study completion, an average of 7 months

• Anxiety Symptoms

  through study completion, an average of 7 months

Study Arms (2)

Standard/As Usual CBT+/EBP Initiative Implementation

ACTIVE COMPARATOR

All CMHCs involved in the CBT+/EBP Initiative receive virtual clinician training, CBT-phone consultation options over 6-months, access to a supervisor monthly call, listservs (one supervisor-focused), and a yearly advanced clinical training and supervisor training. The Initiative is a program that has been ongoing since 2009.

Behavioral: Supervisor-led Implementation Coaching

Supervisor-led Implementation Coaching

EXPERIMENTAL

The structure of this arm will depend on Aim 1. However, the investigators imagine that peer supervisors leading implementation coaching, trained in Aim 1, will have 3-5 virtual meetings with supervisors and email communication. Meetings focus on orientation to the theory and rationale for Coaching and supervisors' role as frontline leaders to support EBP implementation. Meetings are likely over 6 months and focus on different implementation phases. Coaches will support supervisors in developing tailored workplans for implementation in their CMHCs. In each meeting, the coach will review the strategies in the workplan, provide examples of how the strategy could be specified, and then facilitate discussion among supervisors. The coach will support supervisors in building a tailored workplan for their CMHC. Supervisors in the Coaching condition receive Coaching plus standard Initiative Implementation support.

Behavioral: Supervisor-led Implementation Coaching

Interventions

Supervisor-led Implementation Coaching BEHAVIORAL

Implementation coaching, support, or facilitation includes the support provided to supervisors and their organizations for successfully delivering an evidence-based practice (EBP). Implementation support can include consultation, supervision, and coaching.

Also known as: Facilitation; Implementation Support

Standard/As Usual CBT+/EBP Initiative Implementation; Supervisor-led Implementation Coaching

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Supervisors in aim 1a and clinicians/supervisors in aim 2 must
• be employed in CMHCs whose leadership has agreed to participate in the study
• have participated or be participating in the Initiative.
• Clinicians in aim 1b do not need to be employed in a CMHC whose leadership has agreed to participate in the study.

You may not qualify if:

• Supervisors who participate in Aim 1 will be excluded from participating in Aim 2 as recipients of Implementation Coaching.

Sponsors & Collaborators

• University of Washington: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

WA EBP Initiative

Seattle, Washington, 981095, United States

Location

Related Links

• Initiative's online dashboard system

Study Officials

• Shannon Dorsey, PhD

  University of Washington

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Clinicians, supervisors and study staff will be aware of the implementation support conditions that participants have been randomized into in Aim 2.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, Psychology

Model Details: Aim 1a: The investigators will utilize Ideation to develop coaching strategies with supervisors. Aim 1b: The investigators will conduct an online experimental vignette study to gather preliminary evidence for how effectively different strategies emerging from Aim 1 impact our theorized mechanism (Implementation Climate-e.g., CBT use expected). Aim 1 activities are not part of the clinical trial (which starts with Aim 2 activities). Aim 2: The investigators will utilize a 2-arm randomized controlled trial to compare outcomes for anxiety, depression, PTSD, and behavioral problems for the group in the Implementation Coaching strategy optimized in Aim 1 and the Initiative's standard/as usual implementation. The groups will engage in the implementation support for 6 months and will complete a survey before and after the implementation support is terminated.

Study Record Dates

• First Submitted: January 12, 2023
• First Posted: April 5, 2023
• Study Start: July 22, 2022
• Primary Completion: October 29, 2024
• Study Completion: October 29, 2024
• Last Updated: February 19, 2025

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)