Evidence-based treatment strategies in youth mental health treatment as usual: results from a national survey
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Despite widespread calls for the integration of evidence-based treatments (EBTs) into treatment as usual (TAU) for youth mental health problems, the success of such efforts is unclear. Existing survey research suggests that providers use specific EBT manuals infrequently, but whether providers use treatment strategies contained within EBT manuals without adopting the manuals themselves remains unclear. Further, given that use of EBTs as intended (e.g., focusing on prescribed strategies and avoiding nonprescribed strategies) may enhance treatment outcomes, it is important to understand how EBT strategies are typically implemented within TAU. Whether providers rarely use EBT strategies, integrate EBT strategies alongside other strategies regardless of empirical support, or selectively favor EBT strategies over those without strong evidentiary support, remains uncertain. Additionally, research is needed to move beyond assessing use of EBT strategies and to understand the conditions under which providers use EBT strategies in TAU. To address these gaps in the literature, we conducted a large national survey of youth-serving counselors', marriage and family therapists', psychologists', psychiatrists', and social workers' use of a variety of treatment strategies. Results suggest that providers use both EBT and other treatment strategies frequently in TAU but use EBT strategies more frequently than other treatment strategies. A multi-groups analysis also showed that organizational value of quality care, organizational training resources, vii positive provider attitudes toward innovation and evidence, more standardized measure and ongoing assessment use, fewer low income clients, less time since highest degree, and behavioral theoretical orientation predict provider use of EBT strategies.