Predictors of Community Therapists’ Use of Therapy Techniques in a Large Public Mental Health System

In JAMA Pediatrics, Rinad Beidas and colleagues explore the effects of individual and organizational characteristics on therapists’ self-reported use of different therapy techniques - cognitive behavioral therapy (CBT), family therapy, and psychodynamic therapy techniques. The study focuses on the Philadelphia public mental health system, currently engaged in a large-scale effort to increase the use of CBT. The study results show that although both individual and organizational factors are important, the relative significance of the factors varies by treatment type. Key findings include that older therapists and therapists with more open attitudes are more likely to endorse use of CBT. Women are more likely to endorse use of family therapy techniques, as are those in organizations employing more fee-for-service staff and with more stressful climates. Therapists with more divergent attitudes and less knowledge about evidence-based practices were more likely to use psychodynamic therapy techniques. The authors recommend focusing on changing organizational factors in order to drive adherence to evidence-based practice, but that efforts should also include convincing individual therapists to cease outdated practices.