Frontline counselors in organizational contexts: a study of treatment practices in community settings

This study addresses the challenge of implementing evidence-based treatment approaches in typical community settings. It identifies individual and organizational characteristics associated with two contrasting treatment approaches used by frontline practitioners. One treatment approach involves techniques supported by research; the other approach involves techniques primarily supported by experience and tradition. The study uses a nested probability sample of 45 organizations and 279 frontline practitioners. Multilevel (hierarchical linear modeling) regression models appropriately address the nested sample. The findings indicate that practitioner beliefs and components of organizational social contexts are associated with treatment approach. The use of an evidence-supported treatment approach is associated with opportunities to use training and with transformational leadership. A traditional treatment approach is more commonly used when practitioners have more positive perceptions of the organizational climate. The findings underscore the challenge of implementing evidence-based treatment techniques among counselors committed to traditional approaches.