Where Does It Begin? Community-Based Therapists' Intentions for Treating Non-comorbid Youth

Area of Science:

• Child and Adolescent Psychology
• Clinical Psychology
• Mental Health Services Research

Background:

• Public sector therapists often treat youth with anxiety or disruptive behavior problems.
• Understanding therapists' practice intentions is crucial for effective treatment delivery.
• Evidence-based practices (EBPs) are essential, but non-evidence-based practices are also common.

Purpose of the Study:

• To examine the practice element (PE) intentions of public sector therapists for youth mental health.
• To identify patterns and predictors of these intentions for anxiety and disruptive behavior problems.
• To explore the relationship between intentions for evidence-based and non-evidence-based practices.

Main Methods:

• Surveyed 79 public sector therapists on their PE intentions.
• Analyzed intention profiles for hypothetical cases of youth anxiety and disruptive behavior.
• Used hierarchical multiple regression to identify predictors of practice intentions.

Main Results:

• Therapists' PE intentions varied by diagnosis.
• Intention profiles included both practices derived from the evidence base (PDEBs) and practices with minimal evidence support (PMESs).
• Higher intentions for PDEBs were significantly predicted by higher intentions for PMESs for both problem areas.

Conclusions:

• Therapists' treatment intentions are complex, incorporating both evidence-based and minimally supported practices.
• The use of minimally supported practices may paradoxically predict greater use of evidence-based practices.
• Findings have implications for community-based research and implementation strategies to improve youth mental health services.