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Sherry L. Pagoto - One of the best experts on this subject based on the ideXlab platform.

  • translation of the diabetes prevention program into a Community Mental Health organization for individuals with severe Mental illness a case study
    Translational behavioral medicine, 2011
    Co-Authors: Kristin L. Schneider, Cherry J Sullivan, Sherry L. Pagoto
    Abstract:

    Individuals with severe Mental illness (SMI) have significant Health disparities. Wellness services embedded in Community Mental Health organizations could lessen these disparities. This case study illustrates the integration of the Diabetes Prevention Program (DPP) lifestyle intervention into a Community Mental Health organization. The Diffusion of Innovations Theory was used as a model for integration, which included a collaboration between researchers and the organization and qualitative work, culminating in a small pilot of the DPP led by peer specialists to test the feasibility of the DPP in this setting. Fourteen individuals with SMI participated in the 19-week intervention. Three dropped out, but the remaining 11 demonstrated 92% attendance. Weight loss was minimal, but the participants reported benefit and showed continued interest in the intervention. The use of a peer-led DPP in a Community Mental Health organization is feasible and warrants further investigation to demonstrate efficacy.

Paul Critschristoph - One of the best experts on this subject based on the ideXlab platform.

  • psychodynamic psychotherapy for depression in Community Mental Health settings
    2019
    Co-Authors: Mary Beth Connolly Gibbons, Katherine Critschristoph, Paul Critschristoph
    Abstract:

    Abstract This chapter describes how short-term supportive–expressive psychotherapy has been adapted for use in a Community Mental Health setting for the treatment of depression. Our adaptation of supportive–expressive (SE) psychotherapy evolved across our research program evaluating the effectiveness of dynamic psychotherapy in collaboration with a Community partner. A stakeholder team of investigators, expert clinicians, Community administrators, and Community clinicians worked together to adapt the treatment to best meet the needs of patients and therapists working in outpatient Community Mental Health clinics. Our Community SE treatment includes five treatment components: alliance building, relationship focus, culturally sensitivity, education, and treatment socialization. This chapter will delineate the therapeutic techniques used to address each of these components in Community practice.

  • the effectiveness of clinician feedback in the treatment of depression in the Community Mental Health system
    Journal of Consulting and Clinical Psychology, 2015
    Co-Authors: Mary Beth Connolly Gibbons, Donald Thompson, John E Kurtz, Rachel A Mack, Jacqueline K Lee, Aileen B Rothbard, Susan V Eisen, Robert Gallop, Paul Critschristoph
    Abstract:

    While many have suggested that Mental Health treatment outcomes in Community-based settings could be improved through the dissemination of empirically-supported psychotherapies (Stirman, Crits-Christoph, & DeRubeis, 2004; Barlow, Levitt, & Bufka, 1999; Chorpita et al., 2002; Henggeler, Schoenwald, & Pickrel, 1995), such efforts have a variety of hurdles, including the cost of training clinicians in new methods and the resistance of clinicians to adopting new approaches that are discrepant from their own preferred style of therapy. Provider feedback systems that help clinicians identify patients who are not improving as expected may be an important alternative approach to improving psychotherapeutic treatment outcomes in Community settings. A meta-analysis of studies of Mental Health status feedback in psychotherapy (Knaup, Koesters, Schoefer, Becker, & Puschner, 2009) indicates an overall small effect (d = .10) for clinician feedback systems compared to control conditions. However, Lambert and Shimokawa (2011) review two feedback systems that have advantages over other simple Mental Health status feedback methods. Both the Partners for Change Outcome Management System (PCOMS; Miller, Duncan, Sorrell, & Brown, 2005) and the Outcome Questionnaire-45 (OQ-45; Lambert, Gregersen, & Burlingame, 2004) include feedback on patient progress in treatment and include patient ratings of important clinical variables to maximize treatment outcomes. Lambert and Shimokawa (2011) found a moderate combined effect size across three well-designed studies (Reese, Norsworthy, & Rowlands, 2009; Anker, Duncan, & Sparks, 2009) of the PCOMS (d = .47) indicating that patients whose clinicians received feedback were better off than 68% of treatment-as-usual patients. Six controlled studies have been published that examine the effects of providing OQ-45 progress feedback to clinicians (Lambert, Whipple, Smart, Vermeersch, & Nielsen, 2001; Lambert et al., 2002; Whipple et al., 2003; Hawkins, Lambert, Vermeersch, Slade, & Tuttle, 2004; Harmon et al., 2007; Slade, Lambert, Harmon, Smart, & Bailey, 2008). Pooling data across studies, Lambert and Shimokawa (2011) report that for off track patients (i.e., those who are not progressing as expected across the early sessions of treatment) there were moderate effects for those whose clinicians received weekly OQ-45 feedback (d = .58) and for those whose clinician received weekly OQ-45 feedback plus feedback based on the OQ-Clinical Support Tools (d = .81) compared to treatment-as-usual patients. Since the publication of this review, seven additional controlled studies of OQ-45 feedback to Mental Health patients have been conducted (de Jong, van Sluis, Nugter, Heiser, & Spinhoven, 2012; Crits-Christoph et al., 2012; Hansson, Rundberg, Osterling, Ojehagen, & Berglund, 2012; Probst et al., 2013; Simon et al., 2013; Simon, Lambert, Harris, Busath, & Vazquez, 2012; Amble, Gude, Stubdal, Andersen, & Wampold, 2014). Three of the six studies demonstrated a significant positive effect of two-level feedback on patient outcome (Probst et al., 2013; Simon et al., 2013; Simon et al., 2012; Amble et al., 2014) although the effect sizes for two of these studies were much smaller than in previous investigations ranging from .12 to .36. Crits-Christoph et al. (2012) also demonstrated a positive effect of feedback for substance abuse patients, but this investigation did not include a randomized control group. In contrast, two recent investigations did not provide support for the effectiveness of clinician feedback. De Jong et al. (2012) reported a minimal positive effect of feedback post hoc only for the subset of off track patients whose clinicians self-reported using feedback. Lastly, Hansson et al. (2012) did not find significant positive effects of feedback on patient outcome, as measured by the OQ-45. We developed a Community clinician feedback system targeted to the treatment of depression in the Community Mental Health setting working closely with patients, clinicians, and administrators. Our system was designed to be broadly applicable to patients seeking outpatient treatment for clinically meaningful depression in order to facilitate implementation in the Community. We specifically focused on designing a system that met the challenges of delivering Mental Health services in the Community setting. Although the performance feedback studies based on the OQ-45 and PCOMS conducted to date have been impressive, these feedback interventions have not been developed to be sensitive to the broader range of functioning found in Community Mental Health centers and the efficacy of these feedback interventions has never been tested in the Community Mental Health system, which treats the population sector most in need of cost-efficient interventions. Of the three studies of the PCOMS reviewed by Lambert and Shimokawa (2011), one was conducted in a university counseling center, one in a graduate program training clinic, and one with a sample of clients in couples counseling. Studies demonstrating moderate effects for the OQ-45 have focused largely on Caucasian samples and mostly university counseling center patients (mean age 22 in three studies conducted). Our goal was to develop and test a clinician feedback intervention that not only built on the strengths of existing feedback systems by providing weekly feedback on progress in treatment and by including additional clinical help for patients who were not progressing as expected across treatment, but also that addressed some weaknesses for implementing feedback specifically in the Community Mental Health setting. A collaborative effort between the investigators and our Community partner indicated that in order to meet the needs of the Community setting, a feedback system would need to: a) be easy to disseminate with no training required by clinicians to use or understand the reports; b) include measures that were reliable and validated in Community Mental Health settings; and c) go beyond the existing systems in providing clinical feedback to clinicians for patients who were not progressing in treatment as expected. In Community Mental Health centers where clinicians have large difficult caseloads and little free time, additional clinical tools for improving clinical outcomes with patients who are not progressing as expected are vital. Some of the studies of the OQ system did incorporate clinical support tools for off track patients, which included additional patient measures of the therapeutic relationship, motivation, life events, and support networks. We conducted a series of focus groups with Community clinicians and supervisors to determine what additional clinical constructs these providers would want to consider when making important decisions regarding alteration of the treatment course to assist patients who were not progressing as expected. Our patient-specific assessment was designed to help shed light on why certain patients are not progressing as expected and can provide important clinical foci that may be crucial to changing the course of treatment for clinicians treating depression in the Community. The goals of the current manuscript are to a) describe the Community Clinician Feedback System (CCFS), b) present the development of Community recovery curves that serve as the basis for identifying whether patients are progressing as expected, c) provide descriptive statistics of clinician and patient satisfaction ratings of the CCFS, d) present the results of a randomized clinical trial comparing the effectiveness of the CCFS versus no feedback in the treatment of depression in the Community Mental Health setting, and e) evaluate the effectiveness of the CCFS clinical report for the subset of patients who went off track for clinical improvement. We hypothesized that patients in the Community Mental Health setting whose clinicians received feedback regarding their progress in treatment would have significantly better outcomes compared to patients whose clinicians did not receive feedback. Although previous investigations of the OQ-45 demonstrated that feedback was effective only for the subset of patients who went off track for clinical improvement, our system was designed to improve outcomes for the full intent-to-treat population in the Community Mental Health setting where clinicians may have heavy caseloads and patients seeking services often have complex diagnostic syndromes. Whereas providers in settings such as university counseling centers may not need help with on track cases, we hypothesized that providers in the Community Mental Health setting may benefit from the weekly progress reports for all patients in treatment. In these Community settings, it may be important to keep close track of weekly progress even for on track patients to help prevent deterioration. We further hypothesized that for the subset of feedback patients who go off track for clinical improvement, symptom course will be improved after the clinicians receive the clinical report.

  • Community Mental Health provider modifications to cognitive therapy implications for sustainability
    Psychiatric Services, 2013
    Co-Authors: Shannon Wiltsey Stirman, Arthur C Evans, Amber Calloway, Katherine Toder, Christopher J Miller, Andrea K Devito, Samuel N Meisel, Regina Xhezo, Aaron T Beck, Paul Critschristoph
    Abstract:

    ObjectiveThis study identified modifications to an evidence-based psychosocial treatment (cognitive therapy) within a Community Mental Health system after clinicians had received intensive training and consultation.MethodsA coding system, consisting of four types of contextual modifications, 12 types of content-related modifications, seven levels at which modifications can occur, and a code for changes to training or evaluation processes, was applied to data from interviews with 27 clinicians who treat adult consumers within a Mental Health system.ResultsNine of 12 content modifications were endorsed, and four (tailoring, integration into other therapeutic approaches, loosening structure, and drift) accounted for 65% of all modifications identified. Contextual modifications were rarely endorsed by clinicians in this sample. Modifications typically occurred at the client or clinician level.ConclusionsClinicians in Community Mental Health settings made several modifications to an evidence-based practice (EB...

  • supportive expressive dynamic psychotherapy in the Community Mental Health system a pilot effectiveness trial for the treatment of depression
    Psychotherapy, 2012
    Co-Authors: Mary Beth Connolly Gibbons, Sarah M Thompson, Kelli Scott, Donald Thompson, Patricia Green, Lindsay A Schauble, Tessa Mooney, Mary Jo Macarthur, Paul Critschristoph
    Abstract:

    The goal of the current article is to present the results of a randomized pilot investigation of a brief dynamic psychotherapy compared with treatment-as-usual (TAU) in the treatment of moderate-to-severe depression in the Community Mental Health system. Forty patients seeking services for moderate-to-severe depression in the Community Mental Health system were randomized to 12 weeks of psychotherapy, with either a Community therapist trained in brief dynamic psychotherapy or a TAU therapist. Results indicated that blind judges could discriminate the dynamic sessions from the TAU sessions on adherence to dynamic interventions. The results indicate moderate-to-large effect sizes in favor of the dynamic psychotherapy over the TAU therapy in the treatment of depression. The Behavior and Symptom Identification Scale-24 showed that 50% of patients treated with dynamic therapy moved into a normative range compared with only 29% of patients treated with TAU.

  • outcome assessment via handheld computer in Community Mental Health consumer satisfaction and reliability
    Journal of Behavioral Health Services & Research, 2011
    Co-Authors: Lizabeth A. Goldstein, Sarah M Thompson, Kelli Scott, Mary Beth Connolly Gibbons, Donald Thompson, Laura Heintz, Patricia Green, Paul Critschristoph
    Abstract:

    Computerized administration of Mental Health-related questionnaires has become relatively common, but little research has explored this mode of assessment in “real-world” settings. In the current study, 200 consumers at a Community Mental Health center completed the BASIS-24 via handheld computer as well as paper and pen. Scores on the computerized BASIS-24 were compared with scores on the paper BASIS-24. Consumers also completed a questionnaire which assessed their level of satisfaction with the computerized BASIS-24. Results indicated that the BASIS-24 administered via handheld computer was highly correlated with pen and paper administration of the measure and was generally acceptable to consumers. Administration of the BASIS-24 via handheld computer may allow for efficient and sustainable outcomes assessment, adaptable research infrastructure, and maximization of clinical impact in Community Mental Health agencies.

Robert E Drake - One of the best experts on this subject based on the ideXlab platform.

  • use of a computerized medication shared decision making tool in Community Mental Health settings impact on psychotropic medication adherence
    Community Mental Health Journal, 2013
    Co-Authors: Bradley D Stein, Jane N Kogan, Mark J Mihalyo, James M Schuster, Patricia E Deegan, Mark J Sorbero, Robert E Drake
    Abstract:

    Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from Community Mental Health centers over a two-year period from Community Mental Health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient Mental Health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.

  • Community Mental Health putting policy into practice globally
    2011
    Co-Authors: Graham Thornicroft, Atalay Alem, Robert E Drake, Maya Semrau, Jair De Jesus Mari, Peter Mcgeorge, Thara Rangaswamy
    Abstract:

    List of Contributors, viii Foreword, xi Acknowledgements, xiii Section 1 Introduction, 1 1 Global Mental Health: the context, 3 2 Description of the world regions, 14 3 Overview of Mental Health policies worldwide, 23 Section 2 Implementation of Community Mental Health services, 37 4 The current provision of Community Mental Health services, 39 5 Policies, plans, and programs, 90 6 Scaling up services for whole populations, 97 7 Stigma, discrimination, and Community awareness about Mental illnesses, 119 8 Developing a consensus for engagement, 135 9 Human and financial resources, 140 10 Development, organization, and evaluation of services, 151 Section 3 Recommendations, 167 11 Lessons learned and recommendations for the future, 169 Appendix A Terminologies, 213 Appendix B Questions from a survey conducted with regional experts in the Africa region, 221 Appendix C Internet resources, 223 Index, 227

  • trial of an electronic decision support system to facilitate shared decision making in Community Mental Health
    Psychiatric Services, 2011
    Co-Authors: Emily M Woltmann, Sandra M Wilkniss, Alexandra Teachout, Gregory J Mchugo, Robert E Drake
    Abstract:

    Objectives:Involvement of Community Mental Health consumers in Mental Health decision making has been consistently associated with improvements in Health outcomes. Electronic decision support systems (EDSSs) that support both consumer and provider decision making may be a sustainable way to improve dyadic communication in a field with approximately 50% workforce turnover per year. This study examined the feasibility of such a system and investigated proximal outcomes of the system's performance. Methods:A cluster randomized design was used to evaluate an EDSS at three urban Community Mental Health sites. Case managers (N=20) were randomly assigned to the EDSS-supported planning group or to the usual care planning group. Consumers (N=80) were assigned to the same group as their case managers. User satisfaction with the care planning process was assessed for consumers and case managers (possible scores range from 1 to 5, with higher summary scores indicating more satisfaction). Recall of the care plan was a...

  • WPA guidance on steps, obstacles and mistakes to avoid in the implementation of Community Mental Health care
    World Psychiatry, 2010
    Co-Authors: Graham Thornicroft, Renato Antunes Dos Santos, Guilherme Gregorio, Hiroto Ito, Atalay Alem, Eric Latimer, Elizabeth Barley, Charlotte Hanlon, Robert E Drake, Ann Law
    Abstract:

    This paper provides guidance on the steps, obstacles and mistakes to avoid in the implementation of Community Mental Health care. The document is intended to be of practical use and interest to psychiatrists worldwide regarding the development of Community Mental Health care for adults with Mental illness. The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole populations, the importance of promoting Community awareness about Mental illness to increase levels of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the Community. The paper concludes by setting out a series of lessons learned from the accumulated practice of Community Mental Health care to date worldwide, with a particular focus on the social and governMental measures that are required at the national level, the key steps to take in the organization of the local Mental Health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates.

  • individual placement and support a Community Mental Health center approach to vocational rehabilitation
    Community Mental Health Journal, 1994
    Co-Authors: Deborah R Becker, Robert E Drake
    Abstract:

    Individual Placement and Support (IPS) is a vocational rehabilitation intervention for people with severe Mental disabilities. IPS draws from components and philosophies of several other models. Employment specialists, who are part of the Community Mental Health center team, provide services in the Community. IPS emphasizes client preferences, rapid job finding, continuous assessment, competitive employment, integrated work settings, and follow-along supports. Initial research on IPS shows favorable results.

Caitlin Fehily - One of the best experts on this subject based on the ideXlab platform.

  • uptake of a preventive care consultation offered to clients of a Community Mental Health service
    Preventive medicine reports, 2020
    Co-Authors: Caitlin Fehily, Kate Bartlem, John Wiggers, Rebecca K Hodder, Lauren Gibson, Natalie Hancox, Jenny Bowman
    Abstract:

    Abstract Preventive care to address client chronic disease risks is not frequently provided in Community Mental Health services. Offering clients an additional preventive care consultation has been shown to increase client receipt of such care. The ability of this approach to have a beneficial impact at the population level is however dependent on its level of acceptability and uptake among clients. No studies have previously reported these outcomes when the additional consultation is universally offered to all clients of a Community Mental Health service. To address this evidence gap, this descriptive study was undertaken to determine Community Mental Health clients’ (1) reported acceptability, in principle, of such a model of care, (2) of those who were offered the additional consultation, the level of uptake, and (3) clinical and socio-demographic characteristics associated with uptake. Participants were clients of one Community Mental Health service in Australia. Data were collected in 2017 by telephone interviews and study records. Data from three distinct participant sub-groups are reported. In response to a hypothetical question, 79.3% of participants (n = 157) agreed that an offer of an additional preventive care consultation would be acceptable (Aim 1). Of the participants who were offered such a consultation (n = 264), 37.8% took up the offer (Aim 2); and no clinical or sociodemographic characteristics were significantly associated with uptake (Aim 3). Findings support the feasibility of this model of care. However, further research is needed to identify barriers to uptake, and effective strategies to enhance consultation uptake. Trial registration: ACTRN12616001519448.

  • effectiveness of embedding a specialist preventive care clinician in a Community Mental Health service in increasing preventive care provision a randomised controlled trial
    Australian and New Zealand Journal of Psychiatry, 2020
    Co-Authors: Caitlin Fehily, Kate Bartlem, John Wiggers, Paula Wye, Richard Clancy, David Castle, Andrew Wilson, Chris Rissel, Sonia Wutzke
    Abstract:

    Objective:Clinical practice guidelines recommend that Community Mental Health services provide preventive care for clients’ chronic disease risk behaviours; however, such care is often not routinel...

Rinad S Beidas - One of the best experts on this subject based on the ideXlab platform.

  • Clinical Supervision in Community Mental Health: Characterizing Supervision as Usual and Exploring Predictors of Supervision Content and Process
    Community Mental Health Journal, 2020
    Co-Authors: Simone H. Schriger, Emily M. Becker-haimes, Laura Skriner, Rinad S Beidas
    Abstract:

    Clinical supervision can be leveraged to support implementation of evidence-based practices in Community Mental Health settings, though it has been understudied. This study focuses on 32 supervisors at 23 Mental Health organizations in Philadelphia. We describe characteristics of supervisors and organizations and explore predictors of supervision content and process. Results highlight a low focus on evidence-based content and low use of active supervision processes. They underscore the need for further attention to the Community Mental Health context when designing supervision-targeted implementation strategies. Future work should assess whether supervision models specific to Community Mental Health are needed.

  • characterizing the heterogeneity of clinician practice use in Community Mental Health using latent profile analysis
    BMC Psychiatry, 2019
    Co-Authors: Rinad S Beidas, Emily M Beckerhaimes, Viktor Lushin, Torrey A Creed
    Abstract:

    The behavioral Health service provider population is highly heterogeneous. However, it is rarely treated as such within evidence-based practice implementation efforts. This study aimed to evaluate, as a proof of concept, the utility of latent profile analysis to identify distinct profiles of clinician practices in a large sample of youth-serving Community Mental Health clinicians. This study also aimed to identify predictors of profile membership to inform implementation efforts. Participants were 484 practicing clinicians (79.4% female, 45.7% White, M age = 37.1 years). As part of a larger survey, clinicians reported on their use of cognitive, behavioral, family, and psychodynamic treatment techniques with a representative client on their caseload. Latent profile analysis was used to determine the presence of clinician practice profiles. Multilevel multinomial logistic regressions examined predictors of profile membership. Latent profile analysis indicated a 4-profile solution best fit the data, with clinicians who: 1) used generally low levels of all examined techniques and preferred cognitive techniques (Low Eclectics, 16%), 2) delivered moderate levels of all techniques (Moderate Eclectics, 53%), 3) demonstrated preference for use of family techniques (Family Preferred, 11%), and 4) used high levels of all techniques (Super Users, 20%). Clinician discipline (e.g., social work), education, and years of experience predicted profile membership. Findings from this proof of concept study underscore the utility of latent profile analysis to characterize the complex and heterogeneous makeup of Community Mental Health. Results extend prior work highlighting the eclectic nature of Community Mental Health practice. Predictor analyses underscore the important influence of clinician background characteristics on practice use.

  • predictors of clinician use of exposure therapy in Community Mental Health settings
    Journal of Anxiety Disorders, 2017
    Co-Authors: Emily M Beckerhaimes, Arthur C Evans, Courtney Benjamin Wolk, Kelsie H Okamura, Ronnie Rubin, Rinad S Beidas
    Abstract:

    Exposure therapy is recognized as the key component of cognitive-behavioral treatment for anxiety. However, exposure is the least used evidence-based treatment in Community Mental Health settings and is the most challenging technique for clinicians to adopt within the context of effectiveness and implementation trials. Little work has examined clinician and organizational characteristics that predict use of exposure, which is important for identifying implementation strategies that may increase its use. In a large sample of Community Health clinicians (N = 335) across 31 clinical practice sites, this study characterized clinician and organizational predictors of exposure use and relaxation for anxiety. Mixed effects regression analyses indicated that both clinician attitudes and an organization’s implementation climate may be important levers for interventions seeking to increase clinician exposure use. Greater clinician use of relaxation strategies was also associated with less exposure use. Results point to important implications for implementing cognitive-behavioral therapy for anxiety, including de-emphasizing relaxation and attending to organizational climate.

  • policy to implementation evidence based practice in Community Mental Health study protocol
    Implementation Science, 2013
    Co-Authors: Rinad S Beidas, Gregory A Aarons, Frances K Barg, Arthur C Evans, Trevor R Hadley, Kimberly Hoagwood, Steven C Marcus, Sonia Schoenwald, Lucia M Walsh, David S Mandell
    Abstract:

    Background: Evidence-based treatments (EBTs) are not widely available in Community Mental Health settings. In response to the call for implementation of evidence-based treatments in the United States, states and counties have mandated behavioral Health reform through policies and other initiatives. Evaluations of the impact of these policies on implementation are rare. A systems transformation about to occur in Philadelphia, Pennsylvania, offers an important opportunity to prospectively study implementation in response to a policy mandate. Methods/design: Using a prospective sequential mixed-methods design, with observations at multiple points in time, we will investigate the responses of staff from 30 Community Mental Health clinics to a policy from the Department of Behavioral Health encouraging and incentivizing providers to implement evidence-based treatments to treat youth with Mental Health problems. Study participants will be 30 executive directors, 30 clinical directors, and 240 therapists. Data will be collected prior to the policy implementation, and then at two and four years following policy implementation. Quantitative data will include measures of intervention implementation and potential moderators of implementation (i.e., organizational- and leader-level variables) and will be collected from executive directors, clinical directors, and therapists. Measures include self-reported therapist fidelity to evidencebased treatment techniques as measured by the Therapist Procedures Checklist-Revised, organizational variables as measured by the Organizational Social Context Measurement System and the Implementation Climate Assessment, leader variables as measured by the Multifactor Leadership Questionnaire, attitudes towards EBTs as measured by the Evidence-Based Practice Attitude Scale, and knowledge of EBTs as measured by the Knowledge of EvidenceBased Services Questionnaire. Qualitative data will include semi-structured interviews with a subset of the sample to assess the implementation experience of high-, average-, and low-performing agencies. Mixed methods will be integrated through comparing and contrasting results from the two methods for each of the primary hypotheses in this study. Discussion: Findings from the proposed research will inform both future policy mandates around implementation and the support required for the success of these policies, with the ultimate goal of improving the quality of treatment provided to youth in the public sector.