Attitudes to evidence-based interventions and routine outcome measures in mental health professionals

Abstract

The complicated relationship between clinical health science and clinical practice has widely been referred to as the “science-practice gap”. This is for instance visible in the discrepancy between the amount of resources spent to develop and apply evidence-based treatment programmes and interventions (EBI) and the extent to which these interventions are used in real-life mental health care service settings. This is a major impetus for the field of implementation science, which strives for a deeper understanding of factors and strategies that determine the success or failure of implementation in health care organisations. This thesis explores factors that might influence the implementation of EBI in routine mental health care, including the specific intervention of routine outcome monitoring and feedback (ROM). The thesis has a special focus on mental health professionals’ attitudes toward adopting EBI, measurement issues as well as the relationship between attitudes and organizational factors. Data were collected through two different online survey studies in which members of the Norwegian Psychological Association and the Norwegian Nurses Organization, professional group for nurses working in mental health and substance abuse, were invited to participate. Papers I and III provides implementation instruments that could be used both for research and applied purposes. Paper II explore individual and organizational predictors of professionals’ attitudes towards adopting EBI. Paper III aim at gaining insight into professionals’ attitudes that might influence the adoption of ROM, through exploring how attitudinal domains relate to clinicians use of standardized instruments for treatment planning and evaluation. Major results and implications of these studies include the need to consider that professionals exhibit different levels of experience, perspectives and needs, which again may have implications for the choice and design of training efforts and organizational support that will most efficiently lead to successful adoption and sustainability of an implementation initiative.