David A. Patterson Silver Wolf

Is Openness to Using Empirically Supported Treatments Related to Organizational Culture and Climate

ABSTRACT The overall purpose of this study is to investigate workers’ openness toward implementing a new empirically supported treatment (EST) and to determine whether the workers’ openness scores relate to their workplace culture and climate scores. Participants in this study (N = 1,273) worked in a total of 55 different programs in a large child and family services organization and completed a survey measuring their attitudes toward ESTs. Results indicate that work groups that measure themselves as being more open to using ESTs rated their organizational cultures as being significantly more proficient and significantly less resistant to change. With ESTs becoming the gold standard for professional social work practices, it is important to have accessible pathways to EST implementation.

Factors Influencing Worker Morale: Evaluating Provider Demographics, Workplace Environment and Using ESTs

Objectives: Mental health organizations are strongly encouraged to implement empirically supported treatments (ESTs); however, little is known about their working environments. The present study investigated how provider demographics, workplace environment, and whether ESTs were used affected the worker morale. Method: Frontline workers (N = 1,273) from 55 different programs in a single, large organization completed a measure of organizational culture and climate (OCC) and worker morale. A multilevel regression analysis used worker demographics to predict worker morale at Level 1 and EST use and OCC scales to predict program-level worker morale. Results: Worker morale was significantly negatively correlated with EST use and significantly correlated with OCC dimensions. Regression results showed that culture and climate but not EST use predicted morale. Conclusions: Although EST use by programs in this agency had negative effects on both morale and OCC, separately, the effect on morale was subsumed by the effect on OCC.

What Are the Ideal Characteristics of Empirically Supported Treatment Adopters

There has been a clear and consistent shift in social work practice from offering treatment as usual to implementing empirically supported treatments (ESTs). As social work researchers and practitioners continue to evaluate the effectiveness of ESTs, their impact on clinical outcomes, and the various obstacles to their adoption, a developing literature could offer some guidance on characteristics of EST adopters. This article provides a beginning discussion of the ideal characteristics of EST adopters both at the organizational and individual levels. While this is a developing area of study, there are some important findings that could better serve community-based organizations, their work force, and the communities they serve.There has been a clear and consistent shift in social work practice from offering treatment as usual to implementing empirically supported treatments (ESTs). As social work researchers and practitioners continue to evaluate the effectiveness of ESTs, their impact on clinical outcomes, and the various obstacles to their adoption, a developing literature could offer some guidance on characteristics of EST adopters. This article provides a beginning discussion of the ideal characteristics of EST adopters both at the organizational and individual levels. While this is a developing area of study, there are some important findings that could better serve community-based organizations, their work force, and the communities they serve.

Factors Influencing the Implementation of a Brief Alcohol Screening and Educational Intervention in Social Settings not Specializing in Addiction Services

Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers.Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers.

Development of a Brief Abstinence Self-Efficacy Measure.

This study compared the 40-item Alcohol Abstinence Self-Efficacy (AASE) scale with domains of confidence and temptation to a new 12-item version developed by the authors consisting of the same domains. There were 126 participants who completed the survey. Psychometric analysis demonstrated high reliability and validity consisting of high correlations between domains of confidence (α = .92) and temptation (α = .88) in the 40-item version of the scale compared to the briefer version. The 12-item version appears to provide a clinically reliable and valid measure of AASE domains of confidence and temptation, providing a more efficient tool for clinical practice.

Do Organizational Culture and Climate Matter for Successful Client Outcomes

Objectives: The existing literature on the impact of workplace conditions on client care suggests that good cultures and climates provide the best outcomes for clients. The primary purpose of this study was to investigate the relationship between organizational culture and climate and the proportion of children and youth successfully discharged from a large organization in New York state. Method: Thirty-three child and youth programs with existing culture and climate data evaluated outcome information from 1,336 clients exiting its services. Results: Programs reported as having bad culture and climate yielded superior client outcomes, measured as discharge to a lower level of care and successfully completing. Conclusion: This study and its conclusion point to a gap in knowledge concerning the relation between workplace culture and climate and the impact on client care and workers’ perceptions; this warrants further investigation in similar studies of agencies and their outcomes.

Organizational Leaders’ and Staff Members’ Appraisals of Their Work Environment Within a Children’s Social Service System

Several studies have demonstrated the effect of an organization’s culture and climate on the delivery of services to clients and the success of clinical outcomes. Workers’ perceptions are integral components of organizational social context, and in order to create a positive organizational culture and climate, managers and frontline staff need to have a shared understanding of the social context. The existing literature does not adequately address how discrepancies in perceptions of culture and climate between frontline staff and managers affect the implementation of policies and services. The purpose of this study is to compare the workgroup-level culture and climate of a single, large, child and family social services organization, based on the reported experiences of frontline workers and senior managers. The results show that, as a group, senior managers rate the organization as having a culture that is much more proficient and much less rigid and a climate that is more engaged and more functional than the ratings of the average frontline workgroup. The discrepancies between the perceptions of upper management and workgroup-level staff indicate the need for interventions that can improve communication and cohesiveness between these two groups.

Impact of Violence and Relationship Abuse on Grades of American Indian/Alaska Native Undergraduate College Students

Violence and relationship abuse are pervasive public health problems that have a range of negative effects, with exceptionally high prevalence among ethno–racial minority youth. This study assesses the prevalence of these types of violence among American Indian/Alaska Native (AI/AN) students and examines the impact of victimization on academic performance of AI/AN and non-AI/AN student populations using self-reported college health survey data. Results show that students who identified fully or partially as AI/AN reported markedly higher rates of all types of violence/abuse than did other students, and students who had experienced violence/abuse had lower grade point averages (GPAs) compared with those who had not. Recommendations for future research and direct practice with AI/AN students are discussed.

Measuring Attitudes Towards Empirically Supported Treatment in Real World Addiction Services

Mental health workers with favorable attitudes toward empirically supported treatments (ESTs) are more likely to break through implementation barriers. The Evidence-Based Practice Attitude Scale has been shown to be reliable for mental health workers, but it has not been validated with addiction workers. This study investigates the use of the scale with a convenience sample of addiction workers from 4 agencies in 1 city. Results show that compared to mental health providers, addiction workers were more likely to view ESTs favorably if they were mandated and intuitively appealing. They also tended to rely more heavily on practical experience in forming attitudes toward treatment options. These results might help addiction agencies understand which types of workers are more likely to implement ESTs and inform effective engagement approaches specific to addiction workers.

Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation

BackgroundSubstance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation.MethodsDirect service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire “fit continuum”.ResultsDiscrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use.ConclusionsThe current research benefits from a strong theoretical framework, consistent findings, and significant practical implications for substance abuse treatment agencies. Comprehensive attempts to strengthen outcomes related to EBP implementation must consider both provider- and agency-level characteristics regarding EBP use. Organizational efforts to more closely align provider attitudes and agency priorities will likely constitute a key strategy in fostering the implementation of EBPs in substance abuse treatment organizations.