Skip to main content

Advertisement

SpringerLink
Log in

A Survey of the Infrastructure for Children’s Mental Health Services: Implications for the Implementation of Empirically Supported Treatments (ESTs)

  • Original paper
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

A structured interview survey of directors of a large national sample (n = 200) of mental health service organizations treating children examined the governance, financing, staffing, services, and implementation practices of these organizations; and, director ratings of factors important to implementation of new treatments and services. Descriptive analyses showed private organizations financing services with public (particularly Medicaid) funds are prevalent and that employment of professional staff, clinical supervision and training, productivity requirements, and outcomes monitoring are common. Results of random effects regression models (RRMs) evaluating associations between governance, financing, and organizational characteristics and the use of new treatments and services showed for-profit organizations more likely to implement such treatments, and organizations with more licensed clinical staff and weekly clinical supervision in place less likely to do so. Results of RRMs evaluating relations between director ratings of the importance to new treatment and service implementation of three factors—fit with existing implementation practices, infrastructure support, and organizational mission and support—suggest greater importance to public than private organizations of these factors. Implications for EST implementation and future research are described.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Becker, D. R., McHugo, G. J., Halliday, J., & Martinez, R. A. (2006). What predicts supported employment program outcome? Community Mental Health Journal, 42(3), 303–313.

    Article  PubMed  Google Scholar 

  • Bickman, L. (1999). Practice makes perfect and other myths. American Psychologist, 54, 965–978.

    Article  Google Scholar 

  • Bickman, L. (2000). Our quality-assurance methods aren’t so sure. Behavioral Healthcare Tomorrow, June, 41–48.

    Google Scholar 

  • Blatt, S. J., Sanislow, C. A., Zuroff, D. C., & Pilkonis, P.A. (1996). Characteristics of effective therapists: Further analyses of data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 64, 1276–1284.

    Article  PubMed  CAS  Google Scholar 

  • Bond, T. G., & Fox, C. M. (2007). Applying the Rasch model: Fundamental measurement in the human sciences (2nd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Burns, B. J., Phillips, S. D., Wagner, H. R., Barth, R. P., Kolko, D. J., Campbell, Y., & Landsverk, J. (2004). Links: Mental health need and access to mental health services by youthsinvolved with child welfare: a national survey. American Academy of Child and Adolescent Psychiatry, 43(8), 960–70.

    Article  Google Scholar 

  • Center for Mental Health Services (2006). In R. W. Manderscheid & J. T. Berry (Eds.), Mental Health United States, 2004. DHHS Pub No. (SMA)-06-4195. Rockville, MD: Substance Abuse and Mental Health Services Administration.

  • Chapman, J. E., & Schoenwald, S. K. (2007). Rasch Measurement modeling of the dimensions of organizational readiness-revised (DOOR-R) scale in child-serving clinics. Technical report. Charleston, SC: Medical University of South Carolina.

    Google Scholar 

  • Cohen, W. M., & Levinthal, D. A. (1990). Absorptive capacity: A new perspective on learning and innovation. Administrative Science Quarterly, 35, 128–152.

    Article  Google Scholar 

  • Compton, W. M., Stein, J. B., Robertson, E. B., Pintello, D., Pringle, B., & Volkow, N. D. (2005). Charting a course for health services research at the National Institute on Drug Abuse. Journal of Substance Abuse Treatment, 29, 167–172.

    Article  Google Scholar 

  • Damanpour, F. (1991). Organizational innovation: A meta-analysis of effects of determinants and moderators. The Academy of Management Journal, 34, 555–590.

    Article  Google Scholar 

  • Damanpour, F. (1996). Organizational complexity and innovation: Developing and testing multiple contingency models. Management Science, 42, 693–716.

    Article  Google Scholar 

  • Department of Health and Human Services (DHHS) (2005). Final report on the dimensions of organizational readiness (DOOR) in child-serving clinics. National Institutes of Health Grant R24 MH068708–01.

  • Ferlie, E. B., & Shortell, S. M. (2001). Improving the quality of health care in the United Kingdom and the United States: A framework for change. The Milbank Quarterly, 79, 281–315.

    Article  PubMed  CAS  Google Scholar 

  • Grol, R., & Grimshaw, J. (1999). Evidence-based implementation of evidence-based medicine. Journal on Quality Improvement, 25, 503–513.

    CAS  Google Scholar 

  • Guydish, J., Turcotte Manser, S., Jessup, M., Tajima, B., Sears, C., & Montini, T. (2005). Multi-level assessment protocol (MAP) for adoption in multisite clinical trials. Journal of Drug Issues, Summer, 529–546.

    Google Scholar 

  • Heinrich, C. J., & Fournier, E. (2005). Instruments of policy and administration for improving substance abuse treatment practice and program outcomes. Journal of Drug Issues, Summer, 485–506.

    Google Scholar 

  • Henggeler, S. W., Chapman, J. E., Rowland, M. D., Halliday-Boykins, C. A., Randall, J., Shackleford, J., & Schoenwald, S. K. (2007). Statewide adoption and initial implementation of contingency management for substance abusing adolescents. Manuscript under review.

  • Hoagwood, K., Schoenwald, S. K., & Chapman, J. E. (2003). Dimensions of Organizational Readiness – Revised (DOOR-R). Unpublished Instrument.

  • Hoge, M.A. (2002). The training gap: An acute crisis in behavioral health education. Administration and Policy in Mental Health, 29(4/5), 305–318.

    Article  PubMed  Google Scholar 

  • Huppert, J. D., Bufka, L. F., Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2001). Therapists, therapist variables, and cognitive-behavioral therapy outcome in a multicenter trial for panic disorder. Journal of Consulting and Clinical Psychology, 69, 747–755.

    Article  PubMed  CAS  Google Scholar 

  • Isett, K. R., Burnam, M. A., Coleman-Beattie, B., Hyde, P. S., Morrissey, J. P., Magnabosco, J., Rapp, C. A., Ganju, V., & Goldman, H. H. (2007). The state policy context of implementation issues for evidence-based practices in mental health. Psychiatric Services, 58, 914–921.

    Article  PubMed  Google Scholar 

  • Knudsen, H. K., & Roman, P. M. (2004). Modeling the use of innovations in private treatment organizations: The role of absorptive capacity. Journal of Substance Abuse Treatment, 26, 51–59.

    Article  Google Scholar 

  • Leslie, L. K., Hurlburt, M. S., Landsverk, J., Rolls, J. A., Wood, P. A., & Kelleher, K. J. (2003). Comprehensive assessments for children entering foster care: A national perspective. Pediatrics, 112, 134–142.

    Article  PubMed  Google Scholar 

  • Linacre, J. M. (2002). Optimizing rating scale category effectiveness. Journal of Applied Measurement, 3, 85–106.

    PubMed  Google Scholar 

  • Linacre, J. M. (2006). WINSTEPS Rasch measurement computer program (Version 3.63) [Computer software]. Chicago: Winsteps.com.

    Google Scholar 

  • Maas, C. J. M., & Hox, J. J. (2005). Sufficient sample sizes for multilevel modeling. Methodology, 1, 86–92M.

    Article  Google Scholar 

  • McClellan, A. T., Carise, D., & Kleber, H. D. (2003). Can the national addiction treatment infrastructure support the public’s demand for quality care? Journal of Substance Abuse Treatment, 25(2), 117–121.

    Article  Google Scholar 

  • McFarlane, W. R., McNary, S., Dixon, L., Hornby, H., & Cimett, E. (2001). Predictors of dissemination of psychoeducation in community mental health centers in Maine and Illinois. Psychiatric Services, 52, 935–943.

    Article  PubMed  CAS  Google Scholar 

  • Raiche, G. (2005). Critical eigenvalue sizes in standardized residual principal components analysis. Rasch Measurement Transactions, 19, 1012.

    Google Scholar 

  • Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (2nd ed.). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Raudenbush, S. W., Bryk, A. S., Cheong, Y. F., Congdon, R., & du Toit, M. (2004). HLM 6: Hierarchical linear & nonlinear modeling (Version 6.02) (Computer software and manual). Lincolnwood, IL: Scientific Software International.

    Google Scholar 

  • Real, K., & Poole, M. S. (2005). Innovation implementation: Conceptualization and measurement in organizational research. Research in Organizational Change and Development, 15, 63–134.

    Article  Google Scholar 

  • Ridgely, M. S., Giard, J., Sern, D., Mulkern, V., & Burnam, A. (2002). Managed behavioral health care: An instrument to characterize critical elements of public sector programs. Health Services Research, 37, 1105–1123.

    Article  PubMed  Google Scholar 

  • Roman, P. M., & Johnson, A. (2002). Adoption and implementation of new technologies in substance abuse treatment. Journal of Substance Abuse Treatment, 22, 211–218.

    Article  PubMed  Google Scholar 

  • Saldana, L., Chapman, J. E., Henggeler, S. W., & Rowland, M. D. (2007). The organizational readiness for change scale in adolescent programs: Criterion validity. Journal of Substance Abuse Treatment, 33, 159–169.

    Article  PubMed  Google Scholar 

  • Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52, 1179–1189.

    Article  PubMed  Google Scholar 

  • Schoenwald, S. K., Kelleher, K., Hoagwood, K., Landsverk, J., & Glisson, C. (2003). The Clinic System Project (CSP) Director Survey. Unpublished instrument.

  • Schoenwald, S. K., Sheidow, A. J., Letourneau, E. J., & Liao, J. G. (2003). Transportability of multisystemic therapy: Evidence for multi-level influences. Mental Health Services Research, 5, 223–239.

    Article  PubMed  Google Scholar 

  • Simpson, D. D. (2002). A conceptual framework for transferring research to practice. Journal of Substance Abuse Treatment, 22, 171–182.

    Article  PubMed  Google Scholar 

  • Snijders, T. A. B., & Bosker, R. J. (1999). Multilevel analysis: An introduction to basic and advanced multilevel modeling. London: Sage.

    Google Scholar 

  • Tennant, A., & Pallant, J. F. (2006). Unidimensionality matters! (A tale of two Smiths?). Rasch Measurement Transactions, 20, 1048–1051.

    Google Scholar 

  • Van de Ven, A. H. (1986). Central problems in the management of innovation. Management Science, 32, 590–607.

    Google Scholar 

  • Wright, B. D., & Masters, G. M. (1982). Rating scale analysis. Chicago: Pluribus Press.

    Google Scholar 

  • Zahra, S. A., & George, G. (2002). Absorptive capacity: A review, reconceptualization, and extension. Academy of Management Review, 27, 185–203.

    Article  Google Scholar 

  • Zammuto, R. F., & Krackower, J. Y. (1991). Quantitative and qualitative studies of organizational culture. Research in Organizational Change and Development, 5, 83 –114.

    Google Scholar 

Download references

Acknowledgments

Preparation of this manuscript was supported by the John D. and Catherine T. MacArthur Foundation and grants 59138 from the National Institute of Mental Health and DA018107 from the National Institute on Drug Abuse, and by the Annie E. Casey Foundation.

Author information

Authors and Affiliations

  1. Family Services Research Center, Medical University of South Carolina, 67 President Street, Ste MC 406, P.O. Box 250861, Charleston, SC, 29425, USA

    Sonja K. Schoenwald & Jason E. Chapman

  2. Columbus Children’s Hospital and the Ohio State University, Columbus, OH, USA

    Kelly Kelleher & Jack Stevens

  3. Columbia University, New York, NY, USA

    Kimberly Eaton Hoagwood

  4. Children’s Hospital, San Diego, USA

    John Landsverk & Jennifer Rolls-Reutz

  5. University of Tennessee, Knoxville, TN, USA

    Charles Glisson

Authors
  1. Sonja K. Schoenwald
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason E. Chapman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kelly Kelleher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kimberly Eaton Hoagwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John Landsverk
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jack Stevens
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Charles Glisson
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jennifer Rolls-Reutz
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

The Research Network on Youth Mental Health

Corresponding author

Correspondence to Sonja K. Schoenwald.

Additional information

The Research Network on Youth Mental Health is a collaborative network funded by the John D. and Catherine T. MacArthur Foundation. Network Members at the time this work was performed included: John R. Weisz, Ph.D. (Network Director), Bruce E. Chorpita, Ph.D., Robert Gibbons, Ph.D., Charles Glisson, Ph.D., Evelyn Polk Green, M.A., Kimberly Hoagwood, Ph.D., Peter S. Jensen, M.D., Kelly Kelleher, M.D., John Landsverk, Ph.D., Stephen Mayberg, Ph.D., Jeanne Miranda, Ph.D., Lawrence Palinkas, Ph.D., Sonja K. Schoenwald, Ph.D.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schoenwald, S.K., Chapman, J.E., Kelleher, K. et al. A Survey of the Infrastructure for Children’s Mental Health Services: Implications for the Implementation of Empirically Supported Treatments (ESTs). Adm Policy Ment Health 35, 84–97 (2008). https://doi.org/10.1007/s10488-007-0147-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-007-0147-6

Keywords

Search

Navigation