Diversity in practitioners' perspectives on the implementation of the evidence‐based Triple P—Positive Parenting Program

Evidence‐based programs (EBPs) have the potential to improve the well‐being of families and children, but do not necessarily produce the expected outcomes when implemented in real‐world settings. It thus appears essential to consider the factors that can impact the implementation process, especially those related to the practitioners who deliver these programs. This study aimed to identify and describe common patterns in practitioners' experience of the implementation of an EBP. To this end, six focus groups were conducted with 38 practitioners from the health, social and education sectors, 1 year after they had received training in the evidence‐based Triple P—Positive Parenting Program. An in‐depth analysis of the content of these interviews revealed a diversity in the practitioners' experience of the implementation of Triple P. Three distinct types of discourse regarding the implementation process, labelled ‘conviction’, ‘mastering’ and ‘estrangement’ discourse, were identified. Motivational theories were used to understand the interaction between the factors that appeared to be key elements differentiating the discourses in this typology (i.e., practitioners' attitudes, perceived organisational support, self‐efficacy and level of program use). This study highlights the dynamic nature of the implementation process, and shows that a negative initial position towards a new EBP can change over time, given the appropriate organisational conditions.     

The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behavior: a comparison with two other treatment conditions

The aim of this randomized controlled trial was to evaluate the efficacy of an evidence-based parenting program (the Triple P-Positive Parenting Program), intending to improve parenting skills and children's well-being. Parents participating in a Group Triple P program (n=50 couples) were compared with parents of a non-treated control group (n=50 couples) and parents participating in a marital distress prevention program (couples coping enhancement training (CCET)) (n=50 couples). The two major goals of this study were (a) to evaluate the efficacy of Triple P compared with the two other treatment conditions over a time-span of 1 year and (b) to answer the question whether this program that was developed in Australia is culturally accepted by Swiss parents. Results revealed that Triple P was effective with Swiss families. Mothers of the Triple P group showed significant improvements in parenting, parenting self-esteem, and a decrease in stressors related to parenting. Women trained in Triple P also reported significantly lower rates of child's misbehavior than women of the two other conditions. However, in men only a few significant results were found. Positive effects of the relationship training (CCET) were somewhat lower than those for the Triple P. These findings are further discussed.     

Sustained Implementation of Evidence‐based Programs in Disadvantaged Communities: A Conceptual Framework of Supporting Factors

This paper presents a review of the empirical literature for studies evaluating factors that facilitate and create barriers to sustained program implementation in disadvantaged communities. It outlines study methodology and sustainment outcomes and proposes a conceptual model that involves implementation sustainment support for providers delivering evidence‐based health and family services in disadvantaged communities. Sustained program implementation in the community setting is a significant issue as only 43% of studies reported successfully sustained programs. The review identified 18 factors that facilitate success and create barriers to program sustainment. The factors are synthesized into three themes; program characteristics, workplace capacity, and process and interaction factors. The majority of factors map onto commonly cited sustainability influences in implementation science. However, there was an additional focus for studies included in this review on the importance of factors such as program burden, program familiarity and perceived competence in program skills, workplace support for the program, staff mobility and turnover, supervision and peer support, and ongoing technical assistance. The need to use a conceptual framework and develop measures to guide and evaluate capacity building in EBP implementation and sustainment in low‐resource community settings is highlighted.     

Challenges in Developing a Cultural Evidence‐Based Psychotherapy in the USA: Suggestions for International Studies

In this article, we underscore some of the cultural challenges and limitations of the evidence‐based psychotherapy (EBP) utilised within the USA with the hope that these problems will be avoided or ameliorated in Australia and other countries. Although the EBP research is very diverse and complex, we categorise this fast‐growing literature using a threefold classification system that underscores culture. This classification system is proposed to examine the influence of culture on EBPs. The three categories used are (a) universal evidence‐based psychotherapies or universal psychotherapies, (b) race and ethnic minority evidence‐based psychotherapies or racial/ethnic psychotherapies, and (c) cultural evidence‐based psychotherapies or cultural psychotherapies. After each category is described, its benefits and limitations are discussed, emphasising implications for culturally diverse and international studies. We conclude with suggestions to promote the advancement of a more effective and inclusive cultural EBP in which researchers from different countries can collaborate and learn from each other.     

Working in Indigenous Contexts: Self‐Reported Experiences of Non‐Indigenous Australian Psychologists

Despite assertions in the literature that psychologists adopt culturally inappropriate strategies for working with Indigenous clients, there is little empirical evidence about this. The aim of this study was to document the self‐reported experiences of non‐Indigenous psychologists working with Indigenous clients, the factors that they felt constrain these interactions, and the clinical, assessment and communication strategies they perceived as effective in Indigenous contexts. Structured interviews were held with 23 psychologists, 18 females and five males, with age groups ranging from 20–30 to 50+. Thematic analysis of the data revealed that participants experienced contradictions between the typical Western white psychologists' ways of interacting with clients, which they had been taught and the typical ways in which relationships are structured in Indigenous communities. The results suggest that the Western model of psychological training does not work very well in Indigenous contexts, and that psychologists working in Indigenous contexts have to work out their own methods on a trial‐and‐error basis. This points to the need for more systematic cultural competence training. However, there is a lack of research into the effectiveness of psychological intervention from the viewpoints of Indigenous clients themselves.     

Post G20: The Challenge of Change,Implementing Evidence‐based Public Order Policing

In the wake of the 2011 ‘riots’, public order policing tactics in England and Wales have once again been brought into question. Yet, the riots came two years since police regulatory authorities in the UK called for fundamental reforms to the policing of public order. Questions are raised about why the change called for appears to have been so slow and what can be done to assist reform. This paper suggests that developing an evidence‐based policing approach within the field of public order policing to inform police decision‐making would provide the answers. By doing so, the paper addresses some of the possible barriers to implementing evidence‐based policing in public order and calls for police academic partnership to overcome these to make ‘change’ an ongoing reality. Copyright © 2012 John Wiley & Sons, Ltd.     

Beyond the Belmont Principles: A Community‐Based Approach to Developing an Indigenous Ethics Model and Curriculum for Training Health Researchers Working with American Indian and Alaska Native Communities

Individuals responsible for carrying out research within their diverse communities experience a critical need for research ethics training materials that align with community values. To improve the capacity to meet local human subject protections, we created the research Ethics Training for Health in Indigenous Communities (rETHICS), a training curriculum aligned within American Indian and Alaska Native (AI/AN) context, culture, and community‐level ethical values and principles. Beginning with the Belmont Report and the Common Rule that defines research with human subjects (46 CFR 45), the authors convened three different expert panels (N = 37) to identify Indigenous research values and principles common across tribal communities. The resulting culturally grounded curriculum was then tested with 48 AI/AN individuals, 39 who also had recorded debriefing interviews. Using a thematic analysis, we coded the qualitative feedback from the expert panel discussions and the participant debriefings to assess content validity. Participants identified five foundational constructs needed to ensure cultural‐grounding of the AI/AN‐specific research training curriculum. These included ensuring that the module was: (a) framed within an AI/AN historical context; (b) reflected Indigenous moral values; (c) specifically linked AI/AN cultural considerations to ethical procedures; (d) contributed to a growing Indigenous ethics; and (e) provided Indigenous‐based ethics tools for decision making. Using community‐based consultation and feedback from participants led to a culturally grounded training curriculum that teaches research ethical principles and procedures for conducting research with AI/ANs. The curriculum is available for free and the community‐based process used can be adapted for other cultural groups.     

Nostalgia in response to group‐based exclusion: The role of attachment‐related avoidance

We proposed that nostalgia, by virtue of its sociality, can be an indirect strategy to counteract relational deficiencies stemming from group‐based exclusion. We instructed Greek participants to recall an event in which they experienced exclusion on the basis of their nationality versus a control event. We anticipated that participants would react to group‐based exclusion with increased nostalgia. Specifically, because low attachment‐related avoidance facilitates proximity‐seeking in response to distress, we hypothesized that group‐based exclusion would increase nostalgia (a form of proximity‐seeking) more strongly when avoidance is low. Results supported this moderation hypothesis. In turn, increased nostalgia in response to group‐based exclusion predicted stronger ingroup identification. For low‐avoidants, then, group‐based exclusion fortified ingroup identification via increased nostalgia (moderated mediation).     

Engagement With Self‐Practice/Self‐Reflection as a Professional Development Activity: The Role of Therapist Beliefs

A number of research studies support self‐practice/self‐reflection (SP/SR) as an experiential learning process that facilitates the acquisition of therapeutic skill in a number of cognitive‐behavioural therapy (CBT) competencies and as showing potential as a valuable professional development activity. Engaging therapists to participate in SP/SR programmes is sometimes difficult, and when they are offered the option to participate in SP/SR programmes as part of professional development, relatively few volunteer. This study investigates the role of therapist beliefs about SP/SR as a potential obstacle to engagement. An online survey was developed to assess the strength of 14 commonly held therapist beliefs concerning the consequences of participating voluntarily in a SP/SR programme. Participants were a combined sample of 44 Psychological Wellbeing Practitioners and high‐intensity CBT therapists employed by an Improving Access to Psychological Therapies service in the United Kingdom. Few negative beliefs about SP/SR emerged. The majority of respondents believed SP/SR programmes were relevant to their work situation, but perceived “lack of time” as a significant barrier to participation. Three factors are considered in relation to introducing SP/SR as a workforce professional development activity: (a) The importance of managing therapist perceptions regarding time; (b) SP/SR as a mechanism to increase self‐care and reduce burnout; and (c) The need to focus mental health services' attention on the potential of SP/SR programmes to increase staff morale and improve service delivery.     

The dark side of cognitive illusions: When an illusory belief interferes with the acquisition of evidence‐based knowledge

Cognitive illusions are often associated with mental health and well‐being. However, they are not without risk. This research shows they can interfere with the acquisition of evidence‐based knowledge. During the first phase of the experiment, one group of participants was induced to develop a strong illusion that a placebo medicine was effective to treat a fictitious disease, whereas another group was induced to develop a weak illusion. Then, in Phase 2, both groups observed fictitious patients who always took the bogus treatment simultaneously with a second treatment which was effective. Our results showed that the group who developed the strong illusion about the effectiveness of the bogus treatment during Phase 1 had more difficulties in learning during Phase 2 that the added treatment was effective.     

Strengthening and Expanding Child Services in Low Resource Communities: The Role of Task‐Shifting and Just‐in‐Time Training

In the United States, the demand for child mental health services is increasing, while the supply is limited by workforce shortages. These shortages are unlikely to be corrected without significant structural changes in how mental health services are provided. One strategy for bridging this gap is task‐shifting, defined as a process by which services that are typically delivered by professionals are moved to individuals with less extensive qualifications or training. Although task‐shifting can increase the size of the workforce, there are challenges related to training new workers. In this paper, we propose Just‐In‐Time Training (JITT) as one strategy for improving task‐shifting efforts. We define JITT as on‐demand training experiences that only include what is necessary, when it is necessary, to promote competent service delivery. We offer a proof of concept from our own work shifting counseling and academic support tasks from school mental health professionals to pre‐baccalaureate mentors, citing lessons learned during our iterative process of JITT development. We conclude with a series of key considerations for scaling up the pairing of task‐shifting and JITT, including expanding the science of JITT and anticipating how task‐shifting and JITT would work within the context of dynamic mental health service systems.     

Supporting Out‐of‐School Time Staff in Low Resource Communities: A Professional Development Approach

Federally funded out‐of‐school time (OST) programs provide academic support, enrichment, and safety for students and families in low‐resource communities. However, programs struggle to meet these aims, in part because of the lack of program structure and limited training and support for staff. This observational case study documents the training and technical assistance (TA) delivered to OST frontline staff and program leadership to implement Positive Behavior in Out‐of‐School Time (Positive BOOST), an adaptation of positive behavior interventions and supports conducted in multiple settings. Findings across three programs indicate that varied levels of TA (i.e., business as usual, performance feedback, coaching) are associated with different levels of staff‐ and program‐level implementation. Taken together with previous research, these findings suggest that targeted investment in developing the skills of OST staff and improving program‐wide outcomes is critical for supporting youth in low‐resource communities.     

The effectiveness of a skills‐based program in reducing public speaking anxiety

Research was conducted to test the effectiveness of a skills‐based program as a method for reducing anxiety during public speaking. Twenty‐five Japanese college sophomores were exposed to a systematic approach for developing a presentation that was theoretically linked to mechanisms to reduce communication apprehension (CA). Students gave four presentations that were graded by both teacher and peer evaluation. Results indicated that the experimental group reported a significantly greater drop in public speaking anxiety than did a control group of 86 students.     

An Initial Investigation of Individual Instructors’ Self‐Perceived Competence and Incorporation of Disability Content Into CACREP‐Accredited Programs: Rethinking Training in Counselor Education

Given the prevalence of children and families who experience disabilities, this study examined how 141 instructors from programs accredited by the Council for Accreditation of Counseling and Related Educational Programs cover disability‐related content in their curriculum. The study also examined the influence self‐perceived disability‐related competencies have on whether and how instructors infuse disability‐related content into counselor pedagogy. Limitations and implications for counselor educators are presented. Dada la prevalencia de niños y familias que experimentan discapacidades, este estudio examinó cómo 141 docentes de programas acreditados por el Consejo de Acreditación en Consejería y Programas Educativos Relacionados (CACREP, por sus siglas en inglés) presentan los contenidos relacionados con la discapacidad en sus currículums. El estudio también examinó la influencia que tienen las competencias autopercibidas relacionadas con la discapacidad sobre si los docentes incluyen contenidos relacionados con la discapacidad en la pedagogía de consejeros y de qué forma lo hacen. Se presentan las limitaciones e implicaciones para educadores de consejeros.     

How perceived interpersonal justice relates to job burnout and intention to leave: The role of leader–member exchange and cognition‐based trust in leaders

Intense competition among companies makes it particularly important for organizations to retain talented and skilled employees to maintain their competitive advantage. This study examines the linkage between employees' perceptions of the interpersonal justice demonstrated by their leaders and consequent job burnout resulting in turnover intention by focusing on the mediating role of leader–member exchange (LMX) as well as the moderating role of employees' cognition‐based trust in their leaders. Data were obtained from 158 MBA students attending a large university in South Korea. Using structural equation modelling, we examined an integrative model that combines interpersonal justice, LMX, job burnout, and turnover intention. The results reveal that (a) LMX partially mediates the relationships between interpersonal justice and job burnout and (b) employees' cognition‐based trust in their leaders moderates the relationship between LMX and job burnout. By examining the mediating role of LMX as well as the moderating role of cognition‐based trust in the relationship between perceived interpersonal justice and employee job burnout, this study (1) provides a comprehensive explanation of employee job burnout and (2) outlines the implications for job burnout research and practice.     

Enhancing Program Quality in a National Sample of After‐school Settings: The Role of Youth–Staff Interactions and Staff/Organizational Functioning

Using multilevel data from the national evaluation of Boys and Girls Clubs of America (BGCA), this study examined associations among programmatic structures, workplace and workforce characteristics, and relational practices of program staff as they relate to young people's ratings of their experience attending local clubs. The sample included 57,710 members and 5,231 staff members at 740 BGCA sites throughout the United States. Staff relational practices—including establishing caring relationships, setting high expectations, positive behavior management, encouraging youth input and agency, and cultural sensitivity—explained associations between staffing and organizational functioning and youths’ perceptions of the quality of their clubs. Findings suggest a central role of staff relational practices in establishing conditions that youth experience positively, and that staffing and organizational processes, including community engagement and teamwork and efficiency can be viewed as foundations for establishing a culture of positive adult‐youth interaction, which in turn can contribute to the promotion of positive youth development. Further, identification with the experiences of youth had a direct association with youths’ perceptions of club quality. These results underscore the importance of staff workforce development initiatives as key to improving youth experiences in after‐school programs.     

A Balancing Act: Integrating Evidence‐Based Knowledge and Cultural Relevance in a Program of Prevention Parenting Research with Latino/a Immigrants

Family therapists have a unique opportunity to contribute toward the reduction of widespread mental health disparities impacting diverse populations by developing applied lines of research focused on cultural adaptation. For example, although evidence‐based prevention parent training (PT) interventions have been found to be efficacious with various Euro‐American populations, there is a pressing need to understand which specific components of PT interventions are perceived by ethnic minority parents as having the highest impact on their parenting practices. Equally important is to examine the perceived cultural relevance of adapted PT interventions. This qualitative investigation had the primary objective of comparing and contrasting the perceived relevance of two culturally adapted versions of the efficacious parenting intervention known as Parent Management Training, the Oregon Model (PMTO). According to feasibility indicators provided by 112 Latino/a immigrant parents, as well as findings from a qualitative thematic analysis, the core parenting components across both adapted interventions were identified by the majority of research participants as relevant to their parenting practices. Participants exposed to the culturally enhanced intervention, which included culture‐specific sessions, also reported high satisfaction with components exclusively focused on cultural issues that directly impact their parenting practices (e.g., immigration challenges, biculturalism). This investigation illustrates the relevant contributions that family therapy scholars can offer toward addressing mental health disparities, particularly as it refers to developing community‐based prevention interventions that achieve a balance between evidence‐based knowledge and cultural relevance.