(PS5-D99) Therapist Factors Related to Dropout from a Statewide Evidence-based Practice Training Program

Research in effective therapist training practices supports ongoing training and consultation for greater evidence-based practice (EBP) adoption and sustainment (e.g., Beidas et al., 2019). Large public system-wide mental health therapist training and consultation efforts are associated with certain financial burdens (Okamura et al., 2018). Despite the high expenditure of training programs, therapist dropout from these initiatives are often high, and little is known about factors contributing to withdrawal. Since a significant portion of behavioral health services for youth are provided through schools, there is a continued public health need for more school-based therapists to be trained in delivering evidence-based mental health practices (Frank et al., 2021). In an effort to understand factors that may improve therapist retention in evidence-based training, the current study evaluates elements of a Hawai'i State Department of Education initiative to offer statewide training on the Managing and Adapting Practice (MAP; PracticeWise, LLC) system, a modular-based approach to evidence-based service delivery. The current study examines the organizational factors (Implementation Climate, Citizenship Behavior, and Leadership Scales; Lyon et al., 2018) and individual therapist characteristics that predict school-based therapists' dropout from this statewide training.

Current evaluation data were collected from 60 school-based therapists who serve diverse youth participating in a prolonged MAP training experience. Trainees were approximately 42.29 (SD = 10.49) years in age, predominantly female (n = 43, 78.2%), identified most often as a cognitive or cognitive-behavioral orientation, and worked in their current position for an average of 7.87 (SD = 6.46) years. MAP training consisted of several implementation initiatives, including 40 hours of therapist training across five consecutive days, 12 sessions of ongoing weekly consultation with a MAP trainer, and the opportunity to submit a portfolio and apply for MAP certification. Of the 60 therapists who participated in the study, 52 completed the 40-hour training, 37 participated in all consultation sessions, and 31 earned their MAP credential. Independent sample t-test and Pearson chi-square procedures were used to preliminarily determine differences and associations between therapists who completed both 40 hours of training, and all 12 consultation sessions across various multilevel variables. Results indicate that therapists who completed these training initiatives were more likely to receive less supervision per month, t(50) = 1.59, p < .01 and reported engaging in less citizenship behavior (i.e., extent to which they exceed expectations of their job to support EBP implementation), t(52) = 1.08, p < .05, particularly in the domain of helping others adopt EBP (e.g., helping teach EBP implementation procedures), t(52) = 1.29, p < .05. Additionally, there was a significant association between participation in training initiatives with theoretical orientation X2 (5, N = 53) = 11.90, p < .05. These and other findings will be discussed and point to the complexities in measuring and understanding determinants of therapist EBP training and participation retention.