A repeated cross-sectional study of clinicians’ use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia

Table 3 Relationships between baseline organizational characteristics and change in clinicians’ use of evidence-based and non-evidence-based psychotherapy techniques over 5 years

	Cognitive-behavioral technique use						Psychodynamic technique use
					% Change from W1 to W3 (Cohen’s d)						% Change from W1 to W3 (Cohen’s d)
Moderator	B	[95% CI]	p	p _adj	Moderator = Low	Moderator = High	B	[95% CI]	p	p _adj	Moderator = Low	Moderator = High
Proficient organizational culture					− 2% (d = − .12)	8% (d = .41)					− 3% (d = − .18)	4% (d = .20)
Main effect of moderator at W1	− .007	[− .023–.008]	.311				− .005	[− .018–.007]	.403
Main effect of wave	.047	[− .041–.135]	.272				.003	[− .083–.090]	.936
Moderator by wave interaction	.007^a	[.001–.013]	.048	.144			.005	[− .002–.011]	.130	.334
Implementation climate					3% (d = .14)	5% (d = .26)					3% (d = .17)	− 1% (d = −.05)
Main effect of moderator at W1	.090	[− .332–.511]	.660				.188	[− .138–.514]	.240
Main effect of wave	.065	[− .022–.152]	.134				.020	[− .063–.103]	.618
Moderator by wave interaction	.039	[− .133–.210]	.641	.641			− .072	[− .226–.081]	.334	.334
Implementation Leadership					1% (d = .07)	8% (d = .38)					− 1% (d = −.08)	4% (d = .20)
Main effect of moderator at W1	− .064	[− .376–.247]	.669				− .145	[− .408–.117]	.258
Main effect of wave	.072	[− .011–.155]	.086				.020	[− .062–.102]	.618
Moderator by wave interaction	.073	[− .060–.207]	.263	.395			.065	[− .067–.198]	.312	.334

K = 20 organizations, N = 340 clinicians. CBT cognitive behavioral therapy, p_adj p value adjusted using the Benjamini-Hochberg procedure with a false discovery rate of .25. W1 wave 1; W3 wave 3. Results based on three-level mixed-effects regression models with wave at level 1, clinician at level 2, and organization at level 3. All models control for organization size, clinician education, years of experience, age, gender, attitudes toward evidence-based practice, participation in evidence-based practice (EBP) initiatives upon study entry (yes/ no), and cumulative number of EBP initiatives participated in by wave, and client age. Low and high values of the moderator correspond to ± 1 SD, respectively
^aEffect is statistically significant according to unadjusted p value and based on the Benjamini-Hochberg procedure

ISSN: 1748-5908