Objective: Although data suggest that knowledge of evidence-based practices (EBPs) and attitudes towards EBPs may be related, the relation between attitudes and competence in delivering EBPs has not been examined. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Methods: Community clinicians (N=891) received intensive training in cognitive behavioral therapy skills followed by six months of consultation. Clinician attitudes were assessed using the Evidence Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data was analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase).Results: Latent change models identified significant improvement in attitudes (Mslatent change≥1.07, SEs≤ 0.19, zs≥6.85, ps< .001) and competence (Mslatent change≥13.13, SEs≤3.53, zs≥2.30, ps<.001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop phase and across the full training (bs≥1.58, SEs≤1.13, z≥1.89, p<.048, β≥0.09); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in the consultation phase (b=1.40, SE=1.07, z=1.31, p=.19, β=0.08). Change in attitudes and change in competence in the training period, the workshop phase, and the consultation phase were not significantly correlated. Conclusions: Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training.
Cognitive-Behavioral Therapy: How Medical Providers Can Increase Patient and Family Openness and Access to Evidence-Based Multimodal Therapy for Pediatric Migraine
