Randomized trial of the availability, responsiveness, and continuity (arc) organizational intervention with community-based mental health programs and clinicians serving youth

摘要

Objective: Evidence-based Practice (EBP) implementation is likely to be most efficient and effective in organizations with positive social contexts (i.e., organizational culture, climate, and work attitudes of clinicians). The study objective was to test whether an organizational intervention labeled Availability, Responsiveness and Continuity (ARC) could improve the organizational social contexts of community-based mental health programs for youth. Method: The study randomly assigned 26 community-based mental health programs for youth to ARC or control conditions. The organizational cultures, climates, and work attitudes of clinicians (n = 197) in the programs were assessed with the Organizational Social Context (OSC) measure for mental health services at baseline and following the 18-month ARC intervention. Results: Hierarchical linear models (HLM) analyses indicated that organizational culture, climate, and work attitudes were significantly improved in the ARC condition after 18 months. Clinicians in programs assigned to ARC reported less rigid, less centralized and less apathetic organizational cultures, more engaged and functional organizational climates with less role conflict, and work attitudes with improved morale, job satisfaction, and organizational commitment. Conclusions: ARC improved the organizational social contexts of clinicians in community-based mental health programs for youth. Results suggest that organizational intervention strategies can be used to create the types of organizational social contexts that are believed to be necessary for EBP implementation and other service innovations in mental health programs.