Objectives: To examine the initial feasibility and acceptability of training community MH providers to implement a research-based intervention protocol aimed to decrease behavior problems in children with ASD. The specific goals of this study were to examine changes in therapists’ perceptions of their knowledge and confidence related to treating children with ASD and their observed adherence to the intervention protocol.
Methods: Participants included 14 therapist/ family dyads. Therapists were recruited from three community-based mental health clinics and represented multiple mental health disciplines: 36% MFT, 36% Psychology, 21% Social Work, and 7% Psychiatry. Child age ranged from 5 to 12 years (M=9.71; SD=2.13). Family race/ ethnicity included, 64% White, 14% Hispanic, and 21% Other/ Mixed. Therapists received comprehensive training (i.e., introductory workshop, self-study, bi-weekly consultation) for five months in an intervention protocol that was developed to integrate research-based behavioral and cognitive behavioral methods to address behavior problems in children with ASD ages 5 to 13 (“AIM HI: An Individualized Mental Health Intervention for Children with ASD”). AIM HI was developed based on data on the clinical characteristics of children served in CMH clinics and the training needs of CMH providers. Mixed qualitative and quantitative analytic methods were used to analyze therapist surveys, observational data on therapist behaviors, and observations of consultation/ training process.
Results: Following the introductory workshop, therapists reported significant improvements in their perceived knowledge related to working with children with ASD (i.e., characteristics of ASD, treatment planning, adapting psychotherapy for ASD, and ASD-specific behavioral and cognitive behavioral intervention strategies) (t=-8.0, p<.001). Likewise, therapists reported increased confidence applying their knowledge in their work with children with ASD (t=-7.3, p<.001). Further, initial data indicate that therapists do adhere to certain individual components of the protocol with ongoing consultation. Qualitative analyses of the consultation process indicate that there are a number of organizational and provider-level factors that impede (competing time demands, staff productivity requirements, attitudes, previous training) and facilitate (management/ leadership support, therapist attitudes) the implementation of this model. Parent and therapist perceptions of the utility of the intervention and changes in therapists’ general attitudes towards research-based practices will also be reported.
Conclusions: Initial results from this pilot study suggest that it is feasible to train clinicians to implement a research-based intervention model for ASD in CMH clinics. Therapists actively participated in training, reported more positive attitudes serving children with ASD after initial training, and adhered to many aspects of the intervention. Despite these positive findings, there are a number of challenges to training therapists in this setting, highlighting the importance of developing flexible models that can be adapted to “fit” the constraints of the settings and needs of the providers.