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Nathaniel Williams publishes research on the relationship between workplace climate and clinician’s practices

Nate Williams

New research shows the powerful impact that mid-level managers have on implementing new, evidence-based treatment approaches in mental health clinics that serve youth.

The study, “Testing a theory of strategic implementation leadership, implementation climate, and clinicians’ use of evidence-based practice: a 5-year panel analysis,” was published in the journal Implementation Science and shows that healthcare managers can shape clinicians’ use of innovative practices by creating a supportive organizational climate. The study was led by Nathaniel Williams, an assistant professor in the School of Social Work, and Courtney Benjamin Wolk, Emily Becker-Haimes and Rinad Beidas, all from the Perelman School of Medicine at the University of Pennsylvania.

The study tests the accuracy of an implementation leadership theory, which suggests that mid-level managers in healthcare settings can increase clinicians’ use of evidence-based practices by enacting specific leadership behaviors, such as being proactive, knowledgeable, supportive and perseverant with regard to the new practice. These leadership behaviors create a climate within the organization that conveys to clinicians the importance of the new practice and the organization’s support, which ultimately encourages clinicians to have more positive attitudes toward the practice, and to use it more frequently and in a more skilled manner.

“Supporting healthcare providers to adopt and implement new, research-based treatments, known as ‘evidence-based practices,’ is a major challenge facing all areas of healthcare, including behavioral healthcare,” said Williams. “Implementation science is a discipline dedicated to understanding how we can support community organizations and providers as they work to implement these new, effective practices. It’s about supporting providers and therapists who are doing important, difficult work to make a difference in the real world.”

To test the theory, researchers conducted a five-year study of 496 therapists working in 30 children’s mental health clinics in Philadelphia. Clinicians were asked to report on their mid-level managers’ implementation leadership behavior, their organization’s climate for evidence-based practice implementation, and their use of an evidence-based practice for childhood psychiatric disorders called cognitive behavioral therapy.

Researchers found that in organizations where mid-level managers increased their use of implementation leadership behaviors, the organization experienced significantly greater increases in its climate for evidence-based practice implementation. In turn, improvement in the organizations’ climate for implementation led to increased use of cognitive behavioral therapy by therapists, providing strong evidence that when first-level leaders increase their frequency of implementation leadership behaviors, it improves the organization’s climate for implementation, which in turn increases clinicians’ use of evidence-based practices.

“What this study shows is that clinical supervisors and middle managers in healthcare settings play an important role in shaping the practice behaviors of providers,” said Williams. “When these leaders use specific implementation leadership behaviors, they create a climate within their organization that encourages and supports providers to use evidence-based practices more often in their work with clients.”

– By Taylor Music