Burnout presents a significant challenge for mental health clinicians, affecting not only their well-being and turnover rate but also the quality of care provided to clients. Moreover, studies have shown that clinicians working in community settings face more burnout compared to those in private practice. Among the factors that have been implicated in clinicians’ burnout are the level of education, limited experience and training opportunities, individual variables, and demographic factors. In this study, I examined how clinicians’ reported competencies in core cognitive behavioral therapy (CBT) skills for treating anxiety, depression, trauma, and behavioral concerns are associated with their experiences of burnout. I further evaluated whether the relationship between competencies in core CBT+ skills and experiences of burnout is moderated by CBT+ training. The study draws on a diverse sample of 200+ community mental health clinicians who took part in Washington State’s CBT+ training initiative. I employed t-test and multiple regression models to analyze the data. Based on these analyses, there are anticipated insights of uncovering clinician experiences in how clinicians’ level of CBT skills and professional training experiences intersect with burnout. Findings are expected to inform targeted interventions aimed at reducing burnout and enhancing clinician retention across the workforce.

There is a growing emphasis on providing "equitable" mental health care, and yet ‘equity’ is seldom defined clearly. Publicly-funded community mental health clinics’ (CMHCs) clinicians often serve clients from minoritized and underrepresented backgrounds, and thus may regularly observe and address equity issues, making their perspectives invaluable. This qualitative study explores CMHC clinicians’ perspectives of equity in their clinical practice. Our data was obtained from an online cognitive-behavioral therapy (CBT) training initiative in Washington State targeting CMHC clinicians serving youth. Participating clinicians (N = 245) received nine consultation sessions from CBT experts over a six-month period and completed pre-training and post-consultation surveys. In the pre-training survey, we asked clinicians to define equity and list resources they would want access to that can improve their consideration of equity in their practice. Descriptive statistics summarized clinician demographics. Using thematic analysis, clinicians’ open-ended responses were coded to identify emerging themes. Clinicians were predominantly female (74.7%), White (58.8%), had a master’s level training (90.2%), and a mean age of 34.2 years (SD = 9.3). After coding clinicians’ definitions of equity, ‘accommodation’ (i.e., tailoring services to clients) was the most endorsed theme (38.8%, n = 95), followed by ‘equality’ (i.e., treating clients the same; 19.6%, n = 48) and ‘fairness’ (i.e., treating clients with justness, 17.6%, n = 43). When asked about resources that could improve their considerations of equity, clinicians’ responses most frequently included diversity, equity, and inclusion (DEI) trainings, expanding reach to more diverse populations, equity-focused supervision, and financial aid (e.g., gas cards, food pantry). While CMHC clinicians’ perceptions of equity included common themes, their understanding may at times conflate equity and equality. These findings highlight the importance of increasing access to DEI-focused trainings and supervision along with other resources to assist CMHC clinicians in delivering equitable care.

One of the current challenges with evidence based practices (EBP) is addressing social risk factors (SRF) in conjunction with mental health therapies. SRFs are adverse social conditions which impact the physical and mental health of an individual, group, or community. Addressing SRFs in low-resource settings increases access to and engagement in EBPs by reducing immediate threats presented by SRFs. Training in EBPs does not typically include how to address SRFs. To understand possible ways to address SRFs in EBPs, we examine whether counselors delivering EBPs in a low-to-middle income country are addressing SRFs and how the strategies impact the implementation and delivery of an EBP. This study builds on the parent study, “The Building and Sustaining Interventions for Children (BASIC)”, which examines the implementation and sustainment of an adapted version of Trauma-Focused Cognitive Behavioral Therapy, called Pamoja Tunaweza (PT) implemented by lay counselors in Kenya.To examine strategies used to address SRFs in PT, twelve PT counselors from the BASIC study participated in semi-structured interviews with trained interviewers. We conducted an inductive thematic analysis to identify codes and themes derived directly from the interview data. We identified and organized segments of the interviews into codes which were further categorized into themes. Themes include types of strategies counselors used to address SRFs as well as their impact within the context of PT. We report the frequencies of the codes and themes as they relate to their impact. Preliminary results indicate that when counselors reported using strategies to address SRFs, such as referring guardians to resources and collaborating with school administration, counselors saw increases in child self-esteem and PT attendance. Understanding how addressing SRFs impact mental health and implementation outcomes can help inform training of counselors to effectively improve use and engagement of PT and other EBPs.