Mental health providers’ attitudes toward evidence-based practice are likely to influence what interventions they learn, implement, and sustain over time. A 36-item version of the Evidence-Based Practice Attitude Scale (EBPAS) was recently developed to assess provider attitudes in 12 domains. Research suggests the EBPAS-36 is a promising tool, though inconsistencies across studies signal the need to reexamine its validity and reliability along with the correlates of provider attitudes. This study assessed the factorial structure of the EBPAS-36, the intercorrelations and reliabilities of its subscales, and correlates of practice attitudes in a U.S. sample of 445 practitioners who received training in trauma-focused cognitive behavioral therapy. A confirmatory factor analysis (CFA) verified that the EBPAS-36 fits a 12-factor model representing each of its subscales. Reinforcing prior results, the subscales of the EBPAS-36 were weakly to moderately correlated, indicating that the 12 domains are related yet distinct. A hypothesized second-order CFA model with three overarching latent factors was not validated, but an alternative second-order model with two factors fit the data adequately. Most subscales demonstrated good-to-excellent internal consistency, though values for certain subscales ranged from marginally acceptable to poor. Provider attitudes varied by gender, professional experience, and discipline. Practitioners who more frequently assessed client trauma symptoms reported more positive EBP attitudes, and those who expressed greater concerns that trauma assessments may cause harm reported more negative attitudes. Taken together with previous findings, the results show the EBPAS-36 performs well overall, though some subscales may benefit from refinement. Further validation tests of the EBPAS-36 in diverse samples are warranted.

The current study tested a trauma screening, brief intervention, and referral to treatment (T-SBIRT) interview protocol as implemented within Temporary Assistance to Needy Families programming. Using a non-experimental process evaluation and quasi-experimental outcome evaluation (N = 88), the study assessed four research questions. First, do T-SBIRT providers reach model adherence rates above 90%? Second, do over 90% of T-SBIRT completers experience the intervention as tolerable? Third, is T-SBIRT completion associated with decreases in mental health symptoms? Fourth, is T-SBIRT completion linked to reductions in positive mental health screenings? Process data emerged from provider-completed integrity checklists. Participant-completed baseline and follow-up surveys furnished outcome data, i.e., mental health indicators from validated scales of depression, anxiety, and post-traumatic stress disorder (PTSD). Descriptive statistics answered questions one and two; multivariate analyses addressed questions three and four. Results revealed that providers realized adherence rates at 98.5%; 91.3% of completers found the protocol tolerable; and completers reported significant reductions in depression symptoms, PTSD symptoms, and positive PTSD screenings relative to a comparison group. Findings recommend integrating T-SBIRT into social services to promote participant mental health and potentially enhance program outcomes. Future T-SBIRT research should include a randomized controlled trial assessing long-term mental health, employment, and income outcomes.

Residents of urban American neighborhoods facing economic hardship often experience individual and collective adversities at high levels. This study explores how racially diverse adults experience stress, adversity, and trauma, and how they cope and heal in the context of their environment. Following a critical realist grounded theory methodology, four focus groups were conducted with African American, White and Latinx participants (N = 21) within an employment service program. Participants identified key stressors ranging from financial and job challenges, violence, and trauma. To cope with and heal from adversity, they practiced positivity, named trauma and its effects, sought social connection, envisioned community-based resources, and addressed structural and systemic barriers. The data generated a theory of "a mutual process of healing self and healing the community" through intrapersonal, interpersonal, and structural change. The results of this study indicate a need for peer-led, community-engaged initiatives and holistic, trauma-informed, healing-centered practices.

Research suggests that low-income adults accessing employment services have experienced high levels of trauma exposure and associated consequences. Moreover, the health-related effects of trauma undermine employment and employability. A trauma-informed protocol-trauma screening, brief intervention, and referral to treatment or T-SBIRT-was therefore implemented within employment service programs serving low-income urban residents. To assess the feasibility of integrating T-SBIRT within employment services, five domains were explored as follows: suitability, acceptability, client adherence, provider adherence or fidelity, and intended outcomes. With a sample of low-income adults (N = 83), the study revealed that T-SBIRT is suitable for employment service participants given high rates of trauma exposure (90.4% experienced two or more lifetime traumas), along with high rates of positive screening results for post-traumatic stress disorder (48.8%), major depression (35.4%), and generalized anxiety (47.6%). Study participants appeared to find T-SBIRT acceptable as evidenced by an 83% acceptance rate. All participants accepting T-SBIRT services completed them, revealing strong client adherence. Provider adherence or model fidelity was high, that is, 98.5%. Finally, the majority of participants accepted a referral to a mental health care (i.e., 56.6%), and over three-quarters accepted a referral to any outside service including primary or mental health care. Implications of findings are discussed.