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Examining therapist evidence-based practice (EBP) knowledge seems an important step for supporting successful implementation. Advances in implementation science suggest a distinction between practice specific (i.e., knowing which practices are derived from the evidence base) and EBP process (i.e., integrating research evidence, clinical experience, client characteristics, and monitoring outcomes) knowledge. An examination of how these knowledge types are measured and relate to attitudes appears warranted. In our sample of 58 youth community therapists, both practice specific and EBP process knowledge accounted for EBP attitude scores, which varied by therapist demographic variables. Implications for measurement of therapist constructs and future research in identifying therapist predictors of EBP use and youth clinical improvement are discussed.

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i at Ma ¯noa Geographically isolated adolescents and families face barriers that might interfere with substance use treatment progress. Empirical literature for rural isolated youth is limited and it is unclear what therapeutic practices and approaches are associated with their substance use treatment progress. In a study of youth in Hawai'i receiving in-home treatment (N = 634), geographically isolated adolescents made comparable treatment progress relative to their nonisolated peers and had families that were somewhat more likely to be involved in treatment. Multilevel modeling indicated more practice techniques focused on the youth and/or the family predicted better progress. When entered simultaneously, youth-focused practices were the only significant predictor. Consistent monthly youth involvement in treatment predicted better progress, but this was not true for family involvement in sessions. Hawai'i's geographically isolated youth, their ecologies, and system of care policies might contribute to protective factors that support treatment progress, distinguishing them from youth in rural-based treatment studies elsewhere. Public Health Significance StatementGeographically isolated adolescents and their families face several barriers that might interfere with substance use treatment progress. This study found that geographically isolated adolescents in Hawai'i receiving in-home treatment made similar progress in comparison to their nonisolated peers, and had families who were more often involved in services. Further, youth involvement in treatment, and treatment practices focused on both the youth and/or the family predicted better progress.

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