Predictors of Clinician‐Reported Self‐Efficacy in Treating Trauma‐Exposed Youth

Abstract

Clinicians' self-efficacy with regard to delivering evidence-based interventions (EBIs) to youth is an important target for both improving EBI use in the community and mitigating the risk of clinician burnout and turnover. Examining predictors of clinician self-efficacy to treat trauma-exposed youth is, therefore, an important step for informing the design of implementation strategies to enhance the mental health workforce's capacity to deliver EBIs in this population. We examined predictors of clinician self-efficacy in working with trauma-exposed youth in a sample of practicing mental health clinicians (N = 258, M age = 34.4 years, 85.0% female). Clinicians were recruited and surveyed as part of a larger study examining how clients' exposure to potentially traumatic events influences clinician decision-making. Results of regression models indicated that training in any trauma treatment model, being trained via a variety of formats (e.g., in-person training, online, supervision), and training in a variety of treatment models were all associated with higher perceived self-efficacy regarding effectively treating trauma-exposed youth. Of the treatment models and training formats examined, receiving in-person training, R 2 = .10, and training in trauma-focused cognitive behavioral therapy, R 2 = .10, were the strongest predictors of higher self-efficacy ratings. Clinician discipline, R 2 = .04, and clinical practice factors, R 2 = .20, were also related to self-efficacy. Collectively, the R 2 indicated a large effect, with the predictors explaining 25.4% of the variance in self-efficacy ratings. Implications for designing implementation strategies targeting clinician self-efficacy and future research are discussed.Youth exposed to trauma comprise 46% of the pediatric population (Sacks & Murphy, 2018), and these youth are at risk for a range of psychiatric difficulties that require treatment (

Professional wellbeing and turnover intention among child therapists: a comparison between therapists trained and untrained in Trauma-Focused Cognitive Behavioral Therapy

“…Higher self-beliefs can reciprocally lead to positive attitudes and openness towards learning and mastering new practices. Adequate training and supervision in structured, multifaceted EBPs like TF-CBT can then enhance clinicians’ skills and perceived competency and positive attitudes [ 43 , 54 ]. This increase in perceived self-efficacy will be reinforced when using TF-CBT becomes accompanied with actual improvements in traumatized children.…”

“…According to the job demandsresources theory [48], job and personal resources like access to trauma-specific trainings and the sense of mastery and self-efficacy can either buffer the negative effects of job demands and reduce job strain [33] or facilitate achieving occupational goals by increasing work engagement [49]. Empirical studies, also from Norwegian CAMHS [83] have shown that TF-CBT is indeed highly effective, and a positive association of higher self-efficacy with both training in TF-CBT [54] and higher levels of compassion satisfaction [82] have been recently reported. Although perceived self-efficacy is not measured in the present study, the ProQOL-V items by which compassion satisfaction is measured in the present study include statements that can reflect therapists' perceived level of self-efficacy (e.g., "I am pleased with how I am able to keep up with professional updates").…”

“…While the majority of available EBPs for childhood psychiatric disorders are rarely found in public mental health settings, TF-CBT has been widely disseminated and proven effective both in western and low- and middle-income countries [ 42 , 52 , 53 ]. In a recent study, Becker-Haimes and colleagues [ 54 ] found that compared to other treatment models, training in TF-CBT was the strongest predictor of higher self-efficacy ratings. When implemented successfully, in addition to increasing therapy skills and sense of self-efficacy, training in TF-CBT can also provide other job resources like more job clarity through predefined and structured treatment sessions along with necessary boundaries, proper administrative support, and social support from devoted teams and supervisors that give constructive feedback [ 38 , 43 ].…”