TPC-Journal-V4-Issue5

The Professional Counselor \Volume 4, Issue 5 470 Larson et al. (1999) attempted to extend these findings utilizing a sample of practicum counseling trainees, and found that self-evaluation of success in the session moderated the level of CSE postintervention (Larson et al., 1999), with perception of success significantly impacting the potency of the role-play scenarios. The same effect was not found for individuals in the videotape condition. In addition to impacting clinician performance, CSE has been reported to indirectly impact positive client outcome (Urbani et al., 2002); for example, CSE has been associated with more positive outcomes for clients, more positive self-evaluations and fewer anxieties regarding counseling performance (Larson & Daniels, 1998). Thus, increasing CSE, which decreases clinicians’ anxiety, is important for client outcomes, as anxiety is reported to decrease level of clinical judgment and performance (Urbani et al., 2002). While there is some evidence that CSE is influential for client outcomes, minimal work has been done to evaluate this relationship. CSE has been evaluated in a variety of samples; however, little work has been done to evaluate CSE of SMH practitioners and the factors that play into its development. Additionally, although some investigation has been conducted on factors that impact SMH practitioners’ abilities and performance, CSE is an element that seldom has been studied. The current study aimed to examine the influence of a quality assessment and improvement (QAI) intervention on CSE in SMH practitioners, as well as the importance of CSE in regard to practice-related domains. The primary question of interest was, Does an intervention focused on QAI (target) result in higher levels of CSE than a comparison condition involving a focus on professional wellness (W) and supervision (control)? We investigated the influence of differential quality training and supervision on one’s level of CSE by comparing postintervention CSE scores between each condition after evaluating preintervention equivalency of CSE levels. Thus, we hypothesized that long-term exposure to the QAI intervention, family engagement/ empowerment and modular EBP would result in significantly higher reports of CSE from those exposed to the QAI intervention than those exposed to the comparison intervention. Based on previous research, it is possible that specific counselor characteristics (e.g., age, experience) would predict CSE, such that individuals who are older and have more experience counseling children and adolescents would have higher CSE (Melchert et al., 1996; Tang et al., 2004; Watson, 2012). Thus, when evaluating training effects, these variables were included as covariates in the analysis of the relation between CSE and training. Secondarily, this study aimed to evaluate the relation of professional experiences to CSE following exposure to the intervention. For this aim, the research question was, Does postintervention level of CSE predict quality of self-reported SMH practice, as well as knowledge and use of EBP? We hypothesized that level of CSE would predict quality of SMH practice, as well as attitude toward, knowledge and use of EBP regardless of intervention condition. Method This article stems from a larger previous evaluation of a framework to enhance the quality of SMH (Weist et al., 2009), funded by the National Institute of Mental Health (#1R01MH71015; 2003-2007; M. Weist, PI). As a part of a 12-year research program on quality and EBP in SMH, researchers conducted a two-year, multisite (from community agencies in Delaware, Maryland, Texas) randomized controlled trial of a framework for high-quality and effective practice in SMH (EBP, family engagement/empowerment and systematic QAI) as compared to an enhanced treatment as usual condition (focused on personal and school staff wellness). Only the methods pertaining to the aims of the current study have been included here (see Stephan et al., 2012; Weist et al., 2009 for more comprehensive descriptions).