TPC-Journal-V4-Issue5

The Professional Counselor \Volume 4, Issue 5 475 Controlling for age, race, years of experience and years with the agency, findings did not confirm the primary hypothesis. No statistically significant differences in clinician reports of CSE from pre- to postintervention were observed between the QAI and W conditions. Regarding the secondary aim, however, clinician postintervention level of CSE was found to serve as a significant predictor of quality of practice; total knowledge of EBP specific to treating ADHD, DBD, anxiety and depression; and usage of EBP specific to treating depression. Findings are consistent with previous literature suggesting that CSE levels influence performance in a number of practice- related domains (Larson & Daniels, 1998). Results did not support a significant predictive relation between CSE level and usage of EBP specific to treating ADHD, DBD and anxiety. The failure to find an association may be due to evaluating level of usage of EBP across conditions due to limited power to run the analyses by condition. Results from the original study suggested that individuals in the QAI condition were more likely to use established EBP in treatment (see Weist et al., 2009). Thus, as provider characteristics including CSE (Aarons, 2005) are known to be associated with adoption of EBP, it may be that examining these associations across conditions resulted in null findings. While current results did support the importance of high CSE regarding practice-related domains, there was no significant difference in level of CSE between those who received information, training and supervision in QAI; use of EBP; and family engagement and empowerment compared to those in the W condition. Findings from the current study contrast with other research that has documented improvements in CSE following targeted interventions. Previous targeted interventions to increase CSE have resulted in positive outcomes when using micro-skills training and mental practice (Munson, Stadulis, & Munson, 1986; Munson, Zoerink, & Stadulis, 1986), role-play and visual imagery (Larson et al., 1999), a prepracticum training course (Johnson, Baker, Kopala, Kiselica, & Thompson, 1989) and practicum experiences (Larson et al., 1993). As a curvilinear relation is reported to exist between CSE and level of training (Larson et al., 1996; Sutton & Fall, 1995), it may be that the amount of previous training and experience of this sample of clinicians, being postlicensure, was such that the unique experiences gained through the QAI and W conditions in the current study had a minimal impact on overall CSE. Many prior studies utilized students untrained in counseling and interpersonal skills (Munson, Zoerink & Stadulis, 1986) and beginning practicum students and trainees (Easton, Martin, & Wilson, 2008; Johnson et al., 1989; Larson et al., 1992, 1993, 1999). Regarding the usefulness of a prepracticum course and practicum experiences for level of CSE, significant increases were only observed in the beginning practicum students with no significant changes seen in advanced students. Additionally, no previous studies have evaluated the success of CSE interventions with clinicians postlicensure. It also is plausible that failure to detect an effect was due to the high preintervention levels of CSE observed across clinicians. At baseline, clinicians in the QAI condition reported CSE levels of roughly 71.9% of maximum potential, whereas those in the W condition reported CSE levels of 71.3% of maximum potential. Previous research has found high levels of CSE among practitioners with comparable amounts of previous experience, with those having 5–10 years of experience reporting mean CSE levels of 4.35 out of five points possible (Melchert et al., 1996). Thus, the average level of CSE may be accounted for by the amount of previous education and training reported by clinicians, and the observed increase of 1.5% at postintervention may be a reflection of the sample composition. Limitations Due to a small sample size, the power to detect changes in CSE was modest. Because of efforts to increase power by increasing the sample size, the time between reports of pre- and postintervention levels of CSE varied within the sample. Some participants completed only a year or a year and a half instead of the full 2 years.