A cluster-randomised controlled trial of values-based training to promote autonomously held recovery values in mental health workers.

Virginia Williams,Joseph Ciarrochi,Trevor P Crowe,Lindsay G Oades,Frank P Deane,Retta Andresen

doi:10.1186/s13012-015-0363-5

Abstract

BackgroundThe implementation and use of evidence-based practices is a key priority for recovery-oriented mental health service provision. Training and development programmes for employees continue to be a key method of knowledge and skill development, despite acknowledged difficulties with uptake and maintenance of behaviour change. Self-determination theory suggests that autonomy, or a sense that behaviour is self-generated, is a key motivator to sustained behaviour change, in this case practices in mental health services. This study examined the utility of values-focused staff intervention as a specific, reproducible method of autonomy support.MethodsMental health workers (n = 146) were assigned via cluster randomisation to either a values clarification condition or an active problem-solving control condition.ResultsResults demonstrated that a structured values clarification exercise was useful in promoting integrated motivation for the changed practice and resulted in increased implementation planning.ConclusionsStructured values clarification intervention demonstrates utility as a reproducible means of autonomy support within the workplace. We discuss future directions for the study of autonomous motivation in the field of implementation science.Trial registration ACTRN12613000353796

Highlights

The implementation and use of evidence-based practices is a key priority for recovery-oriented mental health service provision
Participating mental health workers ranged in age from 18–60 and over, with 29 % aged 18–30, 27 % aged 31–40, 18 % aged 41–50 and 22 % aged 51–60 and 4 % were aged above 6 years
A hierarchical regression was conducted with variables entered stepwise based on previous research and the strength of the interrelations we identified, with integrated motivation entered in step 1, intrinsic motivation at step 2, introjected motivation at step 3 and extrinsic motivation at step 4

Summary

Introduction

The implementation and use of evidence-based practices is a key priority for recovery-oriented mental health service provision. Training and development programmes for employees continue to be a key method of knowledge and skill development, despite acknowledged difficulties with uptake and maintenance of behaviour change. Previous research attempting to understand the barriers to uptake of newly learned work practices identifies factors ranging from organisational (e.g. lack of time, duplicitous paperwork, ill-equipped administrative and support systems) [8] and managerial issues (e.g. lack of management support and understanding of new practices, pressure for immediate results) [9] to individuals factors (e.g. employee skills, self-perceived competence to adopt new practices and motivation to adopt change) [10, 11]. Little objective support for the organisational, managerial and skill-related barriers cited most often by mental health workers as Williams et al Implementation Science (2016) 11:13 factors impeding transfer has been identified in previous research [12]. Motivation for change has been identified as central to successful transfer and implementation in numerous studies e.g. [10, 11]

Methods

Results

Discussion

Conclusion