Dear Friends of the 4KEEPS Study,

We are writing to provide an update on the 4KEEPS Study. As you know, we are conducting a neutral,
observational study to examine how the 6 original PEI practices spread and continue to be used by
therapists over time in Los Angeles County.

As of September 2016, a total of

846 therapists & 186 program managers
Full Sample
from 68 agencies have completed our
Online Surveys online surveys1 !

In-Depth Sample 25 Programs

In-person Interviews 52 Program Managers

Session Audio
Recordings & 94 Therapists
Questionnaires
253 Clients

626 Sessions

Publications
Lau, A. S., & Brookman-Frazee, L. (2016). The 4KEEPS study: identifying predictors of sustainment of
multiple practices fiscally mandated in childrens mental health services. Implementation Science, 11(1), 1.
Brookman-Frazee, L., Stadnick, N., Roesch, S., Regan, J., Barnett, M., Bando, L., Innes-Gomberg, D., & Lau,
A. (2016). Measuring Sustainment of Multiple Practices Fiscally Mandated in Childrens Mental Health
Services. Administration and Policy in Mental Health and Mental Health Services Research, 1-14.
BEFORE 9/29/16

On average, based on 793 responses, What we are learning

therapists seem to like (1) structured from you!
practices that have prescribed session
content and order and (2) practices that
require ongoing consultation.

How therapists feel about structure and consultation...

[In the consultation groups],

I like the sequence and things. I think it was good to hear
It facilitates a process, and it about challenges that other I really like the consultations[I
reduced the anxiety about how people experienced to know enjoyed] being able to present
to go about it. that I wasnt the only one case examples different people
had to present at different times
So I like the structure in that [] That was nerve-racking, but it
[] it keeps me on track and it just feels a little bit more...I was good nerve-racking, because
think the clients seem to like kind of being able to see the you got feedback as to how you
steps and know where theyre going and know that theres applied the skills, how you could
the end. improve your skills.

Which factors are associated with therapist attitudes*

toward EBP practices?
Higher levels of perceived therapist burnout
Greater workload (reported by?) therapists
Higher degree of therapist openness to EBPs
Licensed
Hispanic or (other?) minority therapists
*Note. + indicates more favorable attitudes; - indicates less favorable attitudes.

If you would like more information about the 4KEEPS study, please visit our website 4keeps.psych.ucla.edu/.
 AFTER
What we are learning from you...

Therapists tend to hold more favorable attitudes

towards (1) structured practices that have
and
(2) practices that .

Some positive views on practices

that have more Some positive views on practices that
have
I like the sequence and things. It facilitates a
process, and it reduced the anxiety about how to [In the consultation groups],
go about it. I think it was good to hear about challenges that
other people experienced to know that I wasnt the only
So I like the structure in that [] it keeps me one feeling challenged.
on track [] I think the clients seem to like
being able to see the steps and know where I really like the consultations[I enjoyed] being
theyre going and know that theres the end. able to present case examples different people had
to present at different times [] That was nerve-
racking, but it was good nerve-racking,
I think I kind of like the structure [] theres a little bit less because you got feedback as to how you
treatment planning because, you know, this week were doing the applied the skills, how you could improve
effective modulation, or whatever. Okay, now were going to start your skills.
the trauma narrative and you know [youll] be doing that for a
couple weeks...that takes some of the pressure off.

These therapists tended to report more positive views

across [all six?] practices:
Those with lower levels of perceived burnout
Those with less [reported? Perceived?] workload
Those with more positive views toward EBPs in general
Unlicensed therapists
Hispanic or other minority therapists

If you would like more information about the 4KEEPS study, please visit our website 4keeps.psych.ucla.edu/.