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What are your colleagues doing?
 
The first initiative of MO Therapy Network was a spring 2008 practices survey sent to all therapists who had billed Missouri Medicaid in the past year. 


Of 3085 therapists surveyed, 1359 replied including 427 social workers, 525 counselors, 270 psychologists, and 24 nurse specialists.  They had a mean of 14.3 years of professional experience (range 0 to 49 years).  Most practice with a master’s degree (70.4%).  They work in a range of settings, including private practice (56.8%), outpatient mental health (26.9%), day treatment (2.3%), residential treatment (10.4%), inpatient (8.5%), schools (6.7%), colleges (5.8%), jail and corrections (1.3%), and managed care organizations (1.2%).   

Therapists work on average 38.6 hours per week with 52.7% work time spent on therapy, 18.6% on paperwork and case management, 9.9% on assessment, 7.3% professional reading or continuing education, and 6.5% supervision or consultation. Therapists report that their practice is most influenced by continuing education (endorsed by 73.2%), consultations with colleagues (43.3%), graduate coursework (41.8%), and professional readings (32.7%).

Of participating therapists, 1120 work with children at least part of the time; the average caseload includes 24.1% children, 42.3% adolescents, and 33.6% adults. Treated youths are ethnically diverse (71.6% Caucasian, 23.2% African American, 5.2% other), come from families who are 80.4% low income or below poverty, and are experiencing multiple problems including trauma history (49.3%), depression (48.9%), disruptive behavior (48.8%), and anxiety (35.7%).

Most therapists report using at least some evidence-based treatment strategies (e.g., building a working alliance; identifying and labeling feelings; discussing the connection between thoughts, feelings and behaviors), but other key components of evidence-based treatment are not often used (e.g., pleasant activity scheduling and challenging unrealistic thinking for depression; parent-child relationship building and behavioral parent training for disruptive behavior; relaxation and exposure for anxiety). Consistent with these findings, 75.6% requested MO Therapy Network pursues training in evidence-based treatments for its members.

By: Kristin Hawley, PhD