Perceptions and Attitudes of Clinicians at a Private Outpatient Mental Health Clinic on Change in Treatment Approach from Individual to Team-Based Delivery

Abstract

The need for mental health services in the United States has increased, and the lack of trained mental health clinicians to meet the demand has led to team-based rather than traditional individual treatment. At a private outpatient mental healthcare clinic serving primarily Medicaid and Medicare clients with a range of services in a Mid-Atlantic state, shortages of skilled providers, overload of clients, and provider burnout resulted in high provider turnover and client loss. To meet these deficits, the researcher proposed a transition from individual to team-based treatment, in which experts in several disciplines collaborate to provide services to clients. The clinicians voiced many objections. To address them, the researcher introduced a transitional clinician team-based intervention that took place over 3 months with new clients. The purpose of this participatory action research study was to qualitatively explore the perceptions and attitudes of mental health clinicians about the change using the Ambrose model. Eleven clinicians responded in semi-structured interviews, and data analysis through coding led to theme identification. Findings centered on these six themes: No Intervention Experience; Uncertainty, Skepticism, Misgivings; Concern for the Clients; Cautious Optimism; Admiration for Vision and Eagerness to Begin; and Caring and Creativity. The findings informed further direction of the clinic during the transition from individual to team approach for mental health treatment. Recommendations include attending to the importance of the clinic location and the need to reintroduce the Ambrose model with providers. Additionally, leaders of other mental health clinics experiencing provider and client dropout and financial difficulties may also use the study findings to inform a potential shift to the team approach.