Date of Award


Document Type

Open Access Dissertation




College of Arts and Sciences

First Advisor

Abraham Wandersman

Second Advisor

Bret Kloos


Getting To Outcomes® in Clinical Practice is an innovation being developed and disseminated in a clinical training center for psychology doctoral students. The innovation is a step-wise framework posited to enhance clinical practice by supporting the planning, implementation, and evaluation of specific evidence-based practices in psychology. The current study introduces and defines the innovation and uses a multiple case study, mixed method analysis to evaluate current innovation use behaviors as well as attitudes about the innovation. The guiding research themes for this study include: (1) innovation use behaviors, (2) attitudes about the innovation, and (3) influential contextual factors that impact adoption and attitudes. Cases studied were student-therapists within the setting where the innovation is being developed and disseminated. Multiple data sources, including therapist interviews, case records, supervisor evaluations, and physical file inventories, were utilized to triangulate innovation use behaviors and organized into a system used to understand variance in adherence to the innovation, called an Innovation Configuration Map (Hall & Hord, 2011). Themes related to relative advantage, compatibility, complexity, trialability, and observability, constructs known to account for innovation adoption (Rogers, 2003), were evaluated during interviews. Cross-case thematic assertions and contextual, case-specific factors were identified that impact implementation and program refinement. Assertions relevant to understanding the program were the following: (1) Behaviors varied in terms of adherence to the model; (2) Therapists developed idiosyncratic ways to adhere to the model and viewed the framework as implicit rather than an explicit step-by-step guide; (3) Attitudes about the utility of the innovation were mixed; (4) There was an overall reaction to the label of the innovation; (5) The steps were difficult to remember and participants desired steps to be consolidated; (6) Implementation support is necessary for successful implementation; (7) Trialibility and observability were difficult to gauge given the implicit use of the framework; (8) Contextual factors, such as program enrollment, caseload characteristics, and the implementation setting, impacted use and attitudes. These findings have implications regarding the refinement of the innovation as well as its measurement system and generate future directions for continued evaluation of this innovation.