Stepping in the right direction? Exploring mental health providers’ beliefs about, training in, and use of stepped-care practices.

Authors

• Caroline A. Lucy*, Eastern Michigan University
• Efthymia Orkopoulou^, Eastern Michigan University
• Eamonn Arble, Eastern Michigan University
• Thomas J. Waltz, Eastern Michigan University
• Alexandros Maragakis, Eastern Michigan University

Document Type

Article

Publication Date

2025

Department/School

Psychology

Publication Title

Professional Psychology: Research and Practice

Abstract

Interventions that can be efficiently and effectively delivered to a larger number of people are needed to address the unmet need for mental health services. By emphasizing the use of lower intensity interventions, stepped-care models have the potential to address this need. However, definitions about what stepped care is and guidelines for its use are limited. Therefore, this study sought to clarify the current state of stepped care in clinical practice. Participants included licensed mental health professionals in the United States (N = 171; M_age = 43.6; 85.4% women; 88.9% White). They completed a survey assessing their use of, beliefs about, and training in stepped care, as well as barriers to its use. Providers generally agreed with the model, with cognitive-behavioral orientation predicting greater agreement. The majority of participants endorsed the use of lower intensity methods, monitoring progress, and using multiple methods, but few reported considering a patient’s severity in deciding which treatment modalities to use. While formal training in lower intensity methods was somewhat uncommon, participants who received training in a greater number of lower intensity methods endorsed more stepped practices. Barriers to stepped care included patient-, provider-, and organizational-level factors. Overall, the results highlight that broad changes to health care delivery systems and provider training are needed to increase effective use of stepped care and maximize its potential benefits.

Comments

E. Arble, T. J. Waltz, and A. Maragakis are faculty members in EMU's Department of Psychology.

*C. A. Lucy is a doctoral student in EMU's Department of Psychology.

^E. Orkopoulou is an EMU student.

Link to Published Version

DOI: 10.1037/pro0000627

Recommended Citation

Lucy, C. A., Orkopoulou, E., Arble, E., Waltz, T. J., & Maragakis, A. (2025). Stepping in the right direction? Exploring mental health providers’ beliefs about, training in, and use of stepped-care practices. Professional Psychology: Research and Practice, 56(4), 324–335. https://doi.org/10.1037/pro0000627