How do behavioral healthcare providers’ attitudes and opinions about traumatic brain injury screening affect their decisions to screen their clients for TBI?

Purpose of the Study: The purpose of this study was to determine to what extent behavioral healthcare providers’ perceptions about screening for TBI determined whether they chose to screen their clients for TBI. We wanted to know about the impact of provider’s attitudes toward screening, perceived ease of screening, and social pressures to conduct screening. We sent out a brief video training on how to use the Ohio State University TBI Identification Method (OSU TBI-ID) to licensed behavioral health providers in the United States. We then asked providers to complete a survey that asked about their thoughts on using the OSU TBI-ID with their clients, and their intentions to use it during the next month. After one month passed, we sent a follow-up survey asking providers how many times they used the OSU TBI-ID to screen their clients for brain injury. After we analyzed the data, we selected several providers to interview for more details regarding why they chose to screen or not screen their clients for brain injury.

Results showed that providers with more favorable opinions about screening, greater perceived pressures to conduct screening, and stronger intentions to screen were more likely to screen their clients for brain injury. Providers believed that screening for brain injury could help them understand their clients better, which would help them to form better treatment plans.  Providers who screened for brain injury explained that they were curious about how it worked and wanted to test out the OSU TBI-ID with some of their clients. Providers who did not screen explained they felt like they did not have enough skills to screen their clients, that their leaders were not supportive or engaged, or that they did not feel comfortable screening without knowing what to do next if their client screened positive for brain injury.   

Who may be affected by these findings? Individuals with TBI getting treated for behavioral health conditions.

Caveats: We only trained providers on how to use the OSU TBI-ID, but not what to do next if a client screened positive. This may have affected providers’ decisions to screen their clients for TBI. In addition, although many other factors can affect a providers’ decision to screen their clients for TBI, we focused on provider-based characteristics for this study. More research is needed to understand how these other factors, like leadership support for example, affect the use of TBI screening in behavioral healthcare settings.

Bottom line: As expected, providers who had more favorable attitudes and opinions about screening for TBI were more likely to screen their clients for a TBI. However, other factors in the organizational setting also affect whether or not providers choose to adopt screening. By highlighting what these factors are, we can identify ways to help change practice from what it is now to what it should be so that clients treated in these settings can have better outcomes.