Apa Leadership Style

As groundwork for this project, a review of the literature was conducted to identify specific leadership styles, attitudes, behaviors and practices that represent effective leadership in school-based health centers and/or for implementation of mental health quality initiatives. Initially, a broad computerized search of Pubmed, CINAHL, and Scopus using the search terms leadership AND (“school based health clinic*” OR SBHC*) returned no results. A narrower search limited to full text research articles since 2006 using the search terms ( "leadership styles" OR "leadership theories" OR “transformational leadership”) AND ( "mental health services" OR “substance abuse” OR “substance use” OR “drug abuse” OR “drug addiction” OR “drug use”

) resulted in fifty-five total results and 23 unduplicated articles. Reviewing the articles for relevancy, including focus on implementation and leadership evaluation, determined six articles pertinent for inclusion. Analysis revealed important themes examining the relationship between leadership and organization climate and evidence-based practice implementation (EBPI). Transformational, transactional, and passive-avoidant leadership styles were identified specifically. Additionally, implementation leadership was recognized as specific leadership behavior that supports effective EBPI.

Organizational climate take account the general staff attitude and perception toward their role and working environment.

All 6 studies established organizational climate influenced quality initiative, and EBPI (Aarons & Sommerfeld, 2012; Aarons et al., 2016; Aarons, 2006; Brimhall et al., 2015; Green, Albanese, Cafri, & Aarons, 2013; Guerrero, Padwa, Fenwick, Harris, & Aarons, 2015). Their research demonstrated positive leadership facilitated a positive organizational climate toward evidence-based practice (EBP) and EBPI (Aarons & Sommerfeld, 2012; Aarons et al., 2016; Aarons, 2006; Brimhall et al., 2015; Guerrero, at al., 2015) as well as directly influencing individual staff attitudes toward EBPI by developing positive attitudes and openness toward EBPI (Aarons, 2006) and perceived ability to facilitate EBPI (Guerrero, at al., 2015). Brimhall et al., (2015) found significant associations between leadership style and organizational climate regarding the perceived burden of EBP and whether a climate was “empowering” or “demoralizing” toward EBPI. Green, et al. (2013) did not examine organizational climate regarding EBPI; however, analysis of 322 children's mental health service providers from 49 public programs demonstrated transformational leadership had a strong positive association with a positive organizational climate exemplified by a sense of fairness, growth and role clarity. While most of the research supported leadership as a significant component for setting the

stage for change and implementation Aarons et al., (2016) further demonstrated qualitatively transformational leadership behavior enhances EBPI sustainment.