# Attitudes Toward and Usage of Evidence-Based Mental Health Practices for Autistic Youth in Bangladesh and Germany: A Cross-Cultural Comparison

## TL;DR

This study compares attitudes and usage of evidence-based mental health practices for autistic youth among professionals in Bangladesh and Germany.

## Contribution

The study identifies cross-cultural differences in attitudes and usage of evidence-based practices for autism between Bangladesh and Germany.

## Key findings

- German professionals were more likely to use evidence-based practices when they personally found them appealing.
- Bangladeshi professionals were more likely to adopt evidence-based practices when required and to enhance job security.
- A broader variety of evidence-based practices was used in Germany compared to Bangladesh.

## Abstract

The implementation of evidence-based practices (EBPs) for autistic youth is a critical concern worldwide. Research examining factors facilitating the implementation of EBPs found that providers’ attitudes are an important factor. In this study, we evaluated cross-cultural differences in attitudes toward and use of EBPs. We tested socio-demographic factors as predictors of attitudes, and attitudes as predictors of EBPs use among mental health professionals working with autistic youth in Bangladesh and Germany. We used purposeful sampling. Two-hundred-ninety-two professionals who worked in a clinical setting responded to the survey and fulfilled the inclusion criteria (101 in Bangladesh, 191 in Germany). Participants were asked to respond to nine subscales of the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), to indicate which of nine types of treatments they used, and to provide sociodemographic data. Measurement invariance across countries could be established for four subscales of the EBPAS-36. Comparative analyses of attitudes showed that professionals in both countries were open to using EBPs, but German practitioners were more likely to use EBPs when they appealed to them. By contrast, Bangladeshi professionals claimed to be more likely to adopt an EBP when required and to be more willing to learn EBPs to enhance job security. The relationship between caseload and attitudes varied between countries. A broader variety of EBPs was used in Germany. The findings highlight the importance of considering country-specific factors when implementing EBPs. Directions for conducting comparative studies on mental health professionals’ attitudes towards EBP including methodological considerations are discussed.

The online version contains supplementary material available at 10.1007/s10803-023-06223-z.