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Transcript of California Implementation of Functional Family Therapy (FFT) California Institute for Mental Health...
California Implementation of Functional Family Therapy (FFT)
California Institute for Mental Health (CiMH)Todd Sosna Ph.D., Senior Associate, Center for Child and Family Services
Pam Hawkins, Associate II, Center for Child and Family Services
California Annual FFT Symposium April 3-4, 2008
California Administration of Functional Family Therapy (FFT)
• California Institute for Mental Health: Intermediary Organization for the Dissemination of Evidence-Based Practice - System Change
• Community Development Team Model
• History of FFT in California
• FFT Statewide Administrative Coordination
Systems Change
• New practices do not fare well in old organizational structures and systems
• System change is disruptive• System change requires new resources• System change requires courage• System change requires dogged persistence
Dean Fixsen & Karen Blasé, National Implementation Research Network (NIRN)
Ineffective Methods of ChangeExcellent experimental evidence for what does not work
• Diffusion/dissemination of information by itself does not lead to successful implementation
• Training alone, no matter how well done, does not lead to successful implementation
• Implementation by edict by itself does not work• Implementation by “following the money” by itself does not work• Implementation without changing supporting roles and functions
does not work
Paul Nutt (2002). Why Decisions Fail
Initiate Systems ChangeDean Fixsen & Karen Blasé, National Implementation Research Network (NIRN)
Initiate & Manage Change
Develop Sustainable Infrastructure
For transformation managementAnd continuous consumer benefit
Implement Innovations and other new ways of work
Community Development Team Goals
• High quality, model adherent (high fidelity) and sustainable implementation of Functional Family Therapy (FFT)
• Prepare practitioners to be proficient in the use of FFT
• Prepare agencies to support and sustain FFT teams
Community Development Team Features
• Clinical training and consultation provided by FFT LLC (national training center)
• Implementation planning and administrative supports provided by CIMH associates
• Channels of communication to support peer-to-peer assistance (conference calls, listserv)
Community Development Team Administrative Supports
• Individualized technical assistance– CIMH associates respond to implementation (system and
program level) issues• Support with outcome evaluation
– Collection, analysis, interpretation and reporting of FFT outcomes across agencies
• Scheduled monthly administrators conference calls– Share successes, raise concerns, and offer solutions
• Listserv– Support communication between Team members
• Coordination with FFT national training center
Community Development Team Expectations
• Each agency is committed to participating fully in all training and consultation activities
• Each agency is committed to implementing FFT with fidelity• Each agency will diligently use the CSS and evaluate
outcomes• Agencies will establish HIPPA agreements to support sharing
of information for clinical consultations and outcome evaluation
California FFT Teams• FFT Community Development Team I (California Endowment Grant)
– 2004– 6 Teams currently in Phase III
• FFT Community Development Team 2 (California Alliance for Child and Family Services)– 2006– 7 Teams currently in Phase II
• FFT Community Development Team 3 (“MIOCR”)– 2007– 10 Teams currently in Phase I
• FFT Community Development Team 4 (Los Angeles Katie A.)– 2007– 3 Teams currently in Phase I
• Projected: FFT Community Development Team 5– 2008– 4 Teams projected
California FFT Sites
California FFT Administrative Coordination
• Monitoring Site Quality Improvement
• Monitoring Site Quality Assurance
• Statewide FFT Coordinator
Monitoring Site Quality Improvement
• Consultation with Sites – Statewide consultants monitor individual sites for quality
improvement and model-adherence• Consultation with Statewide Consultant
– Statewide Consultants participate in regularly scheduled administrative monitoring
• Consultation with National Consultant – Statewide Consultants participate in regularly scheduled
consultation with FFT LLC (national training center)• FFT Annual Symposium
– Statewide Consultants participate in annual FFT Symposium that will provide advanced treatment skills focusing on more difficult treatment issues and circumstances for model-adherence and sustainability of FFT
Monitoring Site Quality Assurance
• Evaluation of Sites – Outcome evaluation reports generated for California FFT implementation
and each individual site • Community Development Team (CDT) Process
– Monthly meetings with each CDT to provide TA in the implementation of model adherent practice
– Identify and mitigate technical, procedural and system barriers to implementation
– Update sites on training– Problem solving, procedural skills development– Peer-to-peer exchange
• Replacement Training Series – Schedule 2 Replacement Training series per year
Statewide FFT Coordinator• Supports and promotes implementation of FFT in California• On-going support, assistance and oversight of statewide FFT
implementation in existing sites• Coordinates all California FFT Training events• Collaborates with FFT LLC and administrators of California FFT sites• Coordinates FFT site Quality Improvement/Quality Assurance
process for California • Collaborates with California Statewide FFT Consultants• Maintains and develops partner relationships through outreach and
FFT presentations