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© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Evidenced-based Practices: Strategies for Taking
Evidence-based Practices to Scale within States'
Systems of Care for Children's Mental Health
The TA Center EIP Committee My Banh, Ph.D.
Alfiee M. Breland-Noble, Ph.D. MHSc. © 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Funding for this training was made possible in part by Grant Number 5UR1SM059944-03 from SAMHSA. The views expressed in written materials or publications and by trainers and facilitators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government
The TA Center EIP Committee:
Acknowledgments
Bruno Anthony, Ph.D.
My Banh, Ph.D.
Alfiee Breland-Noble, Ph.D., MHSc.
Sybil Goldman, M.S.W
Vivian Jackson, Ph.D.
Nicole Kahn, M.A.
Teresa King, B.A.
Sherry Peters, M.S.W., A.C.S.W.
Jim Wotring, M.S.W.
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Presentations
• Scaling up Evidence-Based Practices (EBPs) within Systems of Care (SOC)
– Introduce Integrative Service Systems Approach (ISSA) for scaling up EBPs
– “Real world’ examples from states
• Break
• Cultural Relevance of Evidence Based Practices for Children’s Mental Health
– Important points to consider in scaling up
– Description and role of cultural adaptations of EBPs
• Break
• Small group exercise – Apply model to your real world experience
• Team will provide guidelines for group discussion
• Discussion & Closing – Feasibility of implementing ISSA in real-life settings
Session Agenda
3 © 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Review the Systems of Care philosophy & values
• Describe factors that facilitate scaling up of EBPs within a Systems of Care framework
• Gain practical tenets for cultural adaptations and application of EBPs
• Assess feasibility of scaling up EBPs from a Systems of Care framework
Learning Objectives
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• Include an array of accepted treatment approaches with some degree of evidence for effecting positive mental health outcomes in racially and ethnically diverse children. The range of approaches to consider includes (in no particular order): – Practice-based evidence (PBE) for racially/culturally diverse
groups
– Evidence Based Treatments (EBTs)-Manualized
– Culturally adapted EBTs
–Managing and Adapting Practice (MAP) (Bruce Chorpita)
– Behavioral and Affective Skills for Coping (BASIC) Approach (John Weisz)
Broad Definition of Evidence-based Practices (EBPs)
5 © 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
A system of care is:
• a spectrum of effective community-based services and supports for children and youth with or at risk of mental health challenges and their families
• is organized into a coordinated network
• builds meaningful partnerships
• addresses youth and families cultural and linguistic needs to help them function better.
Stroul, Blau, & Friedman (2010)
Systems of Care: Definition
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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Systems of care are a range of treatment services and supports guided by a philosophy and supported by an infrastructure.
Systems of Care
Stroul, B., & Friedman, R. (1986). A system of care for children and youth with severe emotional
disturbances (Rev. ed.) Washington, DC: Georgetown University Child Development Center, National
Technical Assistance Center for Children’s Mental Health. Reprinted by permission.
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Philosophy and values:
• family-driven
• youth-guided
• culturally and linguistically competent
• individualized based on strengths
• community-based
• comprehensive and coordinated cross-system
Systems of Care Philosophy & Values
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Infrastructure
• Policies and regulations
• Cross-system governance structures (e.g. mental health, substance abuse, health, child welfare, juvenile justice, education, early childhood)
• Financing strategies including incentives
• Strategies for developing and expanding services and supports that are individualized, coordinated, integrated, and evidence-based
• Workforce development, training, and technical assistance
• Quality assurance and the monitoring of outcomes
• Social marketing and strategic communications
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Infrastructure incorporates structures, processes, and
capacity building at state and community levels:
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Maximize impact of SOC and EBPs
• Provide infrastructure for implementing EBPS – Financing, access to care, assessment & monitoring
outcomes
– Strategies for implementation
• Build on the collaborative processes and increase coordinated care across systems
• Increase availability of efficacious mental health treatments Improve mental health outcomes
• Enable families and youth to have more choices for efficacious services
Benefits of Integrating SOC & EBPs
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Child, Youth & Family
Systems of care philosophy & values
Child, Youth, & Families Strategies:
• Family-driven & choice
• Youth-guided
• Individualized
• Culturally/linguistically competent
• Coordinated & effective
• Home & community-based
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Integrated Service Systems Approach (ISSA)
Systems of care philosophy & values
State Systems: Infrastructure
Agency / Organization: Implementation Plan
Services & Providers:
Effective delivery of treatments
Child, Youth & Family: Family Voice & Choice
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State Systems: Creating Infrastructure Systems of care philosophy & values
Common State Systems Elements/Strategies:
• Cross-agency coordination & leadership:
• Core group to lead Interagency Team
• Clear vision, goals, & communication plan
• Data infrastructure for data management:
• Screening/assessment/outcomes
• System wide CQI/performance measurement
systems
• Relevance mapping for EBP selection
• State Center of Excellence
• Financial structures to bill for EBP services
• Waiver programs & case rate financing
• Fiscal incentives for EBPs & CQI
• Higher education certification/ credentialing for EBPs
• Family/youth advocacy for EBPs
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Agency/Organization: Implementation Plan & Supports
Systems of care philosophy & values
Common Agencies/Organizations Strategies:
• Leadership climate & culture
• Collaborations & buy-in at all levels
• Implementation plan & supports
• Integrated data systems
• Staff selection and retention
• Workforce & business training for retention &
sustainability
• Supervision/consultation/feedback
• Incentives for EBP use
• Subsidies for training & monitoring
• Adapt & test promising interventions
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Services & Providers: Effective Delivery of Services
Systems of care philosophy & values
Common Services/Providers Strategies:
• On-going assessment & treatment planning
• Provision of an array of services with fidelity:
• Manualized EBPs
• Common elements: MAP
• Common factors:
• family engagement/alliance
• cultural/linguistic competence
• family/youth support
• Care Coordination/Wraparound
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Child, Youth & Family: Family Voice & Choice
Systems of care philosophy & values
Common Child, Youth, & Families Strategies:
• Informing families about EBPS & focus on positive
outcomes
• Family-driven & choice
• Youth-guided
• Individualized
• Culturally/linguistically competent
• Coordinated & effective
• Home & community-based
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Integrated Service Systems Approach (ISSA)
Systems of care philosophy & values
State Systems: Infrastructure
Agency / Organization: Implementation Plan
Services & Providers:
Effective delivery of treatments
Child, Youth & Family: Family Voice & Choice
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Implemented CASSP
• Implemented Wraparound, Intensive In-home Services, and Respite statewide
• Implemented a Level of Functioning Project (LOF) using the CAFAS: Data
• Implemented evidence based practices
Implementation plan: Waves of
Change
The Michigan SOC-EBP Experience
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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Strategies SOC-CASSP Evidence Based
Practices Strong Leadership Support from the
Directors
Support from the
Directors
Created a Sense of
Urgency : Develop clear
vision
Out of Home Care
Community Based Care
Effective Services
Relevance mapping of
EBPs
Wrap-around CBT and PMTO
MI Scaling-up Implementation Strategies
Adapted from Kotter, J.P. The Heart of Change (2002). © 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
0%
10%
20%
30%
40%
50%
60%
% N
ot
Im
pro
vin
g
Home School Behavior
Toward
Others
Moods Community Substance
Use
Thinking Self-Harm
CAFAS Subscales
Percentage of Youth Not Improving on
each CAFAS Subscale: The Impetus
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Which EBPs Could Help the Most Youths?
Mild Mood/Behavior Thinking
Substance Use
Self-Harm
Delinquency Behavior with Mood
Behavior
Parent Management
Training
(PMT)
Cognitive Behavior
Therapy for
Depression (CBT)
Wrap-around
Services
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Strategies SOC-CASSP Evidence Based Practices
Cross-agency
coordination: Broad
Participatory Planning
Steering Committee-
Strategic Plan for
Visioning
Steering Committee-Logic Model
For Visioning
Core Team to Guide
Implementation
Core Group to Lead-
Interagency Team
Core Group to Lead-Purveyors, State
and Local Staff
Supported Others to
Lead
State and Local Wrap
Teams
State and Local PMTO Teams
Communication Plan Part of Participatory
Planning and
Visioning, Travel
Throughout the State
Part of Participatory Planning and
Visioning , Travel Throughout the
State
Strong Leadership Support from the
Directors
Support from the Directors
MI Core Implementation Strategies
Adapted from Kotter, J.P. The Heart of Change (2002).
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Youth & Families
Representatives from all Child-
Serving Systems
Advocates Service Providers
Attention to Geographic and
Cultural Diversity
Steering Committee & Core Teams
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Strategies SOC-CASSP Evidence Based
Practices
Data system: Celebrate
short-term wins
Used Evaluation Data Used CAFAS Data
Finance Plan Developed extensive
plan
Used plan for EBP’s
Waves of Change –State
Center of Excellence
Wrap-around, Intensive
In-Home, Respite
Expanded PMTO
statewide, Coaches,
Fidelity Monitors
MI Scaling-up Implementation Strategies
Adapted from Kotter, J.P. The Heart of Change (2002).
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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Lead, Lead, Lead
Create sense of Urgency
Regular communication & coordination between and within all levels
Develop and strengthen infrastructure
Develop a finance plan from multiple sources
Develop data monitoring system
Execute and embed policies and practices at multiple levels
Core Strategies that Enhanced SOC + EBP Integration & Scaling up
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Greater emphasis on children and families in the Office of Mental Health
• Statewide CASSP Coordinator
• Children’s Mental Health Specialists in each regional office
• CASSP Coordinators in each county mental health program
• Statewide CASSP Advisory Committee
1985 Federal CASSP grant :
The Pennsylvania SOC & EBPs Experience
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Families and Advocates (over 50%
of members)
Representatives from all Child-
Serving Systems
County CASSP Coordinators
Service Providers
Attention to Geographic and
Cultural Diversity
CASSP Advisory Committee
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Early 1990’s Settlement Agreement required
development of broad service array of home and community
based services
• Huge increases in spending over a decade of service development
• Little evidence that services were effective
• All stakeholders recognized need to find alternative services that would be effective
Intervening 10 Year Long Catalyst Leading to Beginning of EBPs
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Establishing child and family teams and implementing
High-Fidelity Wraparound as a practice model
Developing a process for
identifying and implementing
evidence-based and promising
practices as well as culturally
relevant practices.
2005 - Advisory Committee Set Goal of Transforming the Children’s Behavioral Health
System to Include:
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Multi-Systemic Therapy (MST)
Functional Family Therapy (FFT)
Multi-Dimensional Treatment Foster Care (MTFC)
Parent Child Interaction Therapy (PCIT)
Trauma-Focused Cognitive Behavior Therapy (TF-CBT)
Sanctuary in both Residential and Community Based Settings
Positive Behavioral Interventions and Supports (PBIS) in Schools
Existing Infrastructure for SOC Influenced Selection of EBPs
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Obtaining Buy-In Through Regular
Communication 1992 to present
• Alert, a monthly administrative update
• The PA CASSP Newsletter, a quarterly publication on children’s behavioral health.
Capacity Building Strategy Led by Office of Mental Health
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Cross-System: all the child-serving systems and stakeholders
Cross-Levels: Federal/State/Local
Cross-Branches: Executive, Legislative, Judicial
Cross-Function: Government and Providers of Services
Importance of Collaborative Relationships to Build Capacity
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
State Child-Serving Systems
County Child-Serving Systems
Behavioral Health Managed Care Organizations
Service Providers
Shared Responsibility for Building Statewide Capacity for EBPs
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Federal funding to strengthen infrastructure
Strong relationships at all levels
Regular communication between and within all levels
Shared vision and goals
Shared responsibility for funding and workforce development
Core Strategies that Enhanced SOC + EBP Integration
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Lead, Lead, Lead: Continuity of leadership
Create sense of Urgency: Create shared vision & goals
Develop strong partnerships: Regular communication & coordination between and within all levels
Develop and strengthen infrastructure
Develop a finance plan from multiple sources
Develop data monitoring system
Execute and embed policies and practices at multiple levels
Core Strategies that Enhanced SOC + EBP Integration & Scaling up
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Child, Youth & Family: Family Voice & Choice
Services & Providers: Coordinated & Effective care
Agency / Organization: Implementation Plan
State Systems: Infrastructure
Integrated Service Systems Approach (ISSA)
Systems of care philosophy & values
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The Import of Culturally Relevant Care
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Cultural Relevance of EBPs
• ”If there are systematic differences in the
empirical connection between symptoms and
disorders by race, ethnicity, or other factors, then
failing to take these into account will result in
more diagnostic and treatment referral errors
for… populations [of people of color],
contributing to disparities in services and in
outcomes….” pp.257-258
Alegria, M., & McGuire, T. (2003). Rethinking a universal framework in the
psychiatric symptom-disorder relationship. Journal of Health and Social
Behavior, 44(3), 257-274.
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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• have a defined set of values and principles, and demonstrate
behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally.
• have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge and (5) adapt to diversity and the cultural contexts of the communities they serve.
• incorporate the above in all aspects of policy making, administration, practice, service delivery and involve systematically consumers, key stakeholders and communities.
• Cultural competence is a developmental process that evolves over an extended period. Both individuals and organizations are at various levels of awareness, knowledge and skills along the cultural competence continuum. (adapted from Cross et al., 1989)
Cultural competence requires that organizations:
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
The capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, individuals with disabilities, and those who are deaf or hard of hearing.
Cultural Competence (con’t)
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Requires organizational and provider capacity to respond effectively to the health and mental health literacy needs of populations served. The organization must have policy, structures, practices, procedures, and dedicated resources to support this capacity.
Linguistic Competence
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What are some examples of how your organization ensures Cultural and Linguistic Competence?
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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Examples
• Cultural Competence Hire Racially and Ethnically diverse staff
and providers
Recruit, promote, and support a diverse governance, leadership, and workforce
Collect and maintain demographic data
Conduct assessments of community health assets and needs
Partner with the community
Create conflict and grievance resolution processes
• Linguistic Competence bilingual/bicultural or
multilingual/multicultural staff;
cultural brokers
foreign language interpretation services including distance technologies
sign language interpretation services
multilingual telecommunication systems
videoconferencing and telehealth technologies
TTY and other assistive technology devices
print materials in easy to read, low literacy, picture and symbol formats
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
According to one of the leaders in the field, Dr. Guillermo Bernal of the University of Puerto Rico…
“The systematic modification of an EBT or intervention protocol to consider language, culture, and context in such a way that it is compatible with the client’s cultural patterns, meanings, and values.”pp.361-362
Bernal, G., Jimenez-Chafey, M. I., & Rodriguez, M. M. D. (2009). Cultural Adaptation of Treatments: A Resource for Considering Culture in Evidence-Based Practice. [Article]. Professional Psychology-Research and Practice, 40(4), 361-368.
What is Cultural Adaptation
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Why is this important? – Engagement
– Relevance
– Retention
– Cultural Competence
–Outcomes
Key Points to Consider
• Does it Work?
• Many would argue, yes – Benish, S. G., Quintana, S., & Wampold, B.
E. (2011). Culturally Adapted Psychotherapy and the Legitimacy of Myth: A Direct-Comparison Meta-Analysis. [Article]. Journal of Counseling Psychology, 58(3), 279-289.
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Does it Work?
• Many would argue, yes – Benish, S. G., Quintana, S., & Wampold, B. E. (2011). Culturally Adapted
Psychotherapy and the Legitimacy of Myth: A Direct-Comparison Meta-Analysis. [Article]. Journal of Counseling Psychology, 58(3), 279-289.
• “culturally adapted psychotherapy is more effective than unadapted, bona fide psychotherapy by d = 0.32 for primary measures of psychological functioning.”
• From Abstract
– Griner, D., & Smith, T. B. (2006). Culturally adapted mental health interventions: A meta-analytic review. [Review]. Psychotherapy, 43(4), 531-548. • “Across 76 studies the resulting random effects weighted average ;effect size was d = .45, indicating a moderately strong
benefit of culturally adapted interventions. Interventions targeted to a specific cultural group were four times more effective than interventions provided to groups consisting of clients from a variety of cultural backgrounds.”
• From Abstract
Key Points to Consider
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Involve the population of interest – Patients AND Providers are your experts
• Plan your work
• Work your plan
• Review the literature
• Pilot test your adaptations
• Evaluate & make changes and retest
HOW? To Adapt
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Adaptation Points to Remember
• Examine outcomes
– Patient Level
• Do the children improve?
– Provider Level
• Are your provider comfortable?
• Do they implement using principles taught?
– Policy Level
• Can you pitch utility of adaptation to stakeholders?
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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Group Exercise
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• Within the SOC philosophy of family-driven, youth-guided, individualized, culturally/linguistically competent, coordinated & effective , home & community-based: you have been tasked with scaling up an EBP in your state. At minimum, you need to: • 1) address how this EBP will fit within the diverse
communities that you serve and
• 2) identify key components that will be needed to create a data system to monitor outcomes
• Time permitting, how would you go about developing the workforce to scale-up the EBP?
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st Century. Washington, DC: Author.
• Knitzer, J. (1982). Unclaimed children: The failure of public responsibility to children and adolescents in need of mental health services. Washington, DC: Children's Defense Fund.
• Kotter, J.P. The Heart of Change (2002). Boston, MA: Harvard Business School Publishing. • Meyers, D.C., Durlak, J.A., Wandersman, A. (2012). The Quality Implementation Framework: A Synthesis of Critical Steps in
the Implementation Process. Am J Com Psych, 50, 3-4, pp 462- 480. • President’s New Freedom Commission on Mental Health. (2003). Subcommittee on Children and Families Summary Report. Retrieved March 2005 from http://govinfo.library.unt.edu/mentalhealthcommission/subcommittee/Sub_Chairs.htm
• Stroul, B, Blau, G., & Friedman, R. (2010). Updating the system of care concept and philosophy. Washington, DC: Georgetown University Center for Child and Human Development National Technical Assistance Center for Children’s Mental Health, from: http://www.tapartnership.org/docs/UpdatingTheSOCConcept2010.pdf
• Stroul, B & Blau, G. (2008). The system of care handbook: Transforming mental health services for children, youth, and families. Baltimore, MD: Paul H. Brookes Publishing Co.
• Stroul, B., & Friedman, R. (1986). A system of care for children and youth with severe emotional disturbances (Rev. ed.) Washington, DC: Georgetown University Child Development Center, National Technical Assistance Center for Children’s Mental Health. Reprinted by permission.
• Stroul, B., Goldman, S., Pires, S., & Manteuffel, B. (2012). Expanding systems of care: Improving the lives of children, youth, and families. Washington, DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children’s Mental Health.
• U.S. Public Health Service, U.S. Department of Health and Human Services, Office of the Surgeon General. (1999). Mental health: A report of the Surgeon General. Rockville, MD: Author. Retrieved from http://www.surgeongeneral.gov/library/mentalhealth/
References
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Service and Supports
Services and supports-- that incorporate EBPS:
• prevention
• early intervention
• assessment
• wrap-around approaches
• outpatient modalities
• home-based services
• crisis intervention
• respite care
• behavioral aides
• care management
• range of residential and inpatient options
51 © 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• IOM called for “creating an infrastructure to support evidence-based practice.”
• Both public and private funding mechanisms to facilitate EBP dissemination and implementation emerged.
• Government agencies began to create financial, regulatory incentives, and mandates for implementation of evidence-based practice.
Creating a sense of urgency for EBPs
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• Cognitive Behavior Therapy for Depression
• Parent Management Training – Oregon Model
• Trauma Focused Cognitive Behavioral Therapy
• Multi-systemic Therapy
• Functional Family Therapy
• System of Care for Children w/SED and their Families
• Wraparound Model
• Positive Behavioral Interventions and Supports (PBIS) in Schools
Evidence Based Treatments
Evidence-informed practices
Relevance Mapping of EBPs
© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
Obtaining Buy-In Through Publications
Child, Family and Community Core Competencies, originally
published by the former PA CASSP Training and Technical Assistance
Institute, 1999.
Guidelines for Best Practice in Children’s Mental Health Services, by Gordon R. Hodas, M.D., Office of Mental Health and Substance
Abuse Services, 2001.
Capacity-Building Strategy Led by Professionals
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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY
• “Pennsylvania Model of ‘Towards a Culturally Competent System of Care’” - 1990's (based on the Federal CASSP monograph, “Towards a Culturally Competent System of Care.”)
• Performance Expectations and Recommended Guidelines for County CASSP Systems 2002
Obtaining Buy-In Through
Collaboratively Developed Guidelines
Capacity Building Strategy Led by CASSP Advisory Committee
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