Child & Family EBP Consortium Track
March 3-6, 2019
10:00 am – 11:30 am
Bayshore 6 ~ 30-minute Paper
Strategies to Facilitate Senior Leader Engagement in the Implementation and Sustainability of Evidence-Based Practice
Robert Franks, PhD Judge Baker Children’s Center, Boston, MA
This presentation will describe implementation methodologies utilized within a Learning Collaborative model to facilitate senior leader engagement in the implementation of MATCH-ADTC in a statewide system of care. Strategies including metric and outcome data reporting, consultation and technical assistance, affinity groups and in-person Learning Sessions, and ongoing quality improvement methods used in combination form diverse data feedback systems that enhance senior leader participation and promote the sustainability of MATCH-ADTC both within and across agencies.
10:30 am – 11:30 am
Bayshore 6 ~ 60-minute Symmposium
Evidence-Based Child Trauma Assessment: Barriers, Sustainable Dissemination, and Treatment Implications
Symposium Chair and Discussant: Jeffrey Vanderploeg, PhD, Child Health and Development Institute of CT, Farmington, CT
Given child trauma’s significant prevalence and consequences, identifying, disseminating, implementing, and sustaining evidence-based child trauma assessment practices are needed to assess post-traumatic sequelae and salient comorbidities, tailor treatment for clients, promote treatment retention, and reliably assess the efficacy and effectiveness of those treatments (APA, 2008; Cohen et al., 2017; Saunders et al., 2004). This symposium addresses several gaps in this literature and informs future child behavioral health scholarship and practice. The first paper presents data from 315 community clinicians who participated in six statewide Learning Collaboratives (LCs) to disseminate and implement TF-CBT. Pre-LC, post-LC, and follow-up data evinced significant, sustained improvements in clinician-reported assessment barriers and practices. The second paper presents latent class analysis findings from baseline data of 3,465 children who received TF-CBT. Groups differed on child- and caregiver-reported trauma exposure and symptoms. Findings also indicated differences in the extent to which class membership was linked to treatment retention.
Changes in Child Trauma Assessment Practices and Related Barriers During and After a Learning Collaborative (LC): Specificity, Diffusion, and Sustainability
Samuel O. Peer, PhD, Idaho State University, Pocatello, ID; Rochelle F. Hanson, PhD; Benjamin E. Saunders, PhD, Medical University of South Carolina, Charleston, SC; Alyssa M. Korell, Idaho State University, Pocatello, ID
This longitudinal study examined 315 community clinicians from five LCs to disseminate and implement Trauma-Focused Cognitive Behavioral Therapy. Results identified (a) typical use of and barriers to child trauma assessment, (b) pre- to post-LC decreases in assessment barriers, (c) pre- to post-LC increases in evidence-based child trauma assessment practices, (d) agency-level diffusion, and (d) sustained improvements. Collectively, these findings suggest that the LC framework can improve and sustain child trauma assessment practices in community agencies.
Examining Patterns in Child- and Caregiver-Reported Child Trauma Exposure, Symptoms, and TF-CBT Retention: A Latent Class Analysis
Kellie G. Randall, PhD; Ashley Nelson, BA; Robey B. Champine, PhD; Kyle Barrette, MSW, Child Health and Development Institute of CT, Farmington, CT
Latent class analysis was used to group 3,465 children who received TF-CBT according to child- and caregiver-reported trauma exposure and symptoms. Group membership was assessed in relation to treatment retention. A six-class model provided the best fit to the data. Class 5 (high child-reported trauma symptoms; child-caregiver agreement on trauma exposure and depressive symptoms) had the highest likelihood of completing treatment. These findings suggest how treatment approaches may be tailored to promote retention in TF-CBT.
3:30 pm – 4:00 pm
Bayshore 6 ~ 30 Minute Paper
Evidence-Based Treatments in Child Mental Health: Understanding the Factors Impacting Implementation and Sustainability
Jessica Eslinger, PhD; Ginny Sprang, PhD, University of Kentucky, Lexington, KY
There have been focused efforts to increase the dissemination of evidence-based treatments (EBTs) for child mental health issues. However, the dissemination of these EBTs has not necessarily translated into sustainability and has many challenges associated with the implementation process. Further understanding of the factors that help or hinder the implementation process is needed. An electronic survey was sent to a multi-disciplinary group of mental health providers who received training in one of three EBTs (Trauma-Focused Cognitive Behavioral Therapy, Functional Family Therapy, Encompass CBT+). Two studies using these data were conducted. Results suggest that organizational factors, such as productivity concessions and agency incentives, type of training format, clinical experience, attitudes toward EBT, and post-training barriers impact implementation outcomes. Implications for training and practice are offered.
4:00 pm – 5:00 pm
Bayshore 6 ~ 60-minute Symposium
Evidence-based Practices in Children’s Behavioral Health: Implications for Sustainability and Service Systems
Symposium Chair: Jason Lang, PhD, Child Health and Development Institute, Farmington, CT; Discussant: Benjamin Saunders, PhD, Medical University of South Carolina, Charleston, SC
Great efforts are being made by researchers and providers to disseminate evidence-based practices (EBPs) for children with behavioral health conditions, yet the uptake and sustainability of bringing EBPs to scale remain limited. This symposium addresses several research gaps and common questions about sustaining EBPs as part of large service systems. The first paper analyzes data from 278 clinicians and 2,300 children to describe the relative contributions of organization-, clinician-, and child-level factors toward sustaining EBPs and healthy outcomes for child recipients. The second paper examines the relation between interprofessional collaboration across child service systems and sustainment of child behavioral health EBPs. The final paper describes the extent to which community-based EBPs were provided to children with behavioral conditions that the EBPs were intended to address. Lessons learned and implications for scaling up EBPs and sustaining them efficiently and effectively will be discussed.
The Influences of Child, Clinician, and Organization Factors on EBP Sustainability and Child Outcomes: A Multilevel Assessment
Robey Champine, PhD; Michelle Delaney, MA; Jason Lang, PhD, Child Health and Development Institute, Farmington, CT
The relative contributions of child-, clinician- and organization-level factors towards EBP implementation and outcomes for 2,300 children receiving EBPs will be described. Measures assessed the extent to which clinicians’ organizations supported the implementation of EBPs, clinicians’ perceived self-efficacy in delivering interventions, the number of children served, and change scores in child trauma symptoms. Findings will inform discussion of the roles of individual and contextual factors in the use of EBPs in community settings.
Building Bridges: Does Training Enhance Interprofessional Collaboration to Sustain Trauma-Informed Evidence-Based Practices (EBPs) for Youth and Families?
Rochelle Hanson, PhD; Benjamin Saunders, PhD; Faraday Davies, Medical University of South Carolina, Charleston, SC; Samuel Peer, PhD, Idaho State University, Pocatello, ID; Sonja Schoenwald, PhD, Oregon Social Learning Center, Eugene, OR
Interprofessional collaboration across youth service systems can contribute to improved access to trauma-informed EBPs and positive participant outcomes. This presentation will examine whether the Community-Based Learning Collaborative (CBLC), a multi-component training/implementation model, was linked to increased interprofessional collaboration and sustained use of trauma-informed EBPs. Data from 572 participants to measure changes in interprofessional collaboration included brief monthly online surveys completed throughout the duration of the CBLC and social network surveys completed at two time points.
Evidence-based Practices in Outpatient Child Mental Health Clinics: Relation between Treatment Type and Diagnosis
Phyllis Lee, PhD, Eastern Connecticut State University, Willimantic, CT; Jason Lang, PhD, Child Health and Development Institute, Farmington, CT; Tim Marshall, LCSW, Connecticut Department of Children and Families, Hartford, CT
Although EBPs have been identified for specific mental health disorders, little is known about the types of treatments children receive in community-based clinics and to what extent EBPs are being used with children consistent with how they are intended. Data from 46,729 children showed symptom improvements for children who received EBPs and for children who received EBPs that were empirically supported for their diagnosis. Results and implications for children with comorbid conditions will be discussed.
10:00 am – 11:30 am
Bayshore 6 ~ 90-minute Symposium
Scaling Up: Challenges and Strategies for Implementation of Promising and Evidence-Based Practices in Missouri Public and Private Child Welfare Settings
Symposium Chair: Rosalyn Bertram, PhD, Child and Family Evidence-Based Practice Consortium, Kansas City, MO
Successful, sustainable systems change requires readiness, careful selection of practice models, alignment of implementation drivers, and consistent monitoring and response to fidelity and outcome data. In light of the requirements of the 2018 Family First Prevention Services Act, this symposium first presents challenges experienced and strategies applied in the Missouri Children’s Division statewide introduction of new philosophy (Five Domains of Well-Being) and a promising practice (Signs of Safety). For comparison, a regional private child welfare organization, Cornerstones of Care, presents its challenges and strategies in scaling up Solution-Based Casework, an evidence-based practice. Both efforts were challenged by staff turnover and negotiating model adaptations with purveyors. Implementation of both efforts was informed and supported by the University of Missouri-Kansas City National Child Welfare Workforce Institute (NCWWI) University Partnership grant that integrates implementation science and evidence-based practice into its academic and field curricula.
Transforming Compliance-Driven Child Welfare Practice: Lessons from Installation and Initial Implementation as Missouri Scales Up New Philosophy and Practice
Christy Collins, MS, Missouri Children’s Division, Jefferson City, MO
In 2014, Missouri Children’s Division initiated a three-year, statewide transformation of philosophy and practice. Signs of Safety, a promising Australian practice was integrated with Five-Domains of Well Being, to better engage families and natural supports in a solution-focused, strengths-based approach across all services. Systematic adjustments to policies and procedures, staff selection, training, and coaching unfolded amidst typical child welfare staff turnover. Implementation supports, challenges, lessons and early outcomes are shared in this paper.
Selection, Installation and Initial Implementation of Solution-Based Casework Across Programs in a Regional Private Child Welfare Organization
Megan Elsen, MSW, Cornerstones of Care, Kansas City, MO
Anticipating the Family First Prevention Services Act, Cornerstones of Care, a regional private child welfare organization in the Kansas City area, adopted an evidence-based practice, Solution-Based Casework. This paper presents installation and initial implementation activities and challenges that required continual negotiations with the purveyor and adjustments to training, coaching, policy, procedure, and use of data in implementation teams. Early fidelity and outcome data are presented.
Supporting Child Welfare Service Transformation: Implementation Science and Evidence-Based Practice in Academic and Field Curricula
Rosalyn Bertram, PhD, University of Missouri-Kansas City School of Social Work, Kansas City, MO; Shane Wilcutt MSW, Cornerstones of Care, Olathe KS
By design, the UMKC NCWWI grant seeks to improve child welfare workforce development while simultaneously transforming academic and field curricula to improve implementation of child welfare services (Bertram, Decker, Gillies, & Choi, 2017). Reflecting implementation science, plan-do-study-act feedback loops inform and refine academic and field curricula innovations. These innovations and feedback loops also support the implementation of public and private child welfare programs, and graduates quickly assume leadership roles (Bertram, Choi, & Elsen, 2018).
1:30 pm – 2:30 pm
Bayshore 6 ~ 60-minute Symposium
Listening to Voices, Enacting Vision: Practice-Based Research and Data-Informed Policy Decisions in Hawaii’s System of Care
Symposium Chair: Charles Mueller, PhD, University of Hawaiʻi at Mānoa, Honolulu, HI; Discussant: Eric Daleiden, PhD, PracticeWise, LLC, Satellite Beach, FL
This symposium reviews a 15-year research, service and learning collaborative between the University of Hawaiʻi Department of Psychology and the State of Hawaii Child and Adolescent Mental Health Division (CAMHD) with the objectives of (a) outlining the principles that have guided decision-making within this system, particularly regarding the collection and use of multi-informant locally aggregated data, (b) summarizing selected findings resulting from this collaboration, and (c) describing several examples of the practical application of these findings within the system toward the goal of improving the quality of service delivery.
Leveraging Multiple Voices to Advance Practice-Based Research in a System of Care
Matt Milette-Winfree, PhD, University of Hawaiʻi at Mānoa, Honolulu, HI; Puanani Hee, PhD, State of Hawaii Child and Adolescent Mental Health Division, Honolulu, HI; Charles Mueller, PhD, University of Hawai’i at Manoa, Honolulu, HI
Fifteen years of collaborative scientific inquiry has underscored the value of aggregate multi-informant data in understanding youth public mental health treatment. This talk summarizes practice-based research within a state system of care, beginning with the development and implementation of data tracking measures and then describing findings stemming from their use, including those that speak to therapist decision-making, intervention effectiveness, and the trajectory of treatment progress (with special attention to identifiable risk factors for treatment failure).
Using Local Data to Build Digital Decision-Making Tools and Policies
Trina Orimoto, PhD; Kelsie Okamura, PhD; Max Sender State of Hawaii Child and Adolescent Mental Health Division, Honolulu, HI; Jonathan Ahuna, University of Hawaiʻi at Maāoa, Honolulu, HI; David Jackson, PhD, State of Hawaii Child and Adolescent Mental Health Division, Honolulu, HI
Practice-based evidence relies on locally aggregated client-specific historical data from families, therapists, and stakeholders (Daleiden & Chorpita, 2005). Such data can be leveraged to inform clinical practices and system policies, particularly with the advent of electronic health records. We describe how findings from local aggregate data studies within a system have advanced local knowledge, improved workflows and informed the structure of a new electronic case management system. Examples of workflows and dashboards will be shown.
4:15 pm – 4:45 pm
Bayshore 6 ~ 30 Minute Paper
Minding the Implementation Gap: Fidelity Measurement Variability Within Evidence-Based Interventions
Cricket Mitchell, PhD, Cricket Mitchell Consulting, LLC, Phoenix, AZ; Jennifer Sedivy, MSW, University of Denver, Denver, CO; Jennifer Rolls Reutz, MPH, Chadwick Center for Children and Families, San Diego, CA; Suzanne Kerns, PhD, University of Denver, Denver, CO
There is a widely acknowledged implementation gap with regard to evidence-based interventions. This paper uses data and materials provided from programs rated on the California Evidence-Based Clearinghouse (CEBC) to examine the extent of this gap as it relates to the availability of fidelity measurement implementation supports. Using Schoenwald & Garland’s (2013) fidelity measure criteria, program fidelity characteristics, including source, type, and frequency of use were coded. Characteristics of the available fidelity measures are presented, and strengths and weaknesses are discussed.
4:45 pm – 5:15 pm
Bayshore 6 ~ 30 Minute Paper
Use of Data and Collaborative Problem Solving to Improve Service Delivery and Response at a Statewide Child Welfare Hotline
Charlotte Vieira, MPH; Robert Franks, PhD; Christopher Bellonci, M.D., DFAACAP; Rich Young, Judge Baker Children’s Center, Boston, MA
This presentation will describe a two-year quality improvement initiative to reform service delivery at a statewide 24-hour child welfare hotline. Methods focus on the use of call system data to inform and promote continuous quality improvement with participation by diverse stakeholders. Results from the initiative include a 78% reduction in average wait time for callers. Findings emphasize the benefit of data utilization and engagement of stakeholders to improve complex service systems and are widely applicable.
5:15 pm – 5:45 pm
Bayshore 6 ~ 30 Minute Paper
Integrating Evidence-Based Practices into an Early Childhood Mental Health Network: A Dynamic Approach to Strengthening the Resilience of Young Children and Families
Fatima Zahra Kadik, MA; Shirley Berger, DrPH, MPH, MA; Janice Okeke, MPH, New York City Department of Health and Mental Hygiene, New York, NY
This presentation focuses on the workforce development, effective implementation, and evaluation of evidence-based practices (EBPs) within an early childhood mental health network in a large urban setting. It describes a multi-year and dynamic process of training service providers in appropriate EBPs, such as Child-Parent Psychotherapy and Triple P Positive Parenting Program. Participants will learn strategies to sustain EBPs and use data to improve outcomes at the practice level and at the child/family level.
210. EBP Poster
Challenges and Strategies for Social Workers Training in Integrated Behavioral Health Settings: Observations from the Field
Sharon Johnson, PhD; Riisa Rawlins-Easley, MSW; Sha-Lai Williams Woodson, PhD; Patricia Rosenthal, MSW, University of Missouri-St. Louis, St. Louis, MO
This presentation discusses the challenges of training for integration from the perspectives of MSW-level social work trainees who worked in agencies focused on children, adolescents, and transitional-age adults. Trainee feedback provided during a debriefing session following the successful completion of a clinical field placement suggests infrastructure, convenience, mutual respect, and reciprocal communication are key to successful integrated health teams. We will share the implications of these finding for future training efforts in integrated health practice settings.
Integrating Implementation Science and Evidence-Based Practice to Support Transformational Change in the Child Welfare Workforce
Anna de Guzman, MA, Graduate School of Social Work, University of Denver, Denver, CO; Robin Leake, PhD, University of Denver, Graduate School of Social Work, Butler Institute for Families, Denver, CO; Rosalyn Bertram, PhD, University of Missouri-Kansas City, Kansas City, MO; Christy Collins, MS, Missouri Children’s Division, Jefferson City, MO; Shane Wilcutt, MSW, Cornerstones of Care, Olathe, KS
The National Child Welfare Workforce Institute (NCWWI) supports child welfare agencies in implementing evidence-supported practices and improving workforce health. NCWWI conducts comprehensive organizational health assessments that support collaborative exploration of workforce challenges and interventions. Selected sites implement innovations to improve client outcomes, while NCWWI supports university/agency partnerships and leadership training across each state. This poster session presents the Missouri Workforce Excellence site’s challenges, strategies, and effectiveness in implementing strategies to improve workforce health and development.
10:00 am – 10:30 am
Bayshore 6 ~ 30 Minute Paper
A Mixed Methods Outcome Evaluation of the Technical Assistance Network for Children’s Behavioral Health
Jonathan Olson, PhD; Eric Bruns, PhD, University of Washington, Seattle, WA; Michelle Zabel, MSS; Marlene Matarese, PhD, University of Maryland, Baltimore, MA
The National Technical Assistance Network for Children’s Behavioral Health provides ongoing, proactive support to states, communities, and tribes that are developing and implementing systems of care to support youth with complex behavioral health needs. This study is a multi-method case study evaluation of TA Network activities in a purposefully selected sample of grantee sites. This presentation will review TA Network strategies that are associated with impact and implications for future TA delivery.
10:30 am – 11:30 am
Bayshore 6 ~ 60-minute Discussion Hour
Addressing Gaps in Behavioral Health Workforce Training Needs for Children, Youth, and Families
Rae Beaudry, MSW, The Institute for Innovation and Implementation, Baltimore, MD; David Hussey, PhD, Begun Center for Violence Prevention Research and Education at CWRU, Cleveland, OH; Elena Mazza, PhD, MSW, LCSW, Monmouth University School of Social Work, West Long Branch, NJ; Margo Candelaria, PhD; Michelle Zabel, MSW, The Institute for Innovation and Implementation, Baltimore, MD
The TA Network launched the Behavioral Health Care Development Initiative (BHCDI) to improve knowledge, expertise, and overall preparedness of graduate of MSW degree programs to provide effective behavioral health services to youth. Benefits of this initiative include a greater focus on clinical competencies that address gaps in the child behavioral health workforce; a compendium of flexible course/modular offerings matched to meet student learning needs; and opportunities to develop advanced competency knowledge and practice behavior resources.