10:00 am – 11:30 am Bayshore 6 ~ (90-minute Symposium)
Bridging Science to Practice Gaps in Child Welfare Implementation
Symposium Chair: Rosalyn Bertram, PhD, School of Social Work, University of Missouri-Kansas City, Kansas City, MO;
Discussant: Robert Franks, PhD, Harvard University, Judge Baker Children’s Center, Boston, MA
Gaps between implementation science and practice compromise workforce development and child and family outcomes. This symposium presents common implementation functions that are often not well considered in child welfare.
Three papers present evidence-informed questions and examples to encourage the audience to share questions and lessons from their experiences. From this discourse, the Child and Family Evidence Based Practice Consortium (ebpconsortium.com) will engage participants in producing a series of papers, webinars, and pre-conference events through 2021.
Essential Implementation Functions for Effective Evidence-Based Practice in Child Welfare
Jacquie Brown, MES, RSW, Jacquie Brown and Associates, Child and Family Evidence Based Practice Consortium, Toronto, ON;
Virginia Strand, DSW, National Center for Social Work Trauma Education and Workforce Development, Fordham University Graduate School of Social Service, West Harrison, NY
This paper identifies eight stage-based functions across various implementation frameworks to guide child welfare implementation strategies.This paper draws on our experience across multiple child welfare contexts in North America, Africa, and Asia. Tools and strategies are suggested to address these common functions drawn from multiple implementation frameworks. This presentation will be used to generate audience discussion about the utility of an essential functions framework to serve as a catalyst for exploration and decision-making in child welfare.
Implementation Supports: Program Developer Resources Available to Support Effective Child Welfare Implementation
Jennifer Rolls-Reutz, MPH, Chadwick Center for Children and Families, California Evidence-Based Clearinghouse, San Diego, CA;
Sue Kerns, PhD, Center for Effective Interventions, Graduate School of Social Work, Denver University, Denver, CO;
Cricket Mitchell, PhD, Cricket Mitchell Consulting, LLC, Phoenix, AZ
Data was examined from programs rated by the California Evidence-Based Clearinghouse (CEBC) for Child Welfare to identify the characteristics and types of implementation supports available from program developers. Formats, quality, and practicality of these materials will be presented, including if there was an empirical examination for effectiveness. Finally, we identify strengths and areas where developers, researchers, or implementation intermediaries can focus their efforts to address gaps in these implementation support systems are identified.
Implementation Gaps in Child Welfare: Examples and Responses
Rosalyn Bertram, PhD, University of Missouri-Kansas City School of Social Work, Child and Family Evidence Based Practice Consortium, Kansas City, MO;
George (Tripp) Ake, PhD, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Center for Child and Family Health, Durham, NC
This paper provides three case examples of common elements in the science to practice gap in child welfare implementation. In North Carolina, a mismatch of goals, strategies, and participants compromised trauma-informed care implementation. In Missouri, an ambitious transformation of philosophy and practice was constrained by beginning implementation before completing installation stage activities. However, in Houston, inattention to installation activities before implementing wraparound was corrected within 18 months.
3:30 pm – 5:00 pm Bayshore 6 ~ (90-minute Symposium)
A Tale of Two States: Outcomes from Two State-Wide Demonstration Projects to Expand Evidence-Based Psychotherapies for Traumatized Youth
Symposium Chair: Suzanne Kerns, PhD, Graduate School of Social Work, University of Denver, Denver, CO
Evidence-based psychotherapies for PTSD in children are highly efficacious in controlled trials, yet applying these models into community settings is incredibly challenging. This symposium examines the implementation and clinical outcomes of two multi-year, state-wide efforts to implement evidence-based psychotherapies into community settings for traumatized children involved in the child welfare systems. Clinician drop-out was considerable. However, for the children who did complete treatment, clinical outcomes were similar to those in highly controlled trials.
Evidence-Based Treatment Training Within the Louisiana Child Welfare Trauma Project
Devi Murphy, PhD, Dept. of Psychiatry and Behavioral Sciences, Tulane University, New Orleans, LA
The Louisiana project aimed to expand evidence-based treatment services state-wide for youth with posttraumatic stress disorder (PTSD) involved with child welfare. In a broad-based recruitment effort, 2,036 clinicians were invited to attend a one-day training plus weekly consultation calls in Youth PTSD Treatment (YPT; Scheeringa & Weems, 2014). This presentation will focus on the training model, clinician adherence to the training expectations, and PTSD outcomes for a percentage of the youth who completed YPT.
Outcomes from a State-Wide Project to Implement Two EBP’s for Child Trauma in New Hampshire
Erin Barnett, PhD; Mary K. Jankowski, PhD, Dartmouth College, Lebanon, NH
The NH project examined implementation and clinical outcomes from a state-wide demonstration project to implement two evidence-based treatments for child trauma (TF-CBT and CPP) into community agencies serving child-welfare involved children and families. A total of 292 clinicians were invited to four rounds of two-day trainings and ongoing consultation calls. We tracked clinician adherence to consultation and implementation expectations, client status, and PTSD outcomes were tracked. This presentation will describe project outcomes and implications for widespread dissemination of EBPs.
10:00 am – 11:30 am Bayshore 6 ~ (90-minute Symposium)
Promoting Evidence-Based Practice in Statewide System of Care: the New Hampshire Match Learning Collaborative
Symposium Chair: Robert Franks, PhD, Judge Baker Children’s Center, Boston, MA;
Discussant: George Ake III, PhD, Center for Child and Family Health, Duke Medical Center, Durham, NC
This symposium will provide a comprehensive overview of efforts by the Judge Baker Children’s Center to promote an established modular evidence-based practice, the Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) in the statewide community mental health system in New Hampshire.
The MATCH Treatment Model: Training, Consultation, Supervision, and Sustainability
Daniel Cheron, PhD, Judge Baker Children’s Center, Boston, MA
In this presentation, participants will learn about MATCH-ADTC, the EBP implemented in this statewide Learning Collaborative. Special attention will be paid to methods for providing training and consultation to therapists and supervisors in MATCH using both live and distance-learning techniques, methods for monitoring clinical progress throughout the initiative, and strategies for maintaining a sustainable workforce trained in the intervention. Preliminary outcomes that support the use of MATCH will be provided.
Assessing Organizational Readiness as a Tool to Promote the Successful Implementation of EBP’s
Robert Franks, PhD, Judge Baker Children’s Center, Boston, MA
This presentation will focus on how the Judge Baker Children’s Center used an enhanced change package that included a structured readiness tool developed by Wandersman and Scaccia to assess organizational readiness within multiple sites as part of a statewide learning collaborative to implement the EBP MATCH-ADTC. Further, the organization’s capacities to successfully implement the model were assessed. These data were utilized to inform the implementation process and provide tailored technical assistance to participating agencies.
Tools and Methods to Implement EBP’s with Good Outcomes: the New Hampshire MATCH-ADTC Learning Collaborative
Charlotte Vieira, MPH, Quality Care Initiative, Judge Baker Children’s Center, Boston, MA;
Rachel Kim, PhD, Judge Baker Children’s Center, Boston, MA
This presentation will describe the structured Learning Collaborative methodologies used to implement MATCH-ADTC within a statewide system of care in New Hampshire. Strategies that include the use of metric and outcome data to facilitate implementation, use of consultation and technical assistance, coaching, affinity groups and ongoing quality improvement strategies such as Plan-Do-Study-Act cycles. In addition, strategies for local adaptations and sustainability planning will be provided. These strategies can be used in other systems of care.
1:30 pm – 2:30 pm Bayshore 6 ~ (60-minute Discussion)
Transforming Academic Curricula: New Roles for Intermediary Organizations and Behavioral Health Programs
Rosalyn Bertram, PhD, School of Social Work, University of Missouri-Kansas City, Kansas City, MO
Elisabeth Cannata, PhD, Community-Based Family Services & Practice Innovation, Wheeler Clinic, Plainville, CT;
Dana Marlowe, PhD, LCSW, Graduate School of Social Service, Fordham University, West Harrison, NY;
Suzanne Kerns, PhD, Graduate School of Social Work, University of Denver, Denver, CO
A survey of North American behavioral health care program leaders (n= 589) identified most newly-hired masters level practitioners lacked knowledge and skills essential to evidence-based practice (Barwick, 2011). This discussion hour compares results of two studies that examined academic preparation of future MSW (Bertram et al., 2015) or MFT (manuscript in preparation) practitioners to deliver EBP. Results suggest faculty and behavioral health care programs must take an active role in shaping academic and field curricula.
4:15 pm – 5:45 pm Bayshore 6 ~ (90-minute Symposium)
Factors Related to Implementation of EBPs and Child Outcomes Across Youth Service Systems
Symposium Chair: George (Tripp) Ake, PhD, Duke University Medical Center, Durham, NC
Despite increasing efforts to disseminate evidence-based practices (EBPs), most children served in community settings still do not receive them. This symposium addresses emerging research and practice questions about EBP dissemination from large-scale initiatives in two states. These presentations examine the impact of EBPs compared to usual care in a state system, and the roles that training, consultation, supervision, and other implementation strategies have on implementation and child outcomes.
The Effects of EBPs and Disparities in a Statewide Children’s Behavioral Health System
Phyllis Lee, PhD, Department of Psychological Science, Eastern Connecticut State University, Willimantic, CT;
Jason Lang, PhD, Child Health and Development Institute, Farmington, CT;
Tim Marshall, Connecticut Department of Children and Families, Hartford, CT
This presentation compares EBPs with usual care in a statewide children’s behavioral health system. Data from over 48,000 youth served over four years showed that children receiving EBPs, particularly those disseminated with the Dissemination and Support Center model, had better outcomes than children receiving usual care. Disparities in race/ethnicity and age were observed, and overall rates of EBP use were higher than national averages but still modest. Recommendations for scaling EBPs will be discussed.
The Effects of Training Type and Consultation on Implementation Outcomes
Kellie Randall, PhD; Jason Lang, PhD, Child Health and Development Institute, Farmington, CT;
Erum Nadeem, PhD, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
This presentation describes data from a statewide dissemination of TF-CBT to 29 agencies that participated in a Learning Collaborative (LC). A total of 693 clinicians were trained through a LC, web-based training, or in-person trainings. Implementation outcomes are examined across the three types of training. LC clinicians initiated TF-CBT at a higher rate and saw more cases. However, the groups were similar on quality indicators, suggesting LC participation prepares agencies to successfully sustain the practice.
The Role of In-House Supervision for Evidence-Based Practice (EBP) implementation Across Youth Service Systems
Rochelle Hanson, PhD; , National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC;
Samuel Peer, PhD, Medical University of South Carolina, Charleston, SC;
Benjamin Saunders, PhD, National Crime Victims Research & Treatment Center, Medical University of South Carolina, Charleston, SC
Training alone is insufficient to sustain integration of EBPs in community settings. Pre- and post-implementation data on supervision and EBP practice from 224 therapists who participated in a learning collaborative are presented. Consistent with hypotheses, TF-CBT specific, but not general supervision, was related to changes in TF-CBT practice. However, neither was associated with changes in TF-CBT skills. Findings suggest that supervision is related to increased participation and EBP use.
10:00 am – 10:30 am Bayshore 6 ~ (30-minute Paper)
Using Technical Assistance to Support the Implementation of an Evidence-based Program in the Community: Lessons from Data and Practice with the Legacy for Children Parenting Intervention
Marvin So, MPH, CHES; Sophie Hartwig, MPH; Akilah Heggs, MA, Centers for Disease Control and Prevention, Atlanta, GA;
Lynne Katz, EdD, University of Miami, Linda Ray Intervention Center, Miami, FL;
Lara Robinson, PhD, MPH, Centers for Disease Control and Prevention, Miami, FL
Disseminating evidence-based programs (EBPs) into community settings is critical for meeting the behavioral health needs of children and families. This presentation reports on our experience supporting implementation of the Legacy for Children parenting intervention by diverse agencies serving children (e.g., pediatric primary care, early childhood education, federally qualified health centers). We share lessons that may be useful for similar organizations, drawing from qualitative analyses of technical assistance reports, integrated with perspectives from technical assistance providers.
10:30 am – 11:30 am Bayshore 6 ~ (60-minute Symposium)
Successful Transfer of a Strengths-Based EBP: Going to Scale from Start-up to Sustained Fidelity to Parent Empowerment and Successful Family Outcomes
Symposium Chair: Laura Rains, MSW, MA, Implementation Sciences International, Inc., Eugene, OR;
Discussant: Luann Gray, MSW, Kalamazoo Community Mental Health and Substance Abuse Services, Kalamazoo, MI
This symposium will provide an overview of GenerationPMTO, a parent-empowering evidence-based practice (EBP) implemented in System of Care across contexts, cultures, and countries (Forgatch, Gewirtz, 2017). Previously known as Parent Management Training – Oregon Model (PMTO®), GenerationPMTO is based on 50 years of research, development, and implementation, and demonstrates beneficial effects on child, youth, and parent adjustment.
Sustaining Fidelity Across Multiple Generations: Investment Return, Culture Change, Demonstrated Effects
Laura Rains, MSW, Implementation Sciences International, Inc., Eugene, OR
This presentation will provide an overview of Generation PMTO content, processes, research, and outcomes for children, youth, parents, and families. Previously known as Parent Management Training Oregon Model (PMTO), Generation PMTO is based on 50 years of research, development, and implementation. Laura Rains, the model developer’s director of implementation and training, will describe a multi-tiered approach to implementation and sustained fidelity. Generation PMTO tools will be presented via scenarios, video, small-group and dyadic exercises, and data presentation.
Implementing and Sustaining an EBP with Fidelity in a Mental Health System of Care Statewide
Luann Gray, MSW, Kalamazoo Community Mental Health and Substance Abuse Services, Kalamazoo, MI
This presentation will look at a successful approach to building and sustaining capacity of an evidence-based practice, Parent Management Training- Oregon Model (PMTO). By coordinating state and local efforts, Michigan has offered multiple treatment modalities and services, disseminating effective parenting strategies on a larger scale. The state coordinator, Luann Gray, will facilitate discussion that examines how local and state resources have worked together to build capacity with sustained model fidelity.