exploration work group - sc dhhs · 2016-10-03 · august 2016. exploration work group membership...
TRANSCRIPT
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Exploration Work Group
From the Lens of Implementation: Evaluation of Evidence-Based
Interventions Recommended to PCSC
August 2016
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Exploration Work Group Membership
• Angela Flowers (SCDJJ)• John Connery (YAP)• Dr. Tricia Motes (IFS at UofSC, MPR Div.)• Erin Laughter (SCDHHS)• Lisa Kirchner (FamilyCorps)• Dr. Margaret Meriwether (SCDHHS)• Phil Redmond (The Duke Endowment)• Staffing: Dr. Cheri Shapiro & Joan Amado, SC
Center of Excellence in Evidence-Based Intervention
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Scope of EWG Efforts
• Examine intervention models included in a report “Evidence-Based Interventions for Youth with Behavioral Health and Substance Use Problems” prepared by the SC Center of Excellence in Evidence-Based Interventions (April 2016)– Report not exhaustive; NREPP inclusion was required
• Evidence-based interventions are only a part of what families may need– Report and EWG did not examine peer-to-peer,
advocacy, or family support models
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Implementation Lens
• Program selection is a complex undertaking
– Even for evidence-based interventions, need to evaluate programs in domains relevant for implementation
• NIRN Hexagon Tool as starting framework (http://implementation.fpg.unc.edu/resources/hexagon-tool-exploring-context)
• Examined: Need, Fit, Capacity, Resource Availability
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Meeting Needs
• How well does the intervention meet the needs of the intended population?
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Fit
• How well does the intervention fit with current initiatives, structures, supports, and parent/community values?
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Resources
• What resources are available for training, staffing, technology supports, data systems, and administration?
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Current Capacity
• What current capacity do we have in the state to implement the intervention as intended?
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How did we do this?
• Considered all interventions in the report to the PCSC
– Evidence-Based Intensive Family Interventions
– Evidence-Based Family Interventions
– Evidence-based Parenting and Youth Interventions
• Examined each domain of implementation
• Summarized results
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Evidence-Based Intensive Family Interventions
• Family Centered Therapy
• Homebuilders
• Multisystemic Therapy for Juvenile Offenders
• Multisystemic Therapy Psychiatric
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Family Centered Therapy
1-4 1-51.5-5
2-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Homebuilders
3-52-5
1-3
3-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources CurrentCapacity
MST Juvenile Offenders
2-51.5-5
1-4
1-3
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
MST Psychiatric
2-5
1-41-4
1-2
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0
0.5
1
1.5
2
2.5
3
3.5
4
Homebuilders MST JuvenileOffenders
MST Psychiatric Family Centered Tx
Average Implementation Ratings: Intensive Family Service Models
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Evidence-Based Family Interventions
• Multidimensional Family Therapy
• Adolescent Community Reinforcement Approach
• Brief Strategic Family Therapy
• Family Behavior Therapy
• Functional Family Therapy
• Attachment Based Family Therapy
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Multidimensional Family Therapy
1-4
1-3
2.5-52.5-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Adolescent Community Reinforcement Approach
3-5
3-5
1.5-5
2.5-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Brief Strategic Family Therapy
2-5
1-3
3-4
1-4
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Family Behavior Therapy
1-4 1-3
1-5 2-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Functional Family Therapy
1-31-3
2.5-52.5-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meets needs Fit Resources Current Capacity
Attachment Based Family Therapy
1.5-3
1-4 1-3
1-4
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
AttachmentBased Fam
Ther
Adol CommRA
Brief StratFam Ther
Fam BehTher
FunctionalFam Ther
MultidimFam Ther
Average Implementation Ratings: Family Intervention Models
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Evidence-Based Parenting and Youth Interventions
• Combined Parent-Child CBT
• Incredible Years
• Triple P Positive Parenting Program (Level 4)
• Parent Child Interaction Therapy
• Strengthening Families 4R 2S
• Trauma Focused CBT
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meet needs Fit Resources Capacity
Combined Parent-Child CBT
3-42-4
1-42-3.5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meet needs Fit Resources Capacity
Incredible Years
2-42.5-4
1-3.5
1-3
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meet needs Fit Resources Capacity
Triple P Level 4
2-5 2-42-4.5
2-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meet needs Fit Resources Capacity
Parent Child Interaction Therapy
1.5-4 2.5-5 2-42-4
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meet needs Fit Resources Capacity
Strengthening Families (3R2S)
2-4
2-4
2-4 2-4
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Meet needs Fit Resources Capacity
Trauma Focused CBT
3-5
2.8-53-43-5
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0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Combined Parent-Child CBT
Incredible Years Triple P Level 4 PCIT StrengtheningFamilies (3R2S)
Trauma Foc CBT
Average Implementation Ratings: Parenting and Youth Interventions
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Common Themes Across Program Models
• Capacity to implement interventions was typically the lowest rated area for all program models
– Workforce considerations
• Resources available for implementation also an area of concern
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Highest Rated Programs
• Intensive Models– Homebuilders (new)
– MST Juvenile Offenders (expand)
• Family Intervention Models– ACRA (expand/support)
– Multidimensional Family Therapy (new)
• Parenting and Youth Interventions– Trauma Focused CBT (expand/support)
– Triple P (Level 4) (expand/support)
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EWG Program Ratings
• Most, but not all, are consistent with the report to the PCSC completed by the Center of Excellence
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Thank you to the EWG Members!
What Next?
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Role of the SC Center of Excellence
• Continue to explore program models and implementation capacity– Provider survey under development
• Support 1-2 specific program models within each category– Intensive Family Services
– Family Based Interventions
– Parent and Youth Directed Programs
• Level of support necessary will vary based on program model
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Example Array of Evidence-Based Interventions
Child Age Anxiety Depression Conduct
Problems Trauma
Complex
Needs
Substance
Abuse
Trauma-
Focused
Cognitive
Behavioral
Therapy
8-12
3-8
12-17
SOURCE: Bernstein, D., Bertram, R., Choi, S., Kanary, P., Kerns, S., Marsenich, L., Mettrick, J.
Example suite of EBPs to address a range of mental health needs across childhood development This table presents an example of how multiple EBPs can be leveraged across several service providers to meet a range of mental health needs for children and youth. While a system of care such as this could potentially meet the needs of the majority of families in a community, the extent to which there is community capacity to implement these programs should be carefully assessed. Please refer to “Evidence-Informed Practice in Systems of Care: Misconceptions and Facts” for further information: https://www.scribd.com/doc/295509039/Evidence-Informed-Practice-in-Systems-of-Care-Misconceptions-and-Facts
Coping Cat
Cognitive
Behavioral
Therapy for
Anxiety
Cognitive
Behavioral
Therapy for
Depression
Interpersonal
Treatment for
Adolescents
Triple P -
Positive
Parenting
Program
Incredible
Years
Parent-Child
Interaction
Therapy
Multisystemic
Therapy
Wraparound
Solution-
Based
Casework
Assertive
Case
Management
Dialectical
Behavioral
Therapy
Behavioral
Parent
Training
Brief
Strategic
Family
Therapy
Multi-
Dimensional
Family
Therapy
Functional
Family
Therapy
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Discussion
And
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SC Center of Excellence Contact Information
Cheri Shapiro, PhD
Director, SC Center of Excellence in Evidence-Based Intervention
Research Associate Professor and Associate Director
Institute for Families in Society
University of South Carolina
803-777-8760
Joan Amado, LMSW/MPA
Coordinator, SC Center of Excellence in Evidence-Based Intervention
Institute for Families in Society
University of South Carolina
803-777-6194
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Disclosure
Cheri Shapiro, PhD, is a Consultant for Triple P America.