exploration work group - sc dhhs · 2016-10-03 · august 2016. exploration work group membership...
TRANSCRIPT
Exploration Work Group
From the Lens of Implementation: Evaluation of Evidence-Based
Interventions Recommended to PCSC
August 2016
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
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
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
Meeting Needs
• How well does the intervention meet the needs of the intended population?
Fit
• How well does the intervention fit with current initiatives, structures, supports, and parent/community values?
Resources
• What resources are available for training, staffing, technology supports, data systems, and administration?
Current Capacity
• What current capacity do we have in the state to implement the intervention as intended?
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
Evidence-Based Intensive Family Interventions
• Family Centered Therapy
• Homebuilders
• Multisystemic Therapy for Juvenile Offenders
• Multisystemic Therapy Psychiatric
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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)
EWG Program Ratings
• Most, but not all, are consistent with the report to the PCSC completed by the Center of Excellence
Thank you to the EWG Members!
What Next?
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
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
Discussion
And
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
Disclosure
Cheri Shapiro, PhD, is a Consultant for Triple P America.