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WWW.REDF.ORG
© REDF 2015
Implementing Cognitive
Behavioral Interventions Within
the Social Enterprise Context
© REDF 2017 REDF
Goals and Agenda
Goals
• To introduce social enterprise staff
to cognitive behavioral interventions
• To provide examples of various
ways that social enterprises are
integrating CBI into their
programming.
• To encourage consideration about
whether and how Cognitive
Behavioral Interventions could be a
tool for improving the outcomes of
your target population workers
Agenda
• Welcome, Goals, Agenda,
Introductions
• Cognitive Behavioral Therapy 101
• Overview of Social Enterprises on
Webinar
• Panel Discussion: Implementing
CBI in Social Enterprise Context
• Questions
• Wrap up
PAGE 2
© REDF 2017 REDF
Our Speakers
PAGE 3
Terri Feeley
REDF
Cynthia Brackett
CEO
Christine Kidd
CEO
Shelby Mason
Goodwill Silicon Valley
Sonya Nabkel
Goodwill Silicon Valley
Anisha Chablani- Medley
Roca
Soo Jeong Youn, PhD
Community Psychiatry PRIDE
Community Psychiatry
PRIDE
Soo Jeong Youn, PhDPostdoctoral Fellow
MGH Community Psychiatry PRIDEHarvard Medical School
Agenda for Webinar
MGH PRIDE
Who we are? Partnerships
CBT AND EMPLOYMENT
How is it helpful?
WHAT IS COGNITIVE BEHAVIORAL THERAPY (CBT)?
CBT cycle Characteristics of CBT
What is CBT?
WHAT I THINK (THOUGHTS)
WHAT I FEEL (EMOTIONS)
WHAT I DO (BEHAVIORS)
SITUATION
What we think affects what we do and feel!
What we feel affects what we do and think!
What we do affects what we think and feel!
CBT CYCLE
Characteristics of CBT
Pragmatic StructuredPresent Focused
CollaborativeEvidence-
Based Treatment
Why Evidence Based Treatments (EBTs), such as CBT?
Rapid Symptom
Improvement
Secondary Health
Outcomes
Prevent Relapse
Efficacy and Effectiveness
Economical Advantages
EBTs: Economical Advantages
• $80-100 billion in direct costs
• $43.7 billion in absenteeism from work
• 200 million+ days lost/year
• $1,601/person/year
• $3.77 returned per dollar spent
• $416 million in benefits
MentalHealth
Jobs
COSTS
MentalHealth
Jobs
CBT
CBT and Employment Outcomes
• Job placement1
• Job obtainment2
• Job retention and stability3
• Quality of job placement4
• Work functioning5
• Return to work rate7
• Work absences6
• Time until return to work8
Who We Are
COMMUNITY PSYCHIATRYPROGRAM FOR
RESEARCH IN
IMPLEMENTATION AND
DISSEMINATION OF
EVIDENCE -BASED TREATMENTS
(PRIDE)
What is…
• Implementation?
• Integrating Evidence-Based Practices (EBPs) into practice settings
• Dissemination?
• The process of spreading knowledge
The Problem: The Science-Practice Gap
Green, L. W., Ottoson, J. M., García, C., & Hiatt, R. a. (2009). Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annual Review of Public Health, 30, 151–174.
MGH Community Psychiatry PRIDE
Our Focus and Mission
Focus: Dissemination and implementation research to reduce disparities in community settings
Mission: Bridge the gap between science and practice by bringing EBTs to communities to increase access and quality of care
Our Model: Train the Trainer
C U R R E N T R E S E A R C H P R O J E C T S A N D C O M M U N I T Y P A R T N E R S
Our Partnerships
Populations Served
DIVERSITY
Recently Incarcerated
MenYoung
Adults (17-24 years)
African American
Latinos
Immigrants
Refugees
Single Moms
Mental Health
Emotion Regulation
Substance Use
Anxiety Disorders
PTSD
Anger
Mood Disorders
Social Determinants
Homelessness
High Poverty
Little Support
Unemployment
Uneducated
Legal Status
MGH PRIDE and Partnerships
Needs Assessment
Unique Program Development
Program Implementation
TrainingOutcome
Evaluation
Long-term Sustainability of
Program
Thank you!
Any Questions?
Contact information:Soo Jeong Youn, PhD
Postdoctoral Fellow, PRIDEPhone: 617-887-4061
Email: [email protected]
Contact information:Luana Marques, PhD
Director, PRIDEPhone: 617-887-4066
Email: [email protected]
© REDF 2017 REDF
© REDF 2017 REDF
Annual Impact
4,550Enrollments
400+ Participants
working every day on 70+ work crews
2,600Job
placements
54% Validated employment
after 6 months
47% Validated employment
after 1 year
The CEO Model
21
MissionRoca is dedicated to proving that the highest risk young people, especially those who are not ready to change, can make a future for themselves beyond jail and violence. We help Roca’s young men leave streets and gangs and go to work; and we help Roca’s young mothers get out of violence, go to work and care for their children.
Theory of Change
Roca’s theory of change is that young people, when re‐engaged through positive and intensive relationships, can change their behaviors and develop life, education, and employment skills to disrupt the cycles of poverty and incarceration.
Roca’s Intervention Model
Roca’s Intervention Model is a cognitive behavioral intervention that includes 4 strategic components:
Relentless Outreach and Follow-Up
Transformational Relationships Programming Engaged Institutions
• Youth Workers, Educators, and Crew Supervisors
• (All Staff)
• Life Skills• Education / Pre-Voc• Employment
• Formal System Change• Informal System Change
711 participants served in 2016
Boston 198Chelsea 284Springfield 229
91% Have No
New Arrests
86% of Roca
graduates hold a job
for 6+ months
80% Annual Retention Rate
FY16 Data
Employment Readiness Program (ERP)Designed to help people overcome challenging barriers to employment
Who:
• Out of the workforce for a while
• Gaps in employment or patchy work history
• No HSD diploma
• Substance Abuse or Criminal Charges
• Disability or other limitations
• Homeless
How:
• 6-12 months transitional employment
• Up to 32 hours/week in retail or warehousing
• 3-hour employability workshops totaling
approximately 30 hours
Goals:
● Establish solid work history
● Enhance soft skills
● Build a resume
● Learn computers and how to apply for jobs
online
● Practice interviewing
● Understand what it takes to retain a job once
secured
• Re-Entry Population
• 90 day paid work
experience
• Job Placement
• Retention Services
• Moral Reconation
Therapy - MRT
Goodwill of Silicon Valley’s
New Opportunity Work Program (NOW)
© REDF 2017 REDF
CBT @ Roca
28
What we do affects what we
think and feel
What we think affects what we
do and feel!
What we feel affects what we
do and think
Skill 8: Flex your thinking Skill 9: Problem solvingSkill 10: Conflict resolution
Skill 1: Label your feelingsSkill 2: Feel your feelingsSkill 4: Being presentSkill 5: Facing reality
Skill 3: Filling up your tankSkill 6: Act in line with what you value
Skill 7: Approach! Don’t Avoid
Prioritized CBI Sessions
Recommended CBI-EMP Sessions to Prioritize
Session Job losses connected to skill
Weighing Costs and Benefits of Different Behaviors 63%
Setting a Goal (short and long term) 30%
Behavior is a Choice 27%
Recognizing Risky Situations 27%
Asking Permission 19%
Sites can deviate from these lessons to address skill and cognition gaps
they observe on the ground.
Sample Lesson Format
Moral Reconation Therapy
• Reconation – the
restructuring of the
conscious decision
making process
• Moral Reasoning
• 12 Step Program
• Reduces recidivism rate
30% - 50%
Group Dynamics
• 2 – 1 hour sessions/week
• Certified Facilitators
• Open-ended groups
• Supportive environment
• Continued support
• Supports Job Retention
Receiving an MRT Coin for passing Step 3
STEPS by
Is one of the first workshops ERP clients attend
Introduced in 2009Rolled out in two different formats
Client Focused
STEPS: Steps to Economic & Personal Success
It’s a time for self reflection and to understand the
decision making process and how the mind works. It
helps clients gain the confidence to deal with change,
improve their working relationships with colleagues and
take more accountability for the impact of their own
behavior on the working culture of the organization.
After participating in the program, clients have greater
expectation of success and higher self-efficacy.
Clients see higher levels of motivation • increased self
belief • improved ability to set goals • raised levels of
personal accountability • insight into how their mind
works
Staff Culture
Investment In Excellence
Engages individuals professionally and personally,
providing a new perspective to both their jobs and their
lives, specifically allowing them to manage and effect
significant change, change behaviors, release untapped
potential, empower self and others, take accountability,
motivate oneself over a sustained period, flourish in new
environments, development leadership and
communication skills, and finally move from individual to
team thinking and team development.
How it transformed our culture at GWSV?
1. Top down structure to more of a collaborative culture
2. Opened us to being more creative, innovative and
not being afraid to share ideas.
3. Silos to teams and overall better team functioning
STEPS: Steps to Economic & Personal Success
Designed to build understanding, with a structured process, of how the mind works, and how one can
control the way they think to achieve success- in any part of their life.
● Research based
The term “Hard Skills” has typically been used to identify concrete material or technical types of training,
yet the success of “STEPS – A Guide to Self-Sufficiency” can be credited in the development of “Difficult
Skills.”
“Difficult” skills are the skills employers demand: great attitude, timeliness, dependability, honesty,
willingness and cooperation.
Topics:
Hidden in Plain Site
Expand the Mind to Create the Future
How the Mind Works
The Internal Conversation/Self-talk
Comfort Zones
The Next Time
Out of Order – Into Order
Seeing Myself into the Future
Living in Today
Planning for Tomorrow
The Tools for Change
It’s My Choice
Yes, I am good
Goal Setting/Affirmations
How does it work?
By applying The Pacific Institute’s education, people are able to develop their potential by changing their
habits, attitudes, beliefs and expectations. This, in turn, allows individuals in an organization setting to
achieve higher levels of growth and productivity, as well as shifting the collective behavior. This shift leads
to more constructive organizational cultures, and healthier, higher performing workplaces. Additionally,
everyone is encouraged to keep a personal journal of successes, setbacks, Ah-ha’s (major learning
moments), life events, beliefs,
Implementation
● 15 unit educational program on video, which is facilitated to a group
● Flexible in its implementation: At GWSV: 3hrs, 2x/week, total of two weeks
● Trained facilitator
● STEPS facilitator’s manual
Each participant receives personal learning materials:
● Participant Manual
● 4 Audio CD’s
● Guide to the Next Step
Feedback from staff & clients
● Growth personally and professionally
● Appreciated the thought process behind decision making and understanding
how the mind works
● Apply The Next Time concept
● Common language/terms among employees
● http://educationinitiative.thepacificinstitute.com/success/story/goodwill-
silicon-valley ←- ERP featured on Pacific Institute website. See quotes from
program participants as well as our GWSV CEO.
© REDF 2017 REDF
© REDF 2017 REDFPAGE 40
Next Steps
• Today’s presentation and recording will be emailed to all attendees with a
survey
• Register for the 8/17 webinar on Supporting the Financial Well-Being of
Social Enterprise Workers (email [email protected])
• More questions:
Terri Feeley
703-371-6894
