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Implementing Evidenced-based PracticesSeptember 17, 2014
Beth Ann Rosica, PH.D Francis Mendez, J.D., MSW
About Us
NTTAC ( www.nttac.org) is a central source for accessing the Office of Juvenile Justice and Delinquency Prevention’s (OJJDP) Training and Technical Assistance (TTA) resources; serves as a one-stop shop for requesting the full array of TTA services offered by OJJDP; and supports the OJJDP TTA Network through trainings and leveraging of virtual TTA.
VisionQuest ( www.vq.com) has over 40 years of experience delivering highly successful innovative programs to at-risk and juvenile youth. Over the last 10 years, VisionQuest has made a commitment to evidence-based practices, and all programs utilize at least evidence-based model.
Advancing Evidence Based Practice
(www.advancingebp.org) is a nonprofit association working to promote evidence-based programs for at-risk youth.
How to Identify EBPs?
• Blueprints for Healthy Youth Development
• WSIPP• Coalition for Evidence Based Policy• CrimeSolutions.gov/Model Programs
Guide
Best Proven Model Programs*• Brief Alcohol Screening and Intervention for College
Students (BASICS)• Functional Family Therapy (FFT)• LifeSkills Training (LST)• Multidimensional Treatment Foster Care (MTFC)• Multisystemic Therapy - Problem Sexual Behavior
(MST-PSB)• Multisystemic Therapy® (MST®)• New Beginnings (Intervention for children of divorce)• Nurse-Family Partnership• Positive Action• Project Towards No Drug Abuse• Promoting Alternative Thinking Strategies (PATHS)*Blueprints Model
Programs
Advantages of Proven EBPs
• Reduced crime• Reduced cost to
taxpayers• Save lives• Training, Manuals, QA
EBP Implementation: Getting Customer Buy-In
• Convincing stakeholders of the value and benefits of implementing EBPs- Moving from WHY to HOW.
• Leveraging existing resources as a strategy to introduce EBPs.
• Navigating concerns that EBP implementation comes at the expense of local grass roots programs.
• Overcoming obstacles when there is a disconnect between the state and local jurisdictions.
EBP Implementation: Facing Agency Challenges• The Adoption of EBPs is challenge for providers,
especially large agencies• Requires commitment from the highest levels of
management and a philosophical change within the agency
• Many staff are often threatened as they see their approach as the best
• Human Services professionals are often reluctant to trust research
• The process requires education, re-education and continual reassurances to staff that EBPs are the right thing to do
• Implementing EBPs costs more money than traditional services/programs
• Family Engagement can be a challenge
Components that need to be present to successfully implement evidence-based practices and programs: Competency Drivers (Staff selection, Pre-
service and in-service training, Ongoing consultation and coaching & Staff and program evaluation)
Organization Drivers (Facilitative administrative support, Systems interventions & Decision Support Data System)
Leadership Drivers (Technical & Adaptive) Source: National Implementation Research Network
EBP Implementation: Key Drivers
EBP Implementation: Embedding EBPs in a Juvenile Justice Agency
• Launch EBPs as a collaborative effort with ownership by the Agency.
• Establish a data collection framework.• Integrate EBP referrals into objective decision-
making.• Jointly address referral and engagement
issues.• Establish formal communication protocols at
the case level and system level.
• Family lives out of service area
• Youth is a sex offender
• Youth is too aggressive
• Youth refused treatment
• Incomplete referral packet
• Youth not age appropriate
• AWOL• Youth has
unmanageable psychiatric Issues
• Other• Referral or
funding source rescinded
• Already received EBP services
• Youth placed out of home/detained
• Parents unwilling/unavailable
• No slots available
Referral & Engagement Issues: Data Collection
Data Collection Example
Youth has unmanageable medical issues English is not the primary language
Family lives out of service areaNo slots available
Referral or funding source rescindedAWOLOther
Already received MST services Incomplete referral packet
Youth not age appropriate Youth has unmanageable psychiatric issues
Youth placed out of home/detained Parent unwilling/unavailable 36%
12%
9%10%
7%
7%
5%
3%
3%
2%
2%
2%
1%
0% 10% 20% 30%
Percentage of MST Referrals40%
n=182
Source: FY11 MD State Annual Reports for MST & FFT
Family lives out of service area Youth is a sex offender Youth is too aggressive
Youth refused treatment Incomplete referral packet Youth not age appropriate
AWOLYouth has unmanageable psychiatric Issues
OtherReferral or funding source rescinded
Already received FFT servicesYouth placed out of home/detained
Parents unwilling/unavailable 44%
11%
8%
9%
5%
6%
3%
4%
4%
1%
1%
1%
2%
0% 10% 20% 30% 40% 50%
n=406Percentage of FFT Referrals
Analyzing Family Engagement BarriersContext conducive to engagement• The rationale, benefits, and structure of program
have been explained to the family;• Family strengths have been identified and
acknowledged; • The therapist and the referral organization have
taken a collaborative approach towards engaging the family;
• The family has contributed to the development of the treatment goals; and
• Engagement services are provided at a time that is convenient for the family.
Source: Engaging Multiproblem Families in Treatment: Lessons Learned Throughout the Development of Multisystemic Therapy PHILLIPPE B. CUNNINGHAM., SCOTT W. HENGGELER. July 2004
Family Engagement StrategiesExamples of engagement strategies that can be applied to the FFT and MST referral process are: • Building a relationship prior to first
call/appointment;• Leveraging existing supportive relations;• Using strategic and strengths-based
marketing; and• Identifying, addressing and removing
participation barriers.SOURCE: PRINCIPLES FOR ENGAGING AND RETAINING FAMILIES IN SERVICES
Train and select
probation staff for
EBP referrals
Communication Feedback
Loop b/w program and
probation
Case management
process that is aligned with EBP program
Tracking outcomes and quality
improvement
Joint responsibility for identifying and
problem solving issues
Coordinated and collaborative
process
Tracking of referral
outcomes and analysis
Systems interventions
that integrate
family engagement
Goals
Systems intervention to
address identified barriers
EBP Implementation: Inter-operability Framework
EBP Implementation: Funding & Sustainability• Once you have committed to doing EBPs, there is as
much work in sticking to the model as making the decision to do it.
• High level of discipline to maintain fidelity. Most programs offer supervision/support calls, but the agency needs an infrastructure to support it too.
• Staff turnover presents problems - takes awhile to get staff trained, decreases revenue, decreases customer satisfaction.
• Successful EBPS requires a high level of collaboration between the provider, funder and placing agency.
• EBPs are typically more expensive at the front end but save dollars on the back end.
EBP Implementation: State Review
Delaware Pennsylvania Maryland North Carolina Louisiana California Connecticut Texas
YOUR QUESTIONS
Contact Info
New and improved site coming soon
Beth Ann Rosica, PH.D Francis Mendez, J.D., MSW [email protected] [email protected]
610-486-2280,ext. 3250 1-703-225-2391