Evidence Based Practice Institute Projects

Partnership Access Line (PAL)

The Partnership Access Line (PAL) is a telephone based child mental health consultation system funded by the state legislature currently being implemented in Washington State. PAL employs child psychiatrists, child psychologists, and social workers affiliated with Seattle Children’s Hospital to deliver consultation services. PAL provides rapid consultation responses during business hours (Monday-Friday, 9am-5pm) for any type of child mental health issue that arises with any child.

Washington’s primary care providers are encouraged to call the PAL toll free number 866-599-7257 as often as they like. Care Providers can also refer to and download Primary Care Principals for Child Mental Health, a book offering guidance on diagnosis and treatment of children to help with clinical practice.

Child Psychiatry Consultation for Primary Care Study

The Child Psychiatry Consultation for Primary Care Study is an evaluation of the Partnership Access Line (PAL), a phone and telemedicine consultation service offered in Washington State.  PAL is a collaboration between the EBPI, University of Washington, Seattle Children's Hospital, and Washington State’s Department of Social and Health Services (DSHS).  The goal of PAL is to significantly increase access to specialty child psychiatry consultations for primary care providers in Washington State and improve the emotional and behavioral health of children throughout the state.  Children receiving Medicaid or those who are enrolled in foster care are a particular focus of the PAL program.

Study Overview
Faculty at the Evidence Based Practice Institute (EBPI), in collaboration with faculty from Seattle Children's Hospital and DSHS, have designed and are implementing a research study to investigate the effectiveness of the PAL service.  We are evaluating primary care provider and child outcomes through surveys, phone interviews, medical record reviews, and DSHS administrative data.  DSHS administrative data will be utilized to compare primary care provider and child outcomes to a matched group of providers and children who did not receive a PAL consultation.

Eligibility
Eligible participants are primary care providers and parents/foster parents of children who are targets of a PAL consultation, enrolled in Medicaid, and receiving treatment in regions 1 (Eastern Washington) or 6 (Southwestern Washington/Olympic Peninsula).

Outcomes
Primary care provider outcomes include perceived knowledge about managing child psychiatric issues, PAL satisfaction and feasibility, PAL program utilization, adherence to consultation recommendations (medical record review), and prescriptive practices (DSHS administrative data).  Child outcomes include parent/foster parent interview about child mental health symptoms, telemedicine family satisfaction, and DSHS child level data (e.g., rates of mental health, foster care placement).

Significance
We hope that data from this research study will provide information about the effectiveness of the PAL program.  This study will offer providers, legislators, policy makers, families, consumers, and researchers information on the effectiveness of child psychiatry consultation in improving care for children with emotional and behavioral disorders.

Collaborators
Eric Trupin Ph.D., Primary Investigator PBHJP, EBPI
Michael McDonell, Ph.D., Co-Investigator, PBHJP, EBPI
Robert Hilt, MD, Co-Investigator, Seattle Children’s Hospital
Terry Lee, MD, Co-Investigator, PBHJP, EBPI
Kathleen Myers, MD, Co-Investigator, Seattle Children’s Hospital
Jeffery Thompson, MD, Co-Investigator, Washington State’s DSHS

Study Period 2008 - 2011

Contact 206-685-2085 for more information.

Wraparound Evaluation and Research Teams

Evaluation of Wraparound Washington Pilot Projects. The wraparound process has been defined as an evidence-based or promising practice (Walker & Bruns, 2008) for coordinating care and improving outcomes for youth with serious emotional and behavioral problems and their families. As part of House Bill 1088, in 2007, the Washington Legislature funded three wraparound pilots to begin serving youth and families in July 2008. These pilot projects are located in Skagit, Grays Harbor, and Cowlitz Counties.
The Evidence Based Practice Institute at the University of Washington's Division of Public Behavioral Health and Justice Policy was charged with conducting an evaluation of the pilot project. The evaluation will aim to answer three primary research questions:

  1. What is the level of fidelity and quality of wraparound implementation across the initiative and for its three funded sites?

  2. What outcomes are experienced by individual youth and families across the initiative and for its three funded sites, in terms of improvement from baseline, in the following areas:

    1. Youth behavior and functioning,
    2. Family support and resources,
    3. Caregiver strain,
    4. Maintenance in community settings, and
    5. School, community, and juvenile justice outcomes

  3. What is the adequacy of organizational and system support for implementing wraparound across the state initiative and for the three funded sites?

Preliminary results will be presented to the Legislature in early 2009 and final results of the evaluation will be available in mid 2009.

Partnerships for Success

Partnerships for Success. The Partnerships for Success (PfS) model is a community-based participatory systematic approach designed to strategically enhance the utilization of evidence-based practices for prevention, early intervention, and treatment mental and behavioral health problems in children and youth (www.pfsacademy.org). The PfS model has five primary goals: 1) community empowerment and mobilization, 2) reducing duplicative efforts among state and local agencies, 3) promoting fiscal responsibility, 4) evaluation, and 5) consideration for sustainability. More information...

Workforce Development

Workforce Development. The Workforce Development project is expanding the skill sets of students and clinicians in evidence based practices (EBPs) in order to improve mental health services and access for adults and children. The first of a series of curricula being developed for the University of Washington and participating Community Colleges is a three-credit, interdisciplinary course providing students with an in-depth, hands-on understanding of the practical, cultural, and cross-systems applications of evidence-based parenting interventions. More information...

Youth'N Action

Youth'N Action. Youth ‘N Action is a Statewide youth advocacy program that brings youth voice to public policy and empowers at risk youth ages 14-24 to make differences in their lives, communities and systems that serve youths. More information...

Fostering Hope

Fostering Hope. Dr. Shannon Dorsey has an NIMH-funded study of the application of Trauma-focused Cognitive Behavioral Therapy (TF-CBT) with children and adolescents in foster care. The goal of Fostering Hope is to determine if combining evidence-based engagement strategies with TF-CBT results in greater levels of foster parent attendance and participation in treatment than the provision of TF-CBT alone. The evidence-based engagement strategies were developed by Dr. Mary McKay and have been used successfully in combination with other treatments and for other populations, but have never been utilized with foster parents. In Fostering Hope, these strategies first will be tested in a small feasibility trial, and findings from exit interviews with foster parents and clinicians who participate will be reviewed by community consultants (i.e., other foster parents, DCFS caseworkers, other clinicians, and the research team) to determine how the strategies might need to be revised to better fit the foster care population and to better engage foster parents. Following the feasibility trial and consultant review, the revised combined intervention (TF-CBT plus the engagement strategies) will be compared to delivery of TF-CBT as usual. During this trial, foster parent attendance and participation and information on clinician, foster parent, and youth satisfaction with the intervention will be examined. The trial will also provide preliminary information on child outcomes and impact on placement stability. More information...

Washington State Trauma-focused CBT Initiative

Washington State Trauma-focused Cognitive Behavioral Therapy Initiative (TF-CBT) is a dissemination project for clinicians working in mental health agencies, is funded by the DSHS Mental Health Division. PBHJP faculty offer training in TF-CBT to clinicians working in mental health agencies that have contracts with their local Regional Support Network (RSN). More information...

Tri-Agency Partnership

Three Seattle-based agencies, Valley Cities, Seattle Children’s Home, and Navos (formerly Highline West Seattle Mental Health), have partnered with the Evidence Based Practice Institute (EBPI) to obtain training and consultation in Trauma-Focused Cognitive Behavioral Therapy.  Motivated by their long-standing desire to provide high-quality, effective services, all three agencies have looked to the EBPI to help them develop expertise in TF-CBT and to build their own capacity to provide this treatment to their clients.

Under the direction of Dr. Eric Trupin, Director of the Division of Public Behavioral Health and Justice Policy, EBPI consultants with specific expertise in TF-CBT are helping the agencies acquire training for supervisors and clinicians, connect to available local and statewide resources, build internal consultation and work groups, create resource libraries and toolkits to support their work, and develop plans for continued growth and sustainability.  

The EBPI is also supporting the three agencies in the identification of goals and objectives, at both the clinician and client levels, and the development of outcomes assessment tools that can be used to measure success.  Immediate goals are to train approximately 75 clinicians and their supervisors in TF-CBT; longer term goals include expanding this training to over 100 subcontractors at agencies such as the Ruth Dykeman Center and Youth Eastside Services and, of course, improving the lives of the countless clients that have been impacted by trauma and receive services from these agencies.