Funder: Washington State Legislature (July 2006 – June 2009)
Principal Investigator: Trupin, Eric
Co-Investigators: Kerns, Suzanne; Bruns, Eric
Problem: Scientifically proven effective emotional and behavioral health interventions for children and families rarely achieve broad scale, community-level implementation within agencies providing direct mental health services to families. There are often significant barriers towards effective and adherent translation of these programs within a strictly community context. The inability to effectively translate such programs results in low population penetration, meaning that few families benefit from the extensive, and often impressive, research being conducted at Universities across the country.
Goal: Enhance community capacity to effectively implement evidence-based practices that target known community need and are aligned with local values, cultures, and resources.
Background: Partnerships for Success
Since 1998, there has been legislative support in Ohio to promote the implementation of the Partnerships for Success (PfS) model, a community-based participatory approach towards strategically identifying 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 mobilization, 2) reducing duplicative efforts among state and local agencies, 3) promoting fiscal responsibility, 4) evaluation, and 5) consideration for sustainability. These goals are achieved through manualized activities that can be adapted to meet the overall community needs. Each participating community engages in strategic planning, including conducting a needs and resource assessment, gaps analysis, and identifying targeted impacts and populations and aligning these with evidence-based practices. Additional activities include planning for implementation, evaluation, and sustainability. To date, the PfS model has been successfully implemented in 44 counties in Ohio. Each county tracks outcomes and has demonstrated both positive outcomes for youth across a wide range of problem behaviors as well as fiscal impacts (finding an $11.52 return for every dollar spent).
Pilot Program: Washington State Children’s Mental Health Evidence-Based Practices Pilot Program
Consistent with national trends, Washington State is moving towards mandating use of evidence-based practices within public mental health and child serving agencies. However, merely mandating the use of particular programs is often inadequate for realistically and sustainably implementing new programs. In response, a 2006 Washington State Legislative proviso enabled counties, regional support networks, and tribal groups to submit proposals for participation in the pilot program. The focus of the proviso was to use an adaptation of Ohio’s Partnerships for Success program to support a strategic process in which programs were selected based on the unique needs, values, and resources of the community. Technical assistance is being provided by a team from the Division of Public Behavioral Health and Justice Policy.
Current community projects include: Thurston-Mason Regional Support Network and the Skokomish Tribe (in Mason County).
Relevance: The Partnerships for Success project will provide information on how best to support community efforts to strategically implement evidence-based practices, ultimately improving outcomes for children, youth and families.
The Thurston-Mason Evidence-Based Practices (EBP) project is currently in its third year of funding. During the previous two years, the team successfully implemented two new EBPs (Multisystemic Therapy and Triple P Positive Parenting Program) directly from Legislatively allocated dollars, and leveraged linkages through the collaborative group to bring other effective practices into the community (e.g., Family Integrated Transitions, Trauma-Focused Cognitive Behavioral Therapy and the Foster Care Assessment Program). Funding from the Proviso was also able to fund a related project with the Skokomish Tribe in Mason County.
A process evaluation conducted by the University of Washington revealed particular strengths of the Partnerships for Success model are increasing inter-agency relationships, increasing community access to effective programs, serving children in their home communities, and enhancing sustainability. Challenges encountered during the process of program implementation highlighted important considerations for purveyors (and developers) of EBPs to consider when translating these interventions to a real-world, community-based setting.
The Skokomish Tribe EBP project is currently in its second year of funding. During the past year, the group has successfully conducted a needs and resource assessment, engaged the broader community in the project and decided Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) would fulfill a much needed gap in services for the community, closely aligning with the overarching goal of supporting healthy families. TF-CBT services are expected to begin in late-September/early-October 2008. As families progress through the intervention, the oversight group will carefully identify aspects of the program that may need to be modified to increase cultural relevance. As those changes are made, continued tracking of outcomes will ensure participating families, indeed, having healthy outcomes.
The Skokomish Tribe group experienced the additional benefit of receiving training in Triple P Positive Parenting Program in collaboration with the Thurston-Mason EBP project. Three counselors received training and currently offer Triple P through Tuwaduq Family Services and Indian Child Welfare.
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