Using the CBLC Model to Promote Interprofessional Collaboration and increased Access to Trauma-Focused Services for Children

Transcription

1 Using the CBLC Model to Promote Interprofessional Collaboration and increased Access to Trauma-Focused Services for Children Rochelle F. Hanson, Ph.D., Angela Moreland, Ph.D., Ben Saunders, Ph.D. National Crime Victims Research & Treatment Center Department of Psychiatry and Behavioral Sciences, MUSC Charleston, SC Presentation at the 29th Annual San Diego International Conference on Child and Family Maltreatment, January 26, 2015, San Diego, CA

2 Bringing Evidence Supported Treatments to South Carolina Children and Families Coordinating Centers The Dee Norton Lowcountry Children s Center Charleston, SC National Crime Victims Research and Treatment Center Medical University of South Carolina Project BEST is funded by Grant Appropriation No SP and 1790-SP from The Duke Endowment

3 Program on Adolescent Traumatic Stress (PATS) Funded by SAMHSA Grant No. U79SM

4 Colleagues Rochelle Hanson, Ph.D. Michael de Arellano, Ph.D. Angela Moreland, Ph.D. Dan Smith, Ph.D. Carla Danielson, Ph.D. Jan Koenig, M.Ed. Raelle Saulson, MPH Emily Fanguy Carrie Jackson Nicole Fortune Medical University of South Carolina Elizabeth Ralston, Ph.D. Elizabeth Hinson, MSW Rachael Garrett, MSW Carole Swiecicki, Ph.D. Kim Reese, MSW Dee Norton Lowcountry Children s Center Monica Fitzgerald, Ph.D. University of Colorado Health Sciences Center

5 Very Quick Overview of CBLC CBLC extends LC Includes clinical & broker professionals from all levels and multiple organizations within a community Based on social economic model of supply and demand

6 Community as the Target

7 CBLC Curriculum Areas Common Material and Activities Clinicians, Brokers, Senior Leaders Team Building Clinical Track TF-CBT Senior Leader Track Leadership Support Broker Track EBTP CMTS Joint Community Responsibility

8 CBLC Timeline Month Comm. Prep Orient SL Train Action Pre-Work LS1 LS2 Period Action Period

9 CBLC Overview and Outcomes

10 Learning Collaborative Participation Rates Therapists, Brokers, Senior Leaders Learning Collaborative Learning Session 1 Completed All Requirements Complete Percent Pioneer % Lower State* % Pee Dee % Coastal % Excalibur* % Upstate % Midlands % Edisto % North Central % Statewide* % Total % *Clinical Learning Collaborative Only

11 Learning Collaborative Participation Rates Therapists, Brokers, Senior Leaders Learning Collaborative Learning Session 1 Completed All Requirements Complete Percent Broward % Georgia % Memphis % Orlando* % RRFT* 19 Ongoing (08/15) N/A Broward-2 89 Ongoing (07/15) N/A Wilmington 95 Ongoing (08/15) N/A Total (completed) 465 (262) % *Clinical Learning Collaborative Only

12 Method 5 CBLCs from PATS and PB (n=194) Monthly data measuring interprofessional collaboration (IC) related to assessment, treatment, referral, and information sharing (n=177) Examined IC related to: Completion of CBLC requirements TF-CBT completion

13 Measurement of IC Number of contacts to discuss assessment Number of contacts to discuss treatment Number of times attended MDT meeting Number of cases taken to MDT meeting

14 Overall Interprofessional Collaboration Mean monthly metrics completion = % of clinicians completed at least 50% of metrics Activity M Assessment 12 contacts 85% at least once Treatment 12 contacts 85% at least once Times to MDT 6 MDT meetings 60% at least once Cases to MDT 3 cases to MDT 37% at least one

15 Change in Interprofessional Collaboration throughout CBLC Activity Month 1 (n = 103) Month 4 (n = 98) Month 8 (n = 86) Assessment Treatment Times to MDT Cases to MDT

16 Interprofessional Collaboration and CBLC Completion How is each type of IC related to Therapist completion of CBLC components AND Attendance at learning sessions, consultation call completion Number of completed training cases

17 Therapist Completion of CBLC Components Number of contacts to discuss assessment Related to: # LS s completed***, # of calls completed**, met clinical case requirement* Therapists who rostered in the CBLC* Number of contacts to discuss treatment Related to # of LS s completed***, # of calls completed* *p<.05, **p<.01, ***p<.001

18 Therapist Completion of CBLC Components Number of times attended MDT meeting Related to # LS s completed*, met case requirement* Number of cases taken to MDT meeting Related to # of LS s completed***, met case requirement** Therapists who rostered in the CBLC* *p<.05, **p<.01, ***p<.001

19 Number of Training Cases Completed Number of contacts to discuss assessment** Number of contacts to discuss treatment* Number of times attended MDT meeting* Number of cases taken to MDT meeting** *p<.05, **p<.01, ***p<.001

20 CBLC Component Completion Predicts Interprofessional Collaboration Number of Contacts to Discuss Assessment CBLC Component B t Sig. # of LS s completed ns # of calls completed * # of cases completed *

21 CBLC Component Completion predicts Interprofessional Collaboration Number of Contacts to Discuss Treatment CBLC Component B t Sig. # of LS s completed ns # of calls completed ns # of cases completed *

22 CBLC Component Completion predicts Interprofessional Collaboration Number of Times Attended an MDT Meeting CBLC Component B t Sig. # of LS s completed # of calls completed # of cases completed ns ns ns

23 CBLC Component Completion predicts Interprofessional Collaboration Number of Cases Taken to an MDT Meeting CBLC Component B t Sig. # of LS s completed # of calls completed # of cases completed ns ns ns

24 Conclusions In examining how the CBLC components are related to IC, findings demonstrated that: Clinicians attended MDT meetings more regularly as the CBLC progressed IC significantly predicted the completion of CBLC components, although different IC activities were related to different components IC significantly predicted the number of completed training cases CBLC completion significantly predicted the number of contacts discussed in assessment and treatment, but not other IC components

25 Next Steps Examine relations between IC and treatment outcome Examine relations between IC and referral patterns Collective qualitative data (interviews with key stakeholders) to learn more about IC and relation to CBLC components