Conference on Child, Adolescent and Young Adult Behavioral Health Research and Policy Tampa 2015

Transcription

1 Conference on Child, Adolescent and Young Adult Behavioral Health Research and Policy Tampa 2015

2 WHO WE ARE An international consortium, a rich and growing community of faculty, implementation specialists, program administrators, developers, practitioners, and researchers. WHAT WE DO Consortium members collaborate in technical assistance and research dissemination, and promote networks of learning about evidence based practice, workforce development, and program WHAT S OUR PURPOSE Improving the lives of children, youth and families through effective program selection and implementation and workforce development.

3 Sessions Supported by the Evidence Based Practice Consortium Session 3: Workforce Development Integrating academic and behavioral health care program responsibilities Session 14: Statewide Quality Improvement Enhancing fiscal viability of child and adolescent mental health clinics Session 36: MST Building Stronger Families The power of partnership with child welfare

4 Sessions Supported by the Evidence Based Practice Consortium Session 47: Using implementation science to improve child welfare trauma and behavioral health needs in 4 states Session 57: Centers of Excellence Dissemination and implementation of evidence based practices within systems of care Session 67: Building the evidence for the RENEW Transition Model Theoretical and methodological development Session 77: Implementation science applications to integrate evidence based practices into complex systems

5 Interested in Joining Us? Rosalyn Bertram, Co Chair David Bernstein, Co Chair

6 Behavioral health and academic program collaboration: Promoting workforce EBP readiness Elisabeth Cannata, Ph.D. VP Community-Based Family Services and Practice Innovation, Wheeler Clinic Dana Marlowe, Ph.D., LMSW Clinical Associate Professor Fordham University, Graduate School of Social Service Sebastian Perumbilly, Ph.D., LMFT Assistant Professor, Southern Connecticut State University MFT Program, School of Health and Human Services

7 The original curriculum project described in this presentation was fully funded by the Center for Mental Health Services of Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Dept. of Health and Human Services (DHHS) under a Mental Health Transformation State Incentive Grant to Connecticut (Contract Number SM 57456). The curriculum was developed under subcontract to Yale University as an initiative of the Connecticut Workforce Collaborative on Behavioral Health. Curriculum revisions and ongoing support to the initiative have been funded by the Connecticut Department of Children and Families through use of SAMHSA s mental health block grant funds.

8 Learning Objectives: Recognize the often cited disconnect between provider needs and the graduate training of behavioral health professionals, particularly in the area of readiness for Evidence- Based Practice Understand potential barriers and facilitating factors to disseminating practice-informed courses highlighting EBPs. Recognized components of a provider-developed course that facilitate dissemination to graduate training programs Be able to articulate the different what s in it for us perspectives of providers, faculty, students, providers and EBP model developers in partnering to train graduate students of social work, marriage and family therapy and other behavioral health disciplines

9 Challenge in CT Strong commitment to broad dissemination of EBPs for children and families over past years: positions for masters level clinicians across nine specific in-home family treatment models including MDFT, MST, FFT, BSFT, IICAPS, FBR and some adaptations stemming from those models Over agencies state-wide receiving funding Problem you say

10 BIG challenge for providers: Graduate training programs had not been teaching about these models Insufficient number of well-qualified applicants for the large number of in-home positions across the state: New graduates not aware or misinformed about the models Many lack background/core skill-set to be best prepared for EBP and/or for the specific models widely practiced (Trained) misconceptions and suspiciousness of EBPs

11 Challenge for Graduate Schools: Lack of awareness about changes in the practice world, particularly within the publicly funded sector Disagreement between faculty about value of exposing students to EBPs Even where an interest, faculty not trained or experienced with the particular models So many important topics, yet only so many credit hours

12 Solution: Current Trends in Family Intervention: Evidence-Based and Promising Practice Models of In-Home Treatment in CT Development and dissemination of a targeted 3-credit full semester course to be incorporated in graduate training programs feeding the Connecticut workforce Funded by the state s Mental Health Transformation State Incentive Grant as way to improve the behavioral health workforce Developed by providers to ensure attention to specific workforce needs Support from model developers to review course accuracy and optimum source materials Involvement of families to include client perspective

13 Goals for the Curriculum: Provide positive framework for evidence-based practice to address misconceptions Accurate presentation of targeted models Focus on increasing awareness/interest Basic overview Introduction of some of the tools Identify and highlight shared core competencies for these models Increase connection between the graduate programs and providers

14 Challenges to Address Through Curriculum Design Making it workable and practical for faculty without prior model-specific knowledge or experience Promoting accurate portrayal of each of the models Customizable to the specific needs of each graduate program and applicable to training across behavioral health disciplines (i.e. social work, marriage and family therapy, psychology and counseling)

15 Course Dissemination Development of a tool kit with all necessary course materials Faculty Fellowship to train and support faculty interested in teaching the course Financial support to launch course within graduate curriculum of training programs across the state Assistance with recruitment of students to take the course Assistance in addressing concerns of naysayers among the faculty

16 Curriculum Design Overview of each of the models through: Didactic lectures Interactive skill development activities Therapists from the different models as guest presenters Making the actual work more vivid: a week in the life of the therapist and a case vignette) Clients/Family members who have received one of the models as guest presenters Typically as a panel Focus on What families found helpful Families offered mentoring support to prepare their presentation and stipend

17 Instructors Toolkit: Instructors Manual (hard copy and flash drive) Background Reading List (for faculty and suggested for students) with all required readings supplied Sample Syllabus Power Points Lesson Plans and Teaching Tools Detailed Instructions for In-Class Skill-Building Activities Videos for classroom instructional enhancement Exam Questions Homework and Semester Assignments ***Certificate of Completion for students***

18 Faculty Fellowship: 24 hour pre-teaching workshop to familiarize faculty with all of the tools and to reinforce specific model understanding (with required readings) 6 hours during faculty delivery of the course to provide support and reinforce model adherent instruction 2 hour post-implementation feedback session Certification and CEUs for faculty fellows Ongoing phone and consultation/support

19 Impact to date 14 graduate programs have participated, offering the course at least once regular elective in 8 programs required coursework in 4 25 faculty trained Over 450 students to date with certificates of completion Provider and student feedback that the course is impacting workforce preparedness

20 Impact to Date: Participating Graduate Training Programs Southern Connecticut State University Marriage and Family Therapy Social Work (Counseling) Fordham Social Work University of Connecticut Social Work Marriage and Family Therapy Central Connecticut State University Marriage and Family Therapy Counseling University of St. Joseph Marriage and Family Therapy Social Work (new program) Springfield College Social Work Western Connecticut State University Counseling (Fairfield University Marriage and Family Therapy) (University of Hartford Masters in Psychology)

21 Integrating the EBP course into the MSW curriculum at Fordham University Graduate School of social Service Dana B. Marlowe, LMSW, Ph.D. Fordham University Graduate School of Social Service

22 Demands from the Council on Social Work Education CSWE recognizes that teaching social work students how to access, analyze, interpret, and appropriately employ evidence is critical to effective social work practice (CSWE, 2015)

23 Demands from CSWE CSWE explicit curriculum Competency Apply critical thinking to inform and communicate professional judgments Distinguish, appraise, & integrate multiple sources of knowledge, including research based knowledge & practice wisdom Competency Engage in research-informed practice and practice-informed research.

24 Demands from CSWE - (Continued) Competency Practice knowledge includes identifying, analyzing, and implementing evidence-based interventions designed to achieve client goals Competency 2.3 The program connects the theoretical and conceptual contribution of the classroom with the practice setting, fostering the implementation of evidence informed practice. But how does this really translate into our coursework?

25 Implementation of Current Trends course in Fordham s MSW program Why such a smooth implementation? Two required research classes taught in the MSW program An evidence based practice class was being taught in the doctoral program Support of the Dean and Associate Dean Fordham was already one of ten schools on the Schools of Social Work Dean s Consortium Project for Evidence Based Practice in Mental Health

26 Implementation at Fordham - continued Infrastructure set up with leadership to train and provide ongoing support to MSW faculty members; Support from the Curriculum Committee, Assistant Dean, and Clinical Committee Two faculty members who were very committed to being trained in EBP models through faculty fellowship

27 CE2 Success of the Course at Fordham Consistent support from key players Two faculty members took the fellowship course in 2009 Since 2010 one of the faculty members has offered the course. the class has been offered 7 times. 140 students have taken the class The class will be offered again this summer The class will be offered as an online class this fall

28 Slide 27 CE2 what about student feedback? anecdotal or scores on eval orms? Cannata, Elisabeth, 3/15/2015

29 Challenges Getting the course approved at your school Overall support Syllabus Curriculum committee Maintaining the course as part of the curriculum How to have the school prioritize this course Focus on Connecticut while some students may be from other geographic areas

30 Challenges - continued How to make the course sound appealing The name of the course In-home treatment models Myths about evidence based practice programs

31 Opportunities Offering a relevant class Speakers Resources Networking for the students Having a professor truly trained on teaching something specific

32 Implementing in Your Own Setting Planning Key Players Understand your curriculum find the fit Expect challenges

33 Integrating EBP Focused Curriculum in SCSU s MFT Training Program Sebastian Perumbilly, Ph.D., LMFT Marriage and Family Therapy Program Southern Connecticut State University

34 MFT CURRICULUM: INFLUENTIAL FACTORS SCSU s Marriage and Family Therapy (MFT) Program Curriculum is guided by: Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) accreditation standards; MFT faculty s emphasis on outcome based education, which includes integrating EBPs in MFT curriculum; Ongoing consultation with provider agencies in CT; Directives from Curriculum Committee and Graduate Council at Southern Connecticut State University (SCSU); SCSU s mission and core values, especially, its focus on community service, civic engagement, and social responsibility; Mandates of the Connecticut State Colleges and Universities (ConnSCU); and, Regulatory expectations by the New England Association of Schools and Colleges (NEASC) and Commission on Institutions of Higher Education (CIHE).

35 COAMFTE Accreditation COAMFTE is committed to developing standards based on Multiple-Communities-of-Interests involvement and perspectives (COAMFTE Accreditation Standards, Version 12, preamble, paragraph 1, p.2). In light of this, our MFT program regularly consults with: Leaders in the field of clinical research and education; Stakeholders in CT; Communities of interest (Key Element I-B, COAMFTE Accreditation Standards, Version 12, p. 15).

36 COAMFTE Accreditation COAMFTE requires MFT programs to develop student competencies in MFT research, evaluation methods and in evidence-based practice (FCA 4, COAMFTE Accreditation Standards, Version 12, pp ) COAMFTE does not define what EBP is; While emphasizing the need for training in EBPs, the COAMFTE does not endorse any specific EBP models; In our MFT program, we teach several EBP models since 2009: MST, MDFT, BSFT, FFT, etc.

37 EBP BASED CURRICULUM IN SCSU S MFT PROGRAM Trained MFT faculty members in EBP models; Training, infrastructure and ongoing support provided by a knowledgeable provider in CT; Support received from provider institutions and clinical agencies in CT; Collaborative teaching panel consisted of trained faculty members, EBP practitioners from the field and recipient families; Supportive university system; and, Enthusiastic response and receptivity from MFT students.

38 EBP BASED CURRICULUM IN SCSU S MFT PROGRAM MFT faculty s unanimous decision to make EBP course (MFT 669, 3 credits) a required course within SCSU s MFT Curriculum; Approval of MFT 669 course proposal and syllabus by the Curriculum Committee and Graduate Council (SCSU); Offering this course using curriculum guidelines provided by the leading provider institutions in CT and EBP practicing clinicians in CT; and, Since 2009, over 120 MFT graduates were trained with a focus on EBP models at SCSU.

39 IMPLEMENTING EBP IN MFT: FACILITATING FACTORS MFT program s openness to workforce demands and inputs from provider institutions in Connecticut; High employability of MFT graduates trained in EBP models; Enthusiastic MFT faculty members willing to be trained in EBPs; MFT program s renewed emphasis on preparing graduate students to become critical consumers of research; and, Clinical practices of MFT faculty and consequently faculty members rootedness in clinical realities.

40 IMPLEMENTING EBP IN MFT: CHALLENGES/BARRIERS Orthodoxy and blind loyalty of faculty members to original MFT Models and Founders; Tightness/rigidity of 60 credit curriculum leaving no room for changing traditional MFT curricula; Lack of training of MFT faculty members in EBPs; Increasing demands on tenure-seeking/tenured faculty members to write and publish, and to be involved in administrative jobs at the university; and, MFT faculty s disconnect from clinical practice.

41 CONCLUSION Why EBP focused MFT program at SCSU is successful? Committed and EBP trained faculty members; Ongoing collaboration with EBP practitioners and provider institutions in CT; Openness to feedback from clientele we serve; Supportive university system; and, Enthusiastic and receptive MFT student community. The implementation of EBPs within our MFT curriculum is beginning to serve provider institutions and the general public in CT!!

42 Contact information: Elisabeth Cannata, Ph.D. Vice President Community-Based Family Services and Practice Innovation Wheeler Clinic Dana Marlowe, Ph.D., LMSW Associate Clinical Professor Fordham University, Graduate School of Social Service Sebastian Perumbilly, Ph.D., LMFT Assistant Professor, Southern Connecticut State University MFT Program, School of Health and Human Services