Bridging Disciplinary Boundaries (January 11 - 14, 2007)

There is increasing pressure for community based mental health organizations to deliver evidence-based mental health services that improve outcomes for consumers and their families. Several recent national reports conducted by the Department of Health and Human Services, the National Institute of Mental Health and the President's New Freedom Commission call for major changes in the delivery of mental health services. These reports promote the use of evidence-based practices to produce valued outcomes for consumers and families (Panzano & Herman, 2005). This paper presents the results of an evaluation of the implementation and integration of three evidence-based interventions in one community mental health organization. The three evidence-based interventions include: Assertive Community Treatment (ACT), Multiple Family Group Psychoeducation (MFG) and Integrated Dual Disorders Treatment (IDDT). Supervisors, clinical staff and case managers participated in the evaluation of the implementation and integration of these evidence based practices (EBP). The evaluation study involved the use of focus groups and a written survey. The survey captured the worker beliefs about evidence based practices using Aarons (2005) EBPAS scale and their actual experiences in the implementation of one or more of the EBP's. The focus groups provided opportunities for administrators, supervisors and staff to share what worked and didn't work in the adoption of the evidence based practices. A total of 10 focus groups were held with over 83 participants. In addition, over 80 clinical staff and case managers completed the written survey. This is over a 90% participation rate in the evaluation by the staff involved in the adoption and implementation of the practices. The focus group tapes were transcribed and a thematic analysis of the data was conducted. The data from the written survey was analyzed using descriptive statistics in SPSS. Overall, respondents reported that the integration of more than one EBP worked well in the organization. In both the written survey and the focus group sessions, one major theme that emerged was that according to staff, they now partner more with consumers and families as a result of engaging in these evidence- based practices. Additional key themes from the focus groups that centered on lessons learned in implementing more than one evidence base practice included: 1) the importance of recognizing that implementing more than one intervention is time consuming for staff, 2) not all consumers wanted to participate in the new practices, and 3) real “on the spot” coaching of staff to ensure fidelity to the models is critical. Over 85% of the respondents in the written survey indicated that felt the EBP's improved their work with consumers and families and that using manualized interventions, when supported by good supervision, helps build recovery for consumers and families.

Aarons, G.A. (2004). Mental health provider attitudes toward adoption of evidence-based practices: The evidence-based practice attitude scale (EBPAS). Mental Health Services Research 6(2), 61-74

Panzano, P. & Herman, L. (2005). Developing and sustaining evidence-based systems of mental health services. In R.E. Drake, M.R. Merrens & D.W. Lynde (Eds.) Evidence-based mental health practice: a textbook (pp. 243-272). NY,NY:Norton.