The Society for Social Work and Research

2014 Annual Conference

January 15-19, 2014 I Grand Hyatt San Antonio I San Antonio, TX

Implementing An Evidence-Based Intervention to Reduce Long-Term Foster Care: Practitioner Perceptions of Key Challenges and Supports

Saturday, January 18, 2014: 11:00 AM
HBG Convention Center, Room 001B River Level (San Antonio, TX)
* noted as presenting author
Becci A. Akin, PhD, Assistant Professor, University of Kansas, Lawrence, KS
Susana Mariscal, MSW, PhD Candidate, Graduate Research Assistant, University of Kansas, Lawrence, KS
Linda Bass, PhD, Vice President of Clinical Services, KVC Behavioral Healthcare, Lenexa, KS
Vickie Burgess McArthur, MFT, Clinical Director, St. Francis Community Services, Wichita, KS
Jackie Bhattarai, BA, Graduate Research Assistant, University of Kansas, Lawrence, KS
Kimberly Bruns, MS Ed, Research Projects Coordinator, University of Kansas, Lawrence, KS
Purpose: This study describes key challenges and supports of implementing an evidence-based intervention (EBI) to reduce long-term foster care. Although a growing literature defines core components of systematic implementation (e.g., Aarons, Hurlburt, & Horwitz, 2011; Fixsen, Blase, Naoom, & Wallace, 2009; Kitson, Harvey, McCormack, 1998), little information exists about real-world successes and setbacks from child welfare practitioners’ perspectives. Prior studies identified various factors that influence implementation, including individual differences such as gender and education level; organizational influences like culture and climate, leadership, supervision, and peer support; resources issues; and, fit between the EBI and target population (e.g., Aarons 2005; Aodeo et. al, 2011; Gooiea & Dziadosz, 2008; Gray et. al, 2012; Lundgren et. al, 2011; Patterson et. al, 2012). Using an implementation framework from the National Implementation Research Network (NIRN) (Fixsen et. al, 2009), this study builds actionable knowledge about systematic implementation in a child welfare system as informed by experiences of practitioners.

Method: Semi-structured, individual interviews were conducted with 28 child welfare practitioners implementing an EBI, Parent Management Training Oregon Model (PMTO). The sample represented all but 2 of 30 practitioners involved with a new federally-funded project to reduce long-term foster care. Among those interviewed were 3 practitioners that had resigned from their positions within 12 months and 25 practitioners employed for 12-15 months. Interview questions were informed by the existing literature and the NIRN framework. Transcripts were coded and analyzed using theoretical thematic analysis (Braun & Clarke, 2006). Member checking was used to confirm identified themes across interviews.

Results: Thematic analysis showed descriptive information about factors that influence child welfare practitioners’ experience of implementing an EBI. Key facilitators were: a) individual characteristics of shared values with EBI, use of EBI for enhancing self, flexibility, and willingness to learn; b) organizational and leadership factors of strong leadership, good fit between values of the EBI and organization, and plentiful information-sharing; c) competency drivers including strengths-oriented supervision and coaching, supportive teams, and timely feedback; c) resource factors of adequate time for learning and infrastructure/working conditions; and, d) fit issues of relevance of EBI to population’s needs, and client responsiveness. Implementation barriers included: a) organizational and leadership factors related to lacking knowledge of the model, incongruent values between the organization and the EBI, unresponsive managers; b) competency drivers including training sequence and pace, opportunity for applied learning, inadequate written materials, weak/inexperienced supervisors, infrequent coaching, and inferior coaching due to vague feedback; c) resource issue of poor working conditions; and, d) fit issues related to client contextual factors and poor engagement.

Conclusion: This paper contributes to the current knowledge by describing experiences of practitioners implementing an EBI in child welfare. It offers a realistic picture of the factors that challenge and facilitate effective implementation from a practitioner viewpoint. Findings demonstrate the complexity of implementation and the necessity of resources – both tangible and intangible – that must be leveraged for successfully operationalizing an EBI. Policy and practice implications for overcoming barriers and promoting effective implementation strategies in child welfare are discussed.