Becoming a Research Organization: A Case Study

Background and Purpose:

This is a conceptual work to demonstrate how a non-profit can become research-based. There is a knowledge gap and lack of concrete guidance in this process, making it more difficult for agencies to be successful in this much-needed process. Although measurement-based care (MBC) has been shown to be highly effective, it is seldom used in clinical practice (Oslin, et al., 2018). There has been a need for measurement-based care and implementation research, and this paper is to fill that void.

Methods:

In 2017, a substance-use and behavioral health agency with several programs in Northeastern United States received a 5-year grant from the NCTSN (National Child Traumatic Stress Network) and SAMHSA (Substance Abuse and Mental Health Services Administration) to run program evaluations on their innovative approach to substance use and behavioral health treatment. The agency had already embraced a trauma-informed, evidence-based practice and wanted to measure the efficacy of their approach. The goal was to assess and reassess clients at baseline, three-month intervals and discharge using trauma-informed principles. This would pertain to residents in their 12- and 8-bed residential facilities, and about 100 outpatient clients.

This work outlines specific strategies through a case study that can be used for other organizations that would like to implement measurement-based care, whether they have a need for funding or strive to become research-based. There’s known challenges to measurement-based care and there has been a push for implementation of measurement-based proactive research to track client progress.

The research needed to be informed by the agency’s core tenets of trauma-informed care; The Substance Abuse and Mental Health Services Administration operationalizes TIC (Trauma Informed Care) through six key principles: 1) safety, 2) transparency and trustworthiness, 3) peer support, 4) collaboration, 5) empowerment and, 6) sensitivity to cultural, gender, and historical issues (SAMSHA, 2014).

Research-based strategies include:

1. Creating a safe environment for assessments to occur, including flexible timeframes for assessments. 2. Building rapport between every individual involved, being trustworthy in the experience. 3. Identifying different needs of different populations and when peer support would be an asset. 4. Openly sharing research, findings and data to inform clinical practice. 5. Allowing clients to opt out of assessments and opt back in as appropriate. 6. Assessments are continually reevaluated for their sensitivity and appropriateness and modified as needed.

Implications and Conclusions:

In the first year, the agency had a 10% assessment rate. The most recent year achieved a 100% assessment rate in the residential houses. This was a collaborative effort every step of the way, internally with administration, staff, staff to client, and with the research team to all groups involved. The data collected would serve several purposes, first as program evaluation, but also to inform clinical care. This was achieved through score reports so clinicians would be informed about their clients both through one-on-one work but also assessments. This provided a more robust treatment process, better serving our clients.