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A Statewide Common Elements Initiative for Children’s Mental Health

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Abstract

Many evidence-based treatments (EBTs) for child and adolescent mental health disorders have been developed, but few are available in public mental health settings. This paper describes initial implementation outcomes for a state-funded effort in Washington State to increase EBT availability, via a common elements training and consultation approach focused on four major problem areas (anxiety, posttraumatic stress disorder, depression, and behavioral problems). Clinicians (N = 180) reported significant improvement in their ability to assess and treat all problem areas at post-consultation. Clinicians from organizations with a supervisor-level “EBT champion” had higher baseline scores on a range of outcomes, but many differences disappeared at post-consultation. Outcomes suggest that a common elements initiative, which includes training and consultation, may positively impact clinician-level outcomes and that having “in-house” EBT expertise may provide additional benefits.

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References

  1. Kazdin AE. Psychotherapy for Children and Adolescents: Directions for Research and Practice. London: Oxford University Press, 2000.

    Book  Google Scholar 

  2. Weisz JR, Sandler IN, Durlak JA, et al. Promoting and protecting youth mental health through evidence-based prevention and treatment. American Psychological Association 2005; 60(6): 628–648.

    Article  Google Scholar 

  3. President’s New Freedom Commission on Mental Health. Achieving the Promise: Transforming Mental Health Care in America. Final Report. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2003. Available online at http://govinfo.library.unt.edu/mentalhealthcommission/reports/FinalReport/downloads/FinalReport.pdf.

  4. Weisz JR, Jensen-Doss A, Hawley KM. Evidence-based youth psychotherapies versus usual clinical care: A meta-analysis of direct comparisons. American Psychological Association 2006; 61(7): 671–689.

    Article  Google Scholar 

  5. Mitchell PF. Evidence-based practice in real-world services for young people with complex needs: New opportunities suggested by recent implementation science. Children and Youth Services Review 2011; 33(2): 207–216.

    Article  Google Scholar 

  6. Bruns EJ, Hoagwood KM. State implementation of evidence-based practice for youths, part I: responses to the state of the evidence. Journal of the American Academy of Child and Adolescent Psychiatry 2008; 47(4): 369–373.

  7. Damschroder LJ, Aron DC, Keith RE, et al. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science 2009; 4(1):50.

  8. Fixsen DL, Naoom SF, Blase KA, et al. Implementation research: A synthesis of the literature, 2005. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).

  9. Rogers EM. Diffusion of Innovations. Simon and Schuster, New York, 2003.

  10. Hendy J, Barlow J. The role of the organizational champion in achieving health system change. Social Science & Medicine 2012; 74(3): 348–355.

    Article  Google Scholar 

  11. Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research 2011; 38(1): 4–23.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Powell BJ, McMillen JC, Proctor EK, et al. A compilation of strategies for implementing clinical innovations in health and mental health. Medical Care Research and Review 2012; 69(2): 123–157.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Daleiden EL, Chorpita BF, Donkervoet C, et al. Getting better at getting them better: Health outcomes and evidence-based practice within a system of care. Journal of the American Academy of Child Adolescent Psychiatry 2006; 45(6): 749–756.

    Article  PubMed  Google Scholar 

  14. Cohen JA, Mannarino AP, Deblinger E (Eds). Treating trauma and traumatic grief in children and adolescents. New York: Guilford Press, 2006.

    Google Scholar 

  15. Sigel BA, Lynch CE, Kramer TL, et al. Characteristics of 17 statewide initiatives to disseminate Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT). Psychological Trauma: Theory, Research, Practice, and Policy 2013; 5(4): 323–333.

    Article  Google Scholar 

  16. Gleacher A, Nadeem E, Moy A, et al. Statewide CBT Training for clinicians and supervisors treating youth: The New York State evidence-based treatment dissemination center. Journal of Emotional and Behavioral Disorders 2011; 19(3): 182–92.

    Article  Google Scholar 

  17. Hoagwood KE, Olin SS, Kerker BD, et al. Empirically based school interventions targeted at academic and mental health functioning. Journal of Emotional and Behavioral Disorders 2007; 15(2): 66–92.

    Article  Google Scholar 

  18. Lopez MA, Osterberg LD, Jensen-Doss A., et al. Effects of workshop training for providers under mandated use of an evidence-based practice. Administration and Policy in Mental Health 2011; 38(4): 301–312.

    Article  PubMed  Google Scholar 

  19. Nakamura BJ, Chorpita BF, Hirsch M, et al. Large-scale implementation of evidence-based treatments for children 10 years later: Hawaii’s evidence-based services initiative in children’s mental health. Clinical Psychology: Science and Practice 2011; 18(1): 24–35.

    Google Scholar 

  20. Wonderlich SA, Simonich HK, Myers TC, et al. Evidence-based mental health interventions for traumatized youth: A statewide dissemination project. Behaviour Research and Therapy 2011; 49(10): 579–587.

    Article  PubMed  Google Scholar 

  21. Beidas RS, Kendall PC. Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice 2010; 17(1): 1–30.

    Google Scholar 

  22. Jensen-Doss A, Cusack KJ, de Arellano MA. Workshop-based training in trauma-focused CBT: An in-depth analysis of impact on provider practices. Community Mental Health Journal 2008; 44(4): 227–244.

    Article  PubMed  Google Scholar 

  23. Herschell AD, Kolko DJ, Baumann BL, et al. The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations. Clinical Psychology Review 2010; 30(4): 448–466.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Weisz JR, Chorpita BF, Palinkas LA, et al. Testing standard and modular designs for psychotherapy with youth depression, anxiety, and conduct problems: A randomized effectiveness trial. Archives of General Psychiatry 2012; 69(3): 274–282.

    Article  PubMed  Google Scholar 

  25. Chorpita BF, Taylor AA, Francis SE, et al. Efficacy of modular Cognitive Behavior Therapy for childhood anxiety disorders. Behavior Therapy 2004; 35(2): 263–287.

    Article  Google Scholar 

  26. Dorsey S, Briggs EC, Woods BA. Cognitive-behavioral treatment for posttraumatic stress disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America 2011; 20(2): 255–269.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Burley M. Outpatient treatment differences for children served in Washington’s public mental health system. Document No. 09-10-3401, Olympia, WA: Washington State Institute for Public Policy, 2009. Available online at http://www.wsipp.wa.gov/rptfiles/09-10-3401.pdf.

  28. Garland AF, Brookman-Frazee L, Hurlburt MS, et al. Mental health care for children with disruptive behavior problems: a view inside therapists’ offices. Psychiatric Services 2010; 61(8): 788–795.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Wandersman A, Duffy J, Flaspohler P, et al. Bridging the gap between prevention research and practice: The interactive systems framework for dissemination and implementation. American Journal of Community Psychology 2008; 41(3–4): 171–181.

    Article  PubMed  Google Scholar 

  30. Chorpita BF, Daleiden EL, Weisz JR. Identifying and selecting the common elements of evidence based interventions: A distillation and matching model. Mental Health Services Research 2005; 7(1): 5–20.

    Article  PubMed  Google Scholar 

  31. Embry D, Biglan A. Evidence-based Kernels: Fundamental units of behavioral influence. Clinical Child and Family Psychology Review 2008; 11(3): 75–113.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Chorpita BF, Daleiden EL, Weisz JR. Modularity in the design and application of therapeutic interventions. Applied Preventive Psychology 2005; 11(3): 141–156.

    Article  Google Scholar 

  33. Borntrager CF, Chorpita BF, Higa-McMillan C, et al. Provider attitudes toward evidence-based practices: Are the concerns with the evidence or with the manuals? Psychiatric Services 2009; 60(5): 677–681.

    Article  PubMed  Google Scholar 

  34. Barth RP, Lee BR, Lindsey MA, et al. Evidence-based practice at a crossroads: The timely emergence of common elements and common factors. Research on Social Work Practice 2012; 22(1): 108–119.

    Article  Google Scholar 

  35. Chorpita BF, Regan J. Dissemination of effective mental health treatment procedures: Maximizing the return on a significant investment. Behaviour Research and Therapy 2009; 47(11): 990–993.

    Article  PubMed  Google Scholar 

  36. Garland AF, Bickman L, Chorpita BF. Change what? Identifying quality improvement targets by investigating usual mental health care. Administration and Policy in Mental Health and Mental Health Services Research 2010; 37(1–2); 15–26.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Chorpita BF, Weisz JR (Eds). MATCH-ADC: Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems. Satellite Beach, FL: Practice Wise, 2009.

    Google Scholar 

  38. Chorpita BF, Weisz JR, Daleiden EL, et al. Long term outcomes for the Child STEPs randomized effectiveness trial: A comparison of modular and standard treatment designs with usual care. Journal of Consulting and Clinical Psychology 2013; 81(6): 99–1009.

    Article  Google Scholar 

  39. Wood JJ, Drahota A, Sze K, et al. Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: A randomized, controlled trial. Journal of Child Psychology and Psychiatry 2009; 50(3): 224–234.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Barlow DH, Boisseau CL, Ellard KK, et al. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. Oxford, England: Oxford University Press, 2010.

    Book  Google Scholar 

  41. Ellard KK, Fairholme CP, Boisseau CL, et al. Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice 2010; 17(1): 88–101.

    Article  Google Scholar 

  42. Farchione TJ, Fairholme CP, Ellard KK, et al. Unified protocol for transdiagnostic treatment of emotional disorders: A randomized controlled trial. Behavior Therapy 2012; 43(3): 666–678.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Lyon AR, Charlesworth-Attie S, Vander Stoep A, et al. Modular psychotherapy for youth with internalizing problems: Implementation with therapists in school-based health centers. School Psychology Review 2011; 40(4): 569581.

    Google Scholar 

  44. Stephan SH, Wissow L, Pichler E. Utilizing common factors and practice elements to improve mental health care by school-based primary care providers. Report on Emotional and Behavioral Disorders in Youth 2010; 10(54): 81–86.

    Google Scholar 

  45. Chorpita B, Becker K, Phillips L, et al. Practitioner Guides. Satellite Beach, FL: PracticeWise, 2009.

    Google Scholar 

  46. Murray LK, Dorsey S, Haroz E, et al. A common elements transdiagnostic mental health approach for low- and middle-income countries: Initial pilots. Cognitive and Behavioral Practice in press.

  47. Dorsey S, Pullmann MD, Deblinger E, et al. Improving practice in community-based settings: S randomized trial of supervision - Study protocol. Implementation Science 2013; 8(89): 1–11.

    Google Scholar 

  48. Foa EB, Johnson KM, Feeny NC, et al. The Child PTSD Symptom Scale (CPSS): A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology 2001; 30(3): 376–384.

    Article  CAS  PubMed  Google Scholar 

  49. Sburlati ES, Schniering CA, Lyneham HJ, et al. A model of therapist competencies for the empirically supported cognitive behavioral treatment of child and adolescent anxiety and depressive disorders. Clinical Child and Family Psychology Review 2011; 14(1): 89–109.

    Article  PubMed  Google Scholar 

  50. Morris SB, DeShon RP. Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods 2002; 7(1): 105–125.

    Article  PubMed  Google Scholar 

  51. Beidas RS, Barmish AJ, Kendall PC. Training as usual: Can therapist behavior change after reading a manual and attending a brief workshop on cognitive behavioral therapy for youth anxiety? The Behavior Therapist 2009; 32(5): 97–101.

    Google Scholar 

  52. Glisson C, Schoenwald S, Kelleher K, et al. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Administration and Policy in Mental Health 2008; 35(1–2): 124133.

    Article  PubMed  Google Scholar 

  53. Glisson C, Schoenwald SK, Hemmelgarn A, et al. Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy. Journal of Consulting and Clinical Psychology 2010; 78(4): 537–550.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Atkins MS, Frazier SL, Leathers SJ, et al. Teacher key opinion leaders and mental health consultation in low-income urban schools. Journal of Consulting and Clinical Psychology 2008; 76(5): 905–908.

    Article  PubMed  Google Scholar 

  55. Valente TW. Network interventions. Science 2012; 337(49): 49–53.

    Article  CAS  PubMed  Google Scholar 

  56. Shojania KG, Jennings A, Mayhew A, et al. Effect of point-of-care computer reminders on physician behavior: A systematic review. Canadian Medical Association Journal 2010; 182: E216-E225.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Eby LT, Burk H, Maher CP. How serious of a problem is staff turnover in substance abuse treatment? A longitudinal study of actual turnover. Journal of Substance Abuse Treatment 2010; 39(3): 264–271.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Hurlburt MS, Garland AF, Nguyen K, et al. Child and family therapy process: Concordance of therapist and observational perspectives. Administration and Policy in Mental Health 2010; 37(3): 230–244.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Miller W, Sorensen J, Selzer J, et al. Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. Journal of Substance Abuse Treatment 2006; 31(1): 25–39.

    Article  PubMed  Google Scholar 

  60. Ward AM, Regan J, Chorpita BF, et al. Tracking evidence based practice with youth: Validity of the MATCH and Standard Manual Consultation Records. Journal of Clinical Child Adolescent Psychology 2013; 42(1): 44–55.

    Article  PubMed  Google Scholar 

  61. Beidas RS, Cross W, Dorsey S. Show me, don’t tell me: Behavioral rehearsal as a training and analogue fidelity tool. Cognitive and Behavioral Practice. doi:10.1016/j.cbpra.2013.04.002

  62. Hogue A, Ozechowski TJ, Robbins MS, et al. Making fidelity an intramural game: Localizing quality assurance procedures to promote sustainability of evidence-based practices in usual care. Clinical Psychology Science and Practice 2013; 20(1): 60–77.

    Article  Google Scholar 

  63. Schoenwald SK, Garland AF, Chapman JE, et al. Toward the effective and efficient measurement of implementation fidelity. Administration and Policy in Mental Health 2011; 38(1): 32–43.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Olmstead T, Carrol KM, Canning-Ball M, et al. Cost and cost-effectiveness of three strategies for training clinicians in motivational interviewing. Drug and Alcohol Dependence 2011; 116(1–3): 195202.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This publication was made possible in part by funding from the Washington State Department of Social and Health Services, Division of Behavioral Health Recovery and from grant numbers F32 MH086978, K08 MH095939, and R01 MH095749, awarded from the National Institute of Mental Health (NIMH). Drs. Dorsey, Lyon, and Murray are investigators with the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis, through an award from the National Institute of Mental Health (R25 MH080916) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI).

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The authors have no conflicts of interest to report.

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Correspondence to Shannon Dorsey PhD.

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Dorsey, S., Berliner, L., Lyon, A.R. et al. A Statewide Common Elements Initiative for Children’s Mental Health. J Behav Health Serv Res 43, 246–261 (2016). https://doi.org/10.1007/s11414-014-9430-y

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