Partnering for Success: Implementing a cross-systems collaborative model between behavioral health and child welfare

https://doi.org/10.1016/j.childyouth.2019.104663Get rights and content

Highlights

  • Partnering for Success (PFS) offers training, implementation, and clinical strategies for children receiving child welfare and mental health services.

  • PFS strengthens collaboration between child welfare and mental health professionals on treatment planning and monitoring of outcomes.

  • CBT+ is the clinical intervention in PFS based on the common elements of trauma informed cognitive behavior therapy.

  • Implementation involves cross-training and coaching of child welfare and mental health professionals.

  • Children receiving CBT+ as part of PFS improved their clinical scores over the course of treatment.

Abstract

Many children and youth involved with child welfare services receive mental health services. Yet, substantial evidence suggests efforts are frequently uncoordinated and clinical outcomes are inconsistent. Enhancing the coordination of mental health services is a potential mechanism for improving outcomes when combined with the use of evidence-based practices. The Partnering for Success (PfS) model provides comprehensive coordination support while ensuring children and youth have access to cognitive-behavioral approaches to treating anxiety, depression, and trauma, and/or a parent management approach for behavior problems. PfS leverages a co-training collaborative model for mental health and child welfare professionals to understand the optimal interplay between professionals and families and the targeting of treatment. PfS uses a High-Fidelity Performance Indicator framework organized and assessed at two distinct levels: (1) Delivery System Partnership & Leadership Performance and (2) Child Welfare & Mental Health Workforce Performance. Results across four sites indicate that the model is generally feasible and training efforts result in significant knowledge gain for child welfare workers and mental health practitioners. Over the course of the project, 2285 clients were served using the clinical model and, across all treatment targets, significant improvements in symptoms were observed. The results of this collaborative model are sustained implementation of mental health services that are evidence-based, coordinated between child welfare workers and mental health practitioners, and offered evidence of improved mental health treatment outcomes.

Section snippets

Background of Partnering for Success model development

To strategically address the challenges associated with ensuring that children and youth in the child welfare system have their mental health-related needs identified and addressed, the National Center for Evidence-Based Practice in Child Welfare (National Center), funded in 2013 by the Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, has endeavored to create and deliver two interlaced interventions described and referenced hereafter as

Implementation sites

Thus far, the National Center has implemented PfS in four sites selected through a national request for applications process: Baltimore County Department of Social Services, Maryland; Administration for Children’s Services, Brooklyn, New York; two regions within the Maine Office of Child and Family Services; and Tulsa and surrounding counties as well as 7 other counties within 3 districts, served by the Oklahoma Department of Human Services. The study was approved by the author’s University of

Results

The National Center consolidated data sources to analyze High-Fidelity Performance Indicators in relation to PfS implementation within and across sites. Evaluation activities across the two levels (i.e., Delivery System Partnership & Leadership Performance and Child Welfare & Mental Health Workforce Performance) for the six elements of the HFPI framework are provided in Table 1.

Discussion

Feedback provided by staff and leadership in initial sites proved invaluable to the overall model improvements, which are now institutionalized in the PfS model. This included revision of training content, enhanced continuous quality improvement processes, and extended orientation and engagement activities with staff during the initial installation stages. Although selected sites went through a thorough process of exploration prior to selection, much more work was required during an expanded

Conclusions

Partnering for Success brought together several rapidly evolving fields of practice, including implementation science, common elements of evidence-based practice, high-fidelity coaching, and certification to change practice in four jurisdictions. PfS represents a novel approach to scaling support mechanisms of communication and collaboration between child-serving systems towards a unified goal of improved child mental health outcomes. However, the project highlighted several important

CRediT authorship contribution statement

Richard P. Barth: Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Resources, Writing - original draft, Writing - review -editing. Leslie J. Rozeff: Conceptualization, Data curation, Funding acquisition, Project administration, Resources, Software, Supervision, writing - original draft, writing - review -editing. Suzanne E.U. Kerns: Data curation, Formal analysis, Writing - original draft, Writing - review -editing. Melinda J. Baldwin:

Declaration of Competing Interest

The authors declared that there is no conflict of interest.

Acknowledgment

Partnering for Success is a program of the National Center for Evidence-Based Practice in Child Welfare which is supported through grant 90CT7001-01-02 from the U.S. Department of Health and Human Services, Administration for Children Youth and Families, Children’s Bureau. Funding support was also provided by the Children’s Bureau through the State of Maryland’s Title IV-E Waiver Demonstration project. The National Center for Evidence-Based Practice in Child Welfare (NCEBPCW) is operated by the

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