SOCW6311 Wk 2 Walden: Generating Support for Evidence-Based Practices Due 03/05/2019
When treating clients, social workers must ensure that the evidence-based practice is appropriate for the client and the problem. Then, the social worker must get the client and other stakeholders to support the selected evidence-based practice. To earn that support, the social worker should present the client and stakeholders with a plan for implementation and evidence of the evidence-based practice efficacy and appropriateness. Social workers must demonstrate that they have carefully considered the steps necessary to implement the evidence-based practice, identified factors in the current environment that support implementation of the evidence-based practice, and addressed those factors that may hinder the successful implementation.
For this weeks Discussion, you will take on the role of the social worker in the Levy case study. You will choose an evidence-based practice and attempt to gain the support of both the client and supervisor. To do so, you will address its efficacy, appropriateness, and factors that may impact implementation of the evidence-based practice that you chose.
To prepare for this Discussion, review Levy Episode 2. Then using the registries provided in this weeks resources and the Walden Library, locate an evidence-based practice that you believe would be appropriate for Jakes case. Then, review the Evidence-Based Practice kit for Family Psycho Education from the SAMHSA website from the resources. Note all the steps and considerations involved in implementing the evidence-based practice and which of these considerations apply to this case. Consider issues such as agency support, resources, and costs that might support or limit the application of the evidence-based intervention that you select.
BE Detailed in response, use 4 APA references, and use sub-heading in response
Post an evaluation of the evidence-based practice that you selected for Jake. Describe the practice and the evidence supporting it.
Explain why you think this intervention is appropriate for Jake.
Provide an explanation for the supervisor regarding issues related to implementation.
Identify two factors that you believe are necessary for successful implementation of the evidence-based practice and explain why.
Identify two factors that you believe may hinder implementation and explain how you might mitigate these factors.
Be sure to include APA citations and references.
References
Document: Substance Abuse and Mental Health Services Administration. (2009c). Family psychoeducation: Getting started with evidence-based practices. Retrieved from: http:store.samhsa.gov/shin/content/SMA09-4423/GettingStarted-FP.pdf (PDF)
Laureate Education (Producer). (2013c). Levy family episode 2 [Video file]. Retrieved from https://class.waldenu.edu Levy Family Episode 2
Levy Family Episode 2
Program Transcript
FEMALE SPEAKER: I want to thank you for getting me this Levy case. I think it’s
so interesting. Just can’t wait to meet with the client.
MALE SPEAKER: What do you find interesting about it?
FEMALE SPEAKER: Well, he’s just 31. Usually the vets I work with are older. If
they have PTSD, it’s from traumas a long time ago. But Jake, this is all pretty
new to him. He just left Iraq a year ago.
You know, I was thinking he’d be perfect for one of those newer treatment
options, art therapy, meditation, yoga, something like that.
MALE SPEAKER: Why?
FEMALE SPEAKER: Well, I’ve been dying to try one of them. I’ve read a lot of
good things. Why? What are you thinking?
MALE SPEAKER: I’m thinking you should really think about it some more. Think
about your priorities. It’s a good idea to be open-minded about treatment options,
but the needs of the client have to come first, not just some treatment that you or
I might be interested in.
FEMALE SPEAKER: I mean, I wasn’t saying it like that. I always think of my
clients first.
MALE SPEAKER: OK. But you mentioned meditation, yoga, art therapy. Have
you seen any research or data that measures how effective they are in
treatment?
FEMALE SPEAKER: No.
MALE SPEAKER: Neither have I. There may be good research out there, and
maybe one or two of the treatments that you mentioned might be really good
ideas. I just want to point out that you should meet your client first, meet Jake
before you make any decisions about how to address his issues. Make sense?
FEMALE SPEAKER: Yeah.
Levy Family Episode 2
Additional Content Attribution
©2013 Laureate Education, Inc.
1
Levy Family Episode 2
MUSIC:
Music by Clean Cuts
Original Art and Photography Provided By:
Brian Kline and Nico Danks
©2013 Laureate Education, Inc.
2
Getting Started
with Evidence-Based
Practices
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Mental Health Services
www.samhsa.gov
Family
Psychoeducation
Getting Started
with Evidence-Based
Practices
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Center for Mental Health Services
Family
Psychoeducation
Acknowledgments
This document was prepared for the Substance Abuse and Mental Health Services Administration
(SAMHSA) by the New Hampshire-Dartmouth Psychiatric Research Center under contract number
280-00-8049 and Westat under contract number 270-03-6005, with SAMHSA, U.S. Department
of Health and Human Services (HHS). Neal Brown, M.P.A., and Crystal Blyler, Ph.D., served as
the Government Project Officers.
Disclaimer
The views, opinions, and content of this publication are those of the authors and contributors and
do not necessarily reflect the views, opinions, or policies of the Center for Mental Health Services
(CMHS), SAMHSA, or HHS.
Public Domain Notice
All material appearing in this document is in the public domain and may be reproduced or
copied without permission from SAMHSA. Citation of the source is appreciated. However,
this publication may not be reproduced or distributed for a fee without the specific, written
authorization from the Office of Communications, SAMHSA, HHS.
Electronic Access and Copies of Publication
This publication may be downloaded or ordered at http://www.samhsa.gov/shin. Or, please
call SAMHSAs Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727) (English
and Español).
Recommended Citation
Substance Abuse and Mental Health Services Administration. Family Psychoeducation: Getting
Started with Evidence-Based Practicess. HHS Pub. No. SMA-09-4422, Rockville, MD: Center for
Mental Health Services, Substance Abuse and Mental Health Services Administration,
U.S. Department of Health and Human Services, 2009.
Originating Office
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road
Rockville, MD 20857
HHS Publication No. SMA-09-4422
Printed 2009
Getting Started with
Evidence-Based Practices
Getting Started with EBPs gives you an overview of the activities
that are generally involved in implementing EBPs and tells you
how to make EBPs culturally competent. This booklet is particularly
relevant to the following:
n
Mental health authorities; and
n
Agency staff who develop and manage EBP programs.
For references, see the booklet The Evidence.
Family
Psychoeducation
This KIT is part of a series of Evidence-Based Practices KITs created
by the Center for Mental Health Services, Substance Abuse and
Mental Health Services Administration, U.S. Department of Health
and Human Services.
This booklet is part of the Family Psychoeducation KIT that includes
a DVD, CD-ROM, and seven booklets:
How to Use the Evidence-Based Practices KITs
Getting Started with Evidence-Based Practices
Building Your Program
Training Frontline Staff
Evaluating Your Program
The Evidence
Using Multimedia to Introduce Your EBP
Whats in Getting Started with
Evidence-Based Practices
Consensus Building: Build Support for Change. . . . . . . . 3
Integrate the EBP into Policies and Procedures. . . . . . . . 5
Assess Training Needs . . . . . . . . . . . . . . . . . . . . . . . . . 7
Monitor and Evaluate Regularly. . . . . . . . . . . . . . . . . . 9
aximize Effectiveness by Making Services
M
Culturally Competent. . . . . . . . . . . . . . . . . . . . . . . . . . 11
Family
Psychoeducation
Getting Started
with Evidence-Based Practices
Consensus Building:
Build Support for Change
must be complemented by a broad range
of implementation activities, including the
following:
Within a system, change affects
stakeholders differently. Consequently,
when making changes in the mental
health system, mental health agencies
should expect varied reactions from
staff, community members, consumers,
and families. Since misunderstandings
can stymie your efforts to implement
evidence-based practices (EBPs),
it is important to build consensus
to implement EBPs in the community.
n
Building support for the EBP;
n
Integrating the EBP into agency
policies and procedures;
n
Training staff agency-wide on basic EBP
principles; and
n
Allowing for ongoing monitoring and
evaluation of the program.
Practitioner training alone is not
effective. The experience of mental
health authorities and agencies that have
successfully implemented EBPs reinforces
that fact. Instead, practitioner training
Getting Started with EBPs
3
This overview introduces the general
range of activities involved in successfully
implementing EBPs. For guidelines and
suggestions for EBP?specific activities, see
the remaining sections of each KIT.
How to build support for your EBP
Consensus-building activities are designed to build
support for implementing EBPs. Here are some
ways to develop them:
Step 1?Identify key stakeholders or people who
will be affected by the EBP. Stakeholders
may include agency personnel at all
levels, mental health authority staff, and
consumer and family representatives.
Depending on the EBP, you may also
wish to build relationships with other
community organizations, such as the
Department of Vocational Rehabilitation,
homeless shelters, food banks, police,
hospitals, peer-support programs, and
consumer and family groups.
Step 2?Invite one potential EBP champion from
each stakeholder group to participate in
an EBP advisory committee. According
to agencies that have successfully
implemented EBPs, identifying ongoing
champions and forming an advisory
committee are critical activities. While at
first you may feel that creating an advisory
committee slows the process, any amount
of time used to build stakeholder support is
worth the effort.
BPs have little hope for success if the
E
community doesnt recognize that they are
needed, affordable, worth the effort, and
congruent with community values and the
agencys practice philosophy. Mental health
authorities and agency administrators must
convey to key stakeholders a clear vision
and a commitment to implementing the
EBP. By forming an advisory committee
of potential champions from each
stakeholder group, you will be able to
broadly disseminate information in the
community. After training committee
members in the basic principles of the EBP,
ask them to hold informational meetings
or to regularly disseminate information to
their stakeholder groups.
Step 3?Ask for advice. Developing the advisory
committee and educating its members
in the EBP early in the planning process
will allow you to ask committee members
for their advice during all phases of the
implementation process. Community
members may help assess how ready
the community and the agency are to
implement the EBP and its activities.
Once the EBP is in place, committee
members can keep EBP staff informed of
relevant community trends that may have
an impact on providing the EBP services.
BP advisory committees are crucial
E
for sustaining the EBP over time. When
EBP staff turn over, or other well-trained
staff leave and must be replaced, or when
funding streams or program requirements
change, community and political alliances
are essential. A well-established committee
can champion the EBP through changes.
Step 4 Build
an action plan. Once key
stakeholders basically understand the EBP,
have your advisory committee develop an
action plan for implementation. Action
plans outline activities and strategies
involved in developing the EBP program,
including the following:
n Integrating
the EBP principles into
mental health authority and agency
policies and procedures;
n Outlining
initial and ongoing training
plans for internal and external
stakeholders; and
4
Getting Started with EBPs
n Designing
procedures to regularly
monitor and evaluate the EBP.
Integrate the EBP into Policies
and Procedures
ase the activities in your action plan on
B
the needs of the population you serve, your
community, and your organization.
Examine policies and procedures
Mental health authorities and agencies that have
successfully implemented EBPs highlight the
importance of integrating the EBP into policies and
procedures. For example, you will immediately face
decisions about staffing the EBP program. Mental
health authorities can support the implementation
Step 5?Involve the advisory committee in an
ongoing evaluation of the EBP. Committee
members can help you decide which
outcomes you should target. They can
help you integrate continuous quality
improvements.
To start implementing your EBP
n Outline responsibilities for committee members,
n Pinpoint key stakeholder groups that will be
such as:
affected by implementing the EBP.
o Participating in EBP basic training;
n Identify potential champions from each group
and invite them to participate in an EBP
advisory committee.
o Providing basic information about the EBP to
their stakeholder groups;
n Ask the committee to advise you during
o Advising you during all phases of the
the process.
implementation process; and
n Build an action plan.
o Participating in an ongoing evaluation
of the EBP.
Getting Started with EBPs
5
process by integrating staffing criteria into
regulations. Agency administrators should select
an EBP program leader and practitioners based
on mental health authority regulations and
qualifications that the EBP requires. New EBP
position descriptions should be integrated into
the agencys human resource policies. EBPspecific suggestions in Building Your Program
will help mental health authorities and agency
staff determine the appropriate mix and number
of staff, define staff roles, and develop a
supervision structure.
Agency administrators and mental health
authorities should also review administrative
policies and procedures to ensure that they are
compatible with EBP principles. For example,
you may need to modify admission and discharge
assessment, treatment planning, and servicedelivery procedures. Make sure policies and
procedures include information about how to
identify consumers who are most likely to benefit
from the EBP and how to integrate inclusion
and exclusion criteria into referral mechanisms.
Integrating EBP principles into policies and
procedures will build the foundation of the
EBP program and will ensure that the program
is sustainable. Examine policies and procedures
early in the process. While most changes will occur
in the planning stages, regularly monitoring and
evaluating the program (see discussion below)
will allow you to periodically assess the need for
more changes.
Identify funding issues
Identifying and addressing financial barriers is
critical since specific costs are associated with
starting new EBP programs and sustaining them.
Identify short- and long-term funding mechanisms
for EBP services, including federal, state, local
government, and private foundation funds. You can
work with your EBP advisory committee to project
start up costs by identifying the following:
n Time
for meeting with stakeholders that is not
reimbursed;
n
Time for staff while in training;
n
Staff time for strategic planning;
n
Travel to visit other model EBP programs; and
n
osts for needed technology (cell phones and
C
computers) or other one-time expenses accrued
during the initial implementation effort.
You should also identify funding mechanisms for
ongoing EBP services and to support continuous
quality improvement efforts, such as ongoing
training, supervision, technical assistance, fidelity,
and outcomes monitoring. In addition, you may
need to revise rules for reimbursement that are
driven by service definitions and criteria; this may
require interagency meetings on the federal, state,
and local levels.
6
Getting Started with EBPs
Get these valuable resources to help implement your EBP
Numerous materials are available through the U.S. Department of Health and Human Services
(http://www.hhs.gov) about using Medicaid and Medicare to fund necessary services. If you are
implementing EBPs, one useful resource is Using Medicaid to Support Working Age Adults with Serious
Mental Illnesses in the Community: A Handbook, published by the Assistant Secretary of Planning and
Evaluation, January 2005.
http://aspe.hhs.gov/daltcp/reports/handbook.pdf
This handbook gives you an excellent introduction to the Medicaid program, including essential features,
eligibility, and coverage of mental health services, community services, and waivers. It also provides helpful
information for states seeking Medicaid funding to implement the following:
n Family Psychoeducation;
n Assertive Community Treatment;
n Illness Management and Recovery;
n Integrated Treatment for Co-Occurring Disorders;
n Medication Management;
n Supported Employment;
n Supportive Housing;
n Consumer-Directed Services; and
n Peer Support.
In addition to assessing training needs in the
community, agency administrators should gauge
how well staff across the agency understand the
EBP. Agency administrators who have successfully
implemented EBPs highlight the importance of
providing basic training on the EBP to all levels
of staff throughout the agency. Educating and
engaging staff will ensure support for the EBP.
In the long run, if they are well trained, EBP
staff will have an easier time obtaining referrals,
collaborating with staff from other service
programs, and facilitating a continuum of care.
Assess Training Needs
One of the next steps in implementing your
EBP is to develop a training plan. You may gauge
the amount of training needed by assessing the
readiness of your community. If a community
doesnt know about the EBP and doesnt recognize
the existing need, you may have to conduct a wide
range of educational activities. If a community
already understands the EBP and knows how it may
address problems that community members want
to solve, you may need fewer educational activities.
Ongoing in-service training is an efficient way to
provide background information, the EBP practice
philosophy and values, and the basic rationale
for EBP service components in a comfortable
environment. Consider including members of
your advisory committee in decisions about the
frequency and content of basic EBP training.
You can help train key stakeholder groups if
you first train members of your EBP advisory
committee and then ask them to disseminate
information about the purpose and benefits
of the EBP.
Getting Started with EBPs
7
Offer more intensive training to program
leaders and practitioners
While staff at all levels in the agency should
receive basic EBP training, the program leader and
practitioners will require more intensive training.
To help practitioners integrate EBP principles
into their daily practice, offer comprehensive
skills training to those who provide EBP services.
Each KIT contains a variety of EBP-specific
training tools to help you provide both basic and
intensive training.
Although most skills that practitioners need may
be introduced through these training tools, research
and experience show that the most effective way to
teach EBP skills is through on-the-job consultation.
Consultants may provide comprehensive training
and case consultation to EBP practitioners.
Consultants may also help mental health authorities
and agency administrators to do the following:
n
Provide basic information to key stakeholders;
n
Assess the communitys readiness for change;
n Assist
in integrating EBP principles into policies
and procedures; and
n
Many agencies have also found it useful for
program leaders and practitioners to become
familiar with the structure and processes of the
practice by visiting agencies that have successfully
implemented the EBP.
Early in the process, mental health authorities
and agency administrators must decide how to
accomplish the following:
n Identify
internal and external stakeholders who
will receive basic training;
n Determine
how often basic training will be
offered;
n Identify
who will provide the training;
n Identify
EBP staff and advisory group members
who will receive comprehensive skills training;
n Determine
the training format for ongoing
training to EBP staff; and
n Determine
whether EBP staff may visit a model
EBP program.
EBP-specific suggestions in Building Your Program
will help mental health authorities and agency staff
develop an EBP training plan.
Design ongoing training plans.
In many mental health agencies, turnover of
staff is high. This means that the EBP will not
be sustained unless ongoing training is offered to
all employees.
8
Getting Started with EBPs
Why you should collect process measures
Monitor and Evaluate Regularly
Process measures, such as the EBP Fidelity Scale
and General Organizational Index, help you assess
whether the core elements of the EBP were put
into place in your agency. Research tells us that
the higher an agency scores on a fidelity scale, the
greater the likelihood that the agency will achieve
favorable outcomes (Becker et al., 2001; Bond &
Salyers, 2004). For this reason, it is important to
monitor both fidelity and outcomes.
Key stakeholders who implement EBPs may find
themselves asking two questions:
n Has the EBP been implemented as planned?
n Has the EBP resulted in the expected
outcomes?
Asking these two questions and using the answers
to improve your program is a critical component
for ensuring the success of your EBP.
Process measures give agency staff an objective,
structured way to determine if you are delivering
services in the way that research has shown will
result in desired outcomes. Collecting process
measures is an excellent method to diagnose
program weaknesses, while helping to clarify
program strengths. Process measures also give
mental health authorities a comparative framework
to evaluate the quality of EBPs across the state.
They allow mental health authorities to identify…
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