Implementing Evidence-Based Practices
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Transcript of Implementing Evidence-Based Practices
Implementing Evidence-Based
Practices
Implementing Evidence-Based
Practices
The Addiction Technology Transfer Center Network
Funded by Substance Abuse and Mental Health Services Administration
1. Systems change model• Definitions• Principles• Strategies• Activities• Steps
2. Case study3. Discussion
OverviewOverview
• Policies that accommodate evidence-based practices
• Supportive system administrators• Willing agency directors• Skilled clinical supervisors• Opinion leaders who are convinced• Skilled service providers• Opportunities for staff/client input
A Comprehensive Strategy IncludesA Comprehensive Strategy Includes
Barriers Can IncludeBarriers Can Include
• Administrative philosophy
• Organizational policy
• System structure
• Unclear literature
• Agency staff
• Client population
????????So, how do you decide what to do?
So, how do you decide what to do?
• Principles • Strategies • Activities • Steps
The Change BookThe Change Book
• Relevant
• Clear
• Multifaceted
• Bi-directional
Change Initiatives Must Be
Change Initiatives Must Be
The PrinciplesThe Principles
• Timely
• Credible
• Continuous
• Multifaceted
• Continuous
• Bi-directional
Don’t Forget the Last ThreeDon’t Forget
the Last Three
The PrinciplesThe Principles
Creating Your Blueprint
The Ten Steps
Creating Your Blueprint
The Ten Steps
1. Identify the problem
2. Organize a team
3. Identify an outcome
4. Assess your organization
5. Assess your audience
The StepsThe Steps
Ten Steps of EffectiveChange Initiatives
Ten Steps of EffectiveChange Initiatives
6. Identify the approach
7. Design action and maintenance plans
8. Implement the plans
9. Evaluate your plans
10. Revise your plans
The StepsThe Steps
Ten Steps of EffectiveChange Initiatives
Ten Steps of EffectiveChange Initiatives
• Administrative/structural• Bi-directional dialogue• Information dissemination • Education• Person to person• Evaluation
Types of ActivitiesTypes of Activities
Systems Change:A Case Study
Systems Change:A Case Study
• Chronic substance abusers with extensive criminal histories and serious psychological and social deficits
• Hardcore poly-drug users who began using drugs at 17; most still using 15 years later at treatment entry
Women’s Residential Center: Client Characteristics
Women’s Residential Center: Client Characteristics
• Heavily involved in criminal activity – 73% arrested at least 5 times as an adult
• Victims of physical and sexual abuse in adulthood – 75% physically abused by a partner and 45% sexually abused
• In poor health, lack education and work experience, and have serious mental health problems
Women’s Residential Center: Client Characteristics
Women’s Residential Center: Client Characteristics
• Completed treatment 1999 - 48%
• Did not complete 1999 - 26% 0
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1999
Comp
Non-Comp
VOA Women’s Program No Arrests After One Year VOA Women’s Program
No Arrests After One Year
• Completed treatment1999 - 48%
2001 - 86%
• Did not complete1999 - 26%
2001 - 67%
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1999 2001
Comp
Non-Comp
VOA Women’s Program No Arrests After One Year VOA Women’s Program
No Arrests After One Year
Precontemplation Always assess and re-assess
readiness to change and develop a plan based on stages of change
Bi-directional
Contemplation Preparation
Develop a vision that everyone understands and supports
Clear
Bi-directional
Relevant
Timely
Stage of Change Action Principle
Action Build on what you have and what is already in place
Integrate what you know with the technology you want to apply
Relevant
Credible
Clear
Our Change Process - Lessons Learned
Our Change Process - Lessons Learned
Preparation
Action
It is a process
It’s a long-term effort achieved by meeting short-term objectives
Multi-faceted
Action “Wrap it pretty” Use incentives and
reinforcements What comes off the plate
when new responsibilities are added?
Multi-faceted
Continuous
Stage of Change Action Principle
Our Change Process - Lessons Learned
Our Change Process - Lessons Learned
LSILSI --RRLevel of Service I nventory – Revised
The LSI–R is a quantitative survey of attributes of offenders and their situations. The LSI -R is useful
for identifying dynamic and static risk factors related to recidivism.
Developed by D.A. Andrews, Ph.D. and James L. Bonta, Ph.D.
For More I nformation Contact:MULTI -HEALTH SYSTEMS
P.O. Box 950 North Tonawanda, NY 14120-0950
1-800-456-3003www.mhs.com
• 26-session program for female offenders
• Help women identify and mobilize personal and community resources
• Educational and cognitive skill building
• Delivered in small groups or individually
Marilyn Van Dieten, Ph.DPatricia Mac Kenna, M.A.
Moving OnMoving On
Action
Maintenance
Comprehensive and long-term effort
Utilize training, manuals, supervision, consultation
Use a variety of methods to present information
Build partnerships with customers, funders, stakeholders
Capitalize on staff strengths
Establish a systematic problem-solving process
Multi-faceted
Continuous
Bi-directional
Credible
Stage of Change Action Principle
Our Change Process - Lessons Learned
Our Change Process - Lessons Learned
Maintenance
Relapse
Anticipate barriers and relapse
• Respond with strength-based approaches and interventions based on the stages of change
• Back to precontemplation and contemplation
Continuous
Bi-directional
Stage of Change Action Principle
Our Change Process - Lessons Learned
Our Change Process - Lessons Learned
In SummaryIn Summary
• Assess and address staff and organizational readiness for change
• Check assumptions of all stakeholders as project begins
• Secure staff buy-in
Knowledge Adoption – Lessons Learned
Knowledge Adoption – Lessons Learned
• Utilize researcher and provider collaboration throughout the project
• Implement a design tailored to the realities of the agency
• Develop a plan sufficient to accomplish your objectives
• Have an on-site champion
Knowledge Adoption – Lessons Learned
Knowledge Adoption – Lessons Learned
• No system change works without a process
• Effective strategies are multi-faceted, bi-directional and continuous
• Representation of all stakeholder groups in decision-making facilitates buy-in and adoption
• Continuous promotion, training and mentoring builds top-of-mind awareness and consistent use
Final TipsFinal Tips
Implementing Evidence-Based
Practices
Implementing Evidence-Based
Practices
The Addiction Technology Transfer Center Network
Funded by Substance Abuse and Mental Health Services Administration