The implementation of MultifunC within The National

Board of Institutional Care

General phases in a implementationprocess (Implementation Research, Fixen et al., 2005)

Obtain knowledge from research

Develop best practice

Establish the program (starting up)

Implement

Full operation

Adjustment and innovation

Maintain and keep up

Program establishment in Sweden Anchoring the project in SiS management (-00)

Research review published -03

Recruitment of project leader

Internal information campaign and interest notification (-04)

Practical preparations on site

Recruitment

Education and training

First juvenile in program autumn -05

Education Education and training in procedures to

employees, and in principles for effective institutional care

The model requires basic education in:

Cognitive-behavior theory

Motivational interviewing

ART

Token economy

No Power No Lose

MST analytic process

For the Family and aftercare team also MST and KOMET

All institutions in Sweden has gone trough the same phases

Education and planning Enthusiasm Juveniles challenging the system Revealing weaknesses Frustration and chaos Amendments and adjustments Gradually improved function according to

the principles for MultifunC

Some challenges we have had Handle externalizing behavior Turnover Culture within the institution –This is how we always

done it Challenging to establish good communication within

the institution Comprehension of assessment before placement Comprehension of the concept that time in the

institution is only part of the program Comprehension for school in an external setting Economic conditions

Challenging to go from theory to practice

To learn something is easy – to practice what you have learned is quite another thing

The analytic process before development of interventions

From long term targets to short term targets and evaluations

Balance between autonomy and control

Takes time to integrate new methods and thinking

Demanding and complex model – reflects the juveniles complex needs

Uncertainty -fear of doing the wrong thing

Relapse to traditional thinking

The need for punishment/ sanctions

Implementing a new program is a gradual process

Staff barriers:

•Habits

•Attitudes

•Expectations

•Turnover

Practical barriers:

•Basis for care

•Target group

•Economic conditions

Learned skills Fair performance

AchievementPotential

What have we accomplished? More than 100 juveniles have got the treatment

and it seems they are benefitting from it

Maintaining good implementation status is a never ending story

An independent study of the effect is on its way

SiS has had a great deal of developmental help from this project, principles for effective institutional care, risk assesment, parental management programs…..