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Advancing Evidence Based Practice. Objectives of Today’s Workshop Define EBP Define EBP Review levels of evidence Review levels of evidence Review of.

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Presentation on theme: "Advancing Evidence Based Practice. Objectives of Today’s Workshop Define EBP Define EBP Review levels of evidence Review levels of evidence Review of."— Presentation transcript:

1 Advancing Evidence Based Practice

2 Objectives of Today’s Workshop Define EBP Define EBP Review levels of evidence Review levels of evidence Review of EBP proprietary and generic programs Review of EBP proprietary and generic programs State of EBP in Ohio State of EBP in Ohio Issues in EBP Issues in EBP

3 What is Evidence-based Practice? (1) practices or programs that have been judged effective based on rigorous, scientific evaluations; and and (2) a process for insuring that an individual or group of individuals gets the best possible intervention, service, or support based on an assessment of needs, preferences, and available options (U.S. DHHS)

4 ‘Evidence-based practice cannot deliver certainties, just increase probabilities, and this is the most that any approach claiming to be ‘evidence-based’ can hope to achieve.’ (Newman et al 2005, pp.5)

5 Evidence-Based Practice Uses scientific principles to assess the available evidence regarding program effectiveness, and develops principles for best practice in any particular field; As opposed to practice based on Experience Experience Unproven Theory Unproven Theory

6 Draws Upon Experience in Law:rules for assessing evidence Law:rules for assessing evidence Engineering:codes & standards Engineering:codes & standards Public Health:risk factors Public Health:risk factors Medicine:treatment decisions Medicine:treatment decisions Education:programs and org Education:programs and org Ratings for consumer products (i.e. Consumers’ Report, Car and Driver, Gearhead, etc.) Ratings for consumer products (i.e. Consumers’ Report, Car and Driver, Gearhead, etc.)

7 Benefits of EBP Reducing crime Reducing crime Saving money Saving money Changing lives Changing lives Restoring dignity Restoring dignity Advancing integrity and professionalism Advancing integrity and professionalism

8 What EBPs have to offer Proven effectiveness Proven effectiveness Criminal justice cost savings Criminal justice cost savings Blueprint Blueprint MAYBE Implementing experience - coaching Implementing experience - coaching Fidelity measures Fidelity measures Outcome tracking and reporting Outcome tracking and reporting

9 An Important Qualification Proven programs all require substantial training, ongoing quality assurance & monitoring Proven programs all require substantial training, ongoing quality assurance & monitoring They only work when implemented with a high degree of fidelity They only work when implemented with a high degree of fidelity Proven programs account for only a small percentage of the treatment & rehabilitation market Proven programs account for only a small percentage of the treatment & rehabilitation market

10 Evidence Based Practice Begins With A Basic Logic Model

11 A Situation Inputs Outputs Outcomes _____________________________________________________ Problem Short Medium Long Term NeedCrisis

12 Continuum of EBP Demonstrated Ability to Replicate Demonstrated Outcomes are Impact consistent across replications replications Promising Evaluations show better outcomes Findings for participants than for a matched comparison or control group Evidence Evaluations show positive outcomes for participants Informed--e.g. pre- and post-program evaluations Research The intervention design is based on research evidence about Informedeffective practice in this area – e.g. meta-analyses of effective interventions A strong logic model ties the proposed intervention to what research tells us about how to impact child and family outcomes

13 Assumptions: External factors: Example: One component of a comprehensive parent education and support initiative parent education and support initiative Situation: During a county needs assessment, majority of parents reported that they were having difficulty parenting and felt stressed as a result INPUTS OUTPUTS OUTCOMES Staff Money Partners Research Develop parented curriculum Deliver series of interactive sessions Facilitate support groups Target parents attend Parents increase knowledge of child dev Parents better understanding their own parenting style Parents gain skills in effective parenting practices Parents identify appropriate actions to take Parents use effective parenting practices Improved child- parent relations Strong families

14 A Review of Top Tier Proprietary EBP And Generic Models

15 Top Rated Proven Program Models Functional Family Therapy (FFT) Functional Family Therapy (FFT) Multisystemic Therapy (MST) Multisystemic Therapy (MST) Multidimensional Treatment Foster Care (MTFC) Multidimensional Treatment Foster Care (MTFC) Nurse Family Partnership Nurse Family Partnership Life Skills Training (LST): The Incredible Years; PATHS Midwestern Prevention Project; Project Toward No Drug Abuse Big Brothers Big Sisters: Olweus Bullying Prevention

16 Three of the Most Effective Evidence-Based Approaches: According to Washington State Institute of Public Policy

17 Evidence-Based Practices Versus Common Alternatives:

18 Family Functional Therapy (FFT) : Program: An Empirically grounded, well-documented, and highly successful family intervention for juvenile offenders. Utilizes clinicians in a specific three phase model to engage youth, motivate change, and create change in youths’ behavior. Method: Intervention ranges from 8-30 one hour direct service sessions with youth and family.

19 Family Functional Therapy Accreditations: High rates of effectiveness documented by: High rates of effectiveness documented by: Washington State Institute for Public Policy Washington State Institute for Public Policy Centers for Disease Control Centers for Disease Control US Surgeon General’s Report on Youth Violence US Surgeon General’s Report on Youth Violence Office of Juvenile Justice and Delinquency Prevention (US DOJ) Office of Juvenile Justice and Delinquency Prevention (US DOJ) Center for Substance Abuse Prevention Center for Substance Abuse Prevention Blueprints (Center for the Study and Prevention of Violence at University of Colorado) Blueprints (Center for the Study and Prevention of Violence at University of Colorado)

20 Multisystemic Therapy (MST) : Program: An individualized approach that targets those factors in each youth’s life that contribute to anti-social behavior. MST interventions focus on caregiver discipline practices, youth associations, improving school performance, and the development of an indigenous support network. Method: The program requires 3-5 hours of face-to-face contact each week and typically lasts for 3-5 months.

21 MST Accreditations: High rates of effectiveness documented by: High rates of effectiveness documented by: Washington State Institute for Public Policy Washington State Institute for Public Policy National Institute for Drug Addiction National Institute for Drug Addiction Center for Substance Abuse Treatment Center for Substance Abuse Treatment National Association of State Mental Health Program Directors National Association of State Mental Health Program Directors Office of Juvenile Justice and Delinquency Prevention (US DOJ) Office of Juvenile Justice and Delinquency Prevention (US DOJ) Blueprints (Center for the Study and Prevention of Violence at University of Colorado) Blueprints (Center for the Study and Prevention of Violence at University of Colorado)

22 Multidimensional Treatment Foster Care (MTFC) : Program: MTFC addresses chronic antisocial behavior, delinquency, chronic and severe criminal behavior. The MTFC model requires recruitment, training, and close supervision of community families who provide treatment and intensive supervision at home, in school, and in the community. Method: Live-in treatment with a trained foster family for 6-9+months.

23 MTFC Accreditations: High rates of effectiveness documented by: High rates of effectiveness documented by: Washington State Institute for Public Policy Washington State Institute for Public Policy Blueprints (Center for the Study and Prevention of Violence at University of Colorado) Blueprints (Center for the Study and Prevention of Violence at University of Colorado) Numerous peer reviewed research reports Numerous peer reviewed research reports

24 Promising Programs Behavioral Monitoring and Reinforcement Behavioral Monitoring and Reinforcement Brief Strategic Family Therapy (BSFT) Brief Strategic Family Therapy (BSFT) FAST Track FAST Track Good Behavior Game (GBG) Good Behavior Game (GBG) Guiding Good Choices (GGC) Guiding Good Choices (GGC) I Can Problem Solve (ICPS) I Can Problem Solve (ICPS) Linking the Interests of Families Linking the Interests of Families Teachers Triple P-Positive Parenting Program Teachers Triple P-Positive Parenting Program Perry Preschool Project Perry Preschool Project

25 Generic Models from Meta-Analysis Cognitive Behavioral Therapy Cognitive Behavioral Therapy Behavioral programs Behavioral programs Counseling/Psychotherapy Counseling/Psychotherapy Pre-K education for low-income families Pre-K education for low-income families Teen Court Teen Court Family Counseling Family Counseling Social skills training Social skills training Challenge programs Challenge programs

26 Programs & Strategies That Do Not Work D.A.R.E D.A.R.E Scared Straight Scared Straight Working with at-risk youth in groups Working with at-risk youth in groups Standard probation supervision Standard probation supervision Punishment Punishment Waiver to Adult Court Waiver to Adult Court

27 The State of Evidence Based Practice In Ohio

28 1. Ohio’s Coordinating Centers of Excellence (CCOEs)  Established by ODMH  Includes Ohio Universities, consumer groups, local agencies  They include: Supported Employment – Case Western Reserve Supported Employment – Case Western Reserve Wellness Management & Recovery – Southeast, Inc., University of Toledo, and Lorain County MHB Wellness Management & Recovery – Southeast, Inc., University of Toledo, and Lorain County MHB Integrated Dual Disorder Treatment – SA/MI Focus – Case Western Reserve Integrated Dual Disorder Treatment – SA/MI Focus – Case Western Reserve Center for Innovative Practice – Kent State Center for Innovative Practice – Kent State Mental Illness/Developmental Disabilities – Wright State Mental Illness/Developmental Disabilities – Wright State Criminal Justice – Summit County ADAMH Board and Northeastern Ohio University’s College of Medicine Criminal Justice – Summit County ADAMH Board and Northeastern Ohio University’s College of Medicine

29 2. Ohio Behavioral Health Juvenile Justice Program  Joint effort between ODYS and ODMH  Lucas, Summit, Cuyahoga, Franklin, Montgomery, and Hamilton Counties  J J Youth with serious behavioral issues  Focus and employing EBP  Case Western Reserve is evaluator

30 Advancing EBP in Ohio Juvenile Justice   Targeted Reclaim Funding Metro Counties to employ EBP

31   H.B. 86 – Ohio’s sentencing reform bill Effective September 30, 2011 Explicitly supports EBP Restores judicial discretion

32   S.H. vs. Stickrath (now Reed) Closed four institutions 50% population cut since 2008 Invested $57 million in targeted reclaim & BHJJ Increases EBP

33 EBP and Sex Offender Registration and Notification Act (SORNA) of Adam Walsh Act   Adam Walsh Act A politically popular but wrong headed strategy Requires sex offender registration based on offense – not risk Research now proves that 97-99% of youthful sex offenders never commit another sex offense Actually decreases public safety

34   AND NOW: States are refusing to comply Ohio does not comply fully

35 EBP Resources: Campbell & Cochrane Collaboration Reviews Campbell & Cochrane Collaboration Reviews NREPP (SAMHSA) NREPP (SAMHSA) Blueprints Blueprints CrimeSolutions CrimeSolutions ChildTrends LINKS ChildTrends LINKS Harvard Family Research Project Harvard Family Research Project CA What Works Clearinghouse CA What Works Clearinghouse National Child Traumatic Stress Network National Child Traumatic Stress Network

36 Controversy in EBP The great Mark Lipsey The great Mark Lipsey Community –defined evidence Community –defined evidence Push Back to developers Push Back to developers DMC ( DMC (At the heart of Juvenile Justice Reform)


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