Creating an EBP Framework on a journey to Becoming an EBP agency Beth Archer-Kuhn, Ph.D. Candidate Adelle Greco, MSW Beth Archer-Kuhn, Adelle Greco, 2013 1
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Overview Policy papers Literature Agency Process Reflections on process Implications for practice Creation of Framework Lessons Learned Beth Archer-Kuhn, Adelle Greco, 2013 9
Overview Successes and Challenges Experience of Model Assessing program in your own agency Discussion/Questions Beth Archer-Kuhn, Adelle Greco, 2013 10
Policy Papers 2006 Ministry of Children and Youth Services (MCYS) policy framework 2010 Selection Committee on Mental Health and Addictions 2008 & 2010 Auditor General s Report 2011 - Children s Mental Health Ontario 2007 Health Canada Report, Reaching for the Top Beth Archer-Kuhn, Adelle Greco, 2013 11
Review of the Literature Evidence-based practice, Evidence-based programs, Evidence informed practice Beth Archer-Kuhn, Adelle Greco, 2013 12
Evidence-Based Practice Developed out of McMaster University Focus on systematic appraisals of validity of assessment measures and effectiveness of interventions (Johnson & Austin, 2006) To help mitigate human bias in clinical decision making through reflection and critical thinking (McCraken, 2008) Beth Archer-Kuhn, Adelle Greco, 2013 13
EBP 5 requirements for research evidence to impact practice (Johnson & Austin, 2006) 1) agreement on the nature of evidence, 2) strategic approach to the creation of evidence 3) effective research dissemination approaches 4) initiatives to increase the use of evidence 5) a variety of action steps at the organizational level Beth Archer-Kuhn, Adelle Greco, 2013 14
Agreement on EBP in the Literature The integration of the best available research evidence, combined with clinical expertise and client values (Small, Cooney & O Connor, 2009; Gambrill, 2006; Waddell, Godderis, Wong & Garland, 2005; Spring, 2001) To ensure the most effective prevention and treatment approaches are discussed and utilized with consumers (Waddell, Godderis, Wong & Garland, 2005) Beth Archer-Kuhn, Adelle Greco, 2013 15
Evidence-based programs might have some of the components of evidence-based practices specified curriculum consists of an accepted procedure including practices, activities and strategies (Small, Cooney & O Connor, 2009) identified through assessment as providing effective service and many include an evaluative component Beth Archer-Kuhn, Adelle Greco, 2013 16
Evidence informed practice the term evidence informed practice has been created to respond to the greater accountability required from funders towards agencies servicing children and families Evidence informed practice is a process of incorporating principles of effective programs to improve existing programs (Small, Cooney & O Connor, 2009) level of rigor is not as with evidence-based practice and allows for the realities of practitioners needing to make immediate decisions when research on specific areas may not yet be available (Chorpita et al, 2002). Beth Archer-Kuhn, Adelle Greco, 2013 17
Agency Process New leadership Strategic planning process Accreditation process New partnership with local university Tight financial pressures Ongoing collection of consumer data Gov t discourse of EBP CMHO conference presentation Beth Archer-Kuhn, Adelle Greco, 2013 18
What we did Creation of research committee Assigned 2 navigators Assess and evaluate all agency programs against an EBP framework Following principles and guidelines from the literature, navigators created their own framework Consultation with Center of Excellence Beth Archer-Kuhn, Adelle Greco, 2013 19
Creation of Framework Attention to questions posed by Gambrill (2006) The strength of the evidence The justification of the evidence Criteria used to select innovations Implementation of programs Beth Archer-Kuhn, Adelle Greco, 2013 20
Reflections on Journey Beginning Phase Middle Phase our hopes, dreams & passion Later Phase Lessons Learned Beth Archer-Kuhn, Adelle Greco, 2013 21
Beginning Phase Strategic planning and accreditation confirmed and gave direction Open forums with staff Internal navigator critical Excitement Use of students in placement Beth Archer-Kuhn, Adelle Greco, 2013 22
Goals Review all programs Make recommendations Develop maintenance or knowledge exchange Middle Phase Goals Achieved Evaluation of programs Consultation with families, staff, management, board Next steps: Develop community of practice and research Beth Archer-Kuhn, Adelle Greco, 2013 23 collaborations
Develop as you go Later Phase Lessons Learned Interesting partnerships can develop Passion, commitment to excellence, integrity and solid values can produce amazing things Being out in front can bring positive and negative consequences Beth Archer-Kuhn, Adelle Greco, 2013 24
Lessons Learned Determinants of success gained further appreciation for the importance of research driving practice and practice informing research challenged the leaders in the field of children s mental health to consider where we are at as a service system Beth Archer-Kuhn, Adelle Greco, 2013 25
Experience of Model 2 assessment tools and 1 treatment model were run through the EBP framework BCFPI Brief Child and Family Phone Interview CAFAS Child and Adolescent Functional Assessment Scale ITTM Intergenerational Trauma Treatment Model Beth Archer-Kuhn, Adelle Greco, 2013 26
Assessing the Evidence 1. It is recommended as such by Children s Mental Health Ontario. 2. It is established as such and located in the U.S. National Registry of Evidence-based Programs and Practices (NREPP). 3. It meets the criteria established by the American Psychological Association (APA). Beth Archer-Kuhn, Adelle Greco, 2013 27
APA Criteria for Empirically Validated Treatments: Well Established a. at least two good group designs studies, conducted by different investigators, demonstrating efficacy in one or more of the following ways: i. superior to pill or psychological placebo or to another treatment ii. equivalent to another already established treatment in studies with adequate statistical power (about 30 per group) Beth Archer-Kuhn, Adelle Greco, 2013 28
APA Criteria for Empirically Validated Treatments: Well Established or b. a large series of single case design studies demonstrating efficacy and having: i. used good experimental design and ii. compared the intervention to another treatment as in a i). and c. studies must be conducted with treatment manuals d. characteristics of clients samples must be clearly specified Beth Archer-Kuhn, Adelle Greco, 2013 29
Implications for Practice External organizational factor is strongest predictor of success (Johnson & Austin, 2006) Agency staff/practitioners require strong interpersonal skills (Small, Coonery & O Connor, 2009) May require a paradigm shift (CMHO, 2008; Gambrill, 2006) Beth Archer-Kuhn, Adelle Greco, 2013 30
Implications for Practice Community partners and funders may require education on EBP as critically reflective practice Collaborative networking can lead to a culture of shared responsibility (MCYS, 2006) Beth Archer-Kuhn, Adelle Greco, 2013 31
Assessment of your own program Use 20 minutes to individually or in small group, use EBP framework and run a program from your agency through it Beth Archer-Kuhn, Adelle Greco, 2013 32
Discussion Any further discussion or questions? Beth Archer-Kuhn, Adelle Greco, 2013 33
Thank-you for participating! Take this framework away with you to use within your own organizations Manuscript is scheduled for publication in August 2013 Journal of Evidence-Based Social Work Beth Archer-Kuhn, Adelle Greco, 2013 34