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The 4 th Annual Research and Evaluation of Adventure Programs Symposium Programs, Process, & Progress: The March Towards Evidence-Based Designation. Matt Claybaugh, Ph.D. & A. Scott Allred, LMFT Marimed Foundation. Program. Who we are and what we do. Process. Data in – Data Out

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matt claybaugh ph d a scott allred lmft marimed foundation

The 4th Annual Research and Evaluation of Adventure Programs SymposiumPrograms, Process, & Progress: The March Towards Evidence-Based Designation

Matt Claybaugh, Ph.D. &

A. Scott Allred, LMFT

Marimed Foundation

program
Program
  • Who we are and what we do.
process
Process
  • Data in – Data Out
  • Moving towards EBP designation
progress
Progress
  • Where are we now
  • Barriers to success
programs
Programs
  • How many of you believe/know you are using an evidence-based model in your program(s)?
  • How many of you are replicating a “best practice,” “evidence-based” or “model program?”
marimed s residential programs
Marimed’s Residential Programs
  • Kailana(Calm Seas) (est.1993 on O`ahu)

and

  • Wahiolanona`opio(A Healing Place for Youth) (est. 2004 on Hawai`i Island)

Residential treatment programs for adolescents needing comprehensive treatment and education, including mental health and substance abuse services.

kailana voyaging houses
Kailana Voyaging Houses

Hale Ho`ohua

“House to Bear Fruit”

Hale Kauoha Kākou

“House of Our Will”

wahiolanona opio voyaging houses
Wahiolanona`opio Voyaging Houses

Wahiolanona`opio `O Kea`au:

Girls House

Wahiolanona`opio `O Kapehu:

Boys House

integrated services
Integrated Services

Experiential

Marimed’s

Model

Educational

Clinical

five 5s
Five 5s
  • Organizational Values
  • Experiential Model
  • Interwoven Phase and Level System
  • CPI (Non Violent Crisis Intervention)
  • Behavioral Supports
1 organizational values
#1: Organizational Values
  • Community
  • Honesty
  • Aloha
  • Respect
  • Teamwork
2 experiential model
#2: Experiential Model
  • Welcome Aboard / Preparing for Sea
  • Departure / Commitment to the Voyage
  • Challenge / Windward Leg
  • Mastery / Wayfinding
  • Reflection / Storytelling
3 phase and level system
#3: Phase and Level System
  • Phases of Treatment:

I. Rapport Building: Roles and Rules

II. Accepting Responsibility and Expressing Needs and Issues

III. Coping Skills

IV. Dealing with Past Issues that Continue to Impede Progress

V. Transferring Learning to New Life Settings

4 crisis prevention institute
#4. Crisis Prevention Institute
  • Non-Violent Crisis Intervention
5 behavioral supports
#5. Behavioral Supports
  • Making it Right
  • Restorative Justice
  • Cadet Council
  • Positive Incident Reports
i mua mau ohana imo
I Mua Mau `Ohana: IMO
  • SAMHSA TCE: Targeted Capacity Expansion
  • Joint Program Enhancement Award: 2002 Marimed Foundation and Maui Youth and Family Services
    • Voyaging (For MYFS)
    • 12 month Continuing Care (All Islands)
instrument
Instrument
  • Utilized the Global Appraisal of Individual Needs (GAIN) Core Version
  • GAIN also contains SAMHSA Government Performance and Results Act (GPRA) Instrument
demographics
Demographics
  • Gender: 71% male, 29% female, 1% TG
  • Average age = 16 years old
  • Ethnicity: 62% Native Hawaiian, 41% Caucasian, 37% Asian, 24% other Pacific Islander, and 24% Hispanic (many multi-ethnic)
  • Past 12 months living with: 71% parent(s)
  • Treatment prior to intake:
    • 58% received treatment before; average=1.2 admissions
    • 51% felt they needed treatment
criminal justice involvement
Criminal Justice Involvement
  • 87% had lifetime arrests
education employment
Education & Employment
  • 89% of youth were enrolled in school or training
  • Only 5% reported engaging in some type of “non-full-time work”
summary
Summary
  • Youth mostly Native Hawaiian and other Pacific Islander
  • Youth at intake showed high levels of criminal justice involvement, substance use, and both internal and external behavior problems.
  • Significant reduction in arrests and days in juvenile detention
  • Significant reductions in substance use and related substance problems
  • Significant reduction in emotional problems
wahiolanona opio
Wahiolanona`opio
  • Received SAMHSA TCE Earmark for Methamphetamine Treatment 2004
instruments
Instruments
  • Wahiolanona`opio Survey
    • GAIN-Q
    • Family Management, Family Bonding, Self-Efficacy, Cultural Pride, & School Bonding
  • Government Performance and Results Act (GPRA) Instrument
data collection
Data Collection
  • From July 1, 2004 to September 30, 2006
  • 58 total admissions
  • Baseline assessments
    • 52 GPRA
    • 46 Wahiolanona’opio surveys
  • Three-month assessments
    • 39 GPRA
    • 34 Wahiolanona’opio surveys
  • Six-month assessments
    • 32 GPRA
    • 27 Wahiolanona’opio surveys
  • 12-month assessments
    • 16 GPRA
    • 11 Wahiolanona’opio surveys
demographics1
Demographics
  • Gender: 69% male; 31% female
  • Age: range=13-18, avg.=15.7 years old
  • Education: range=6th-11th grade, avg.=9.2 years
qualitative findings i
Qualitative Findings I
  • Sample of participants from the residential and day treatment programs were interviewed
  • Most participants felt they had changed positively, including increased acceptance of responsibility, honesty, problem solving, anger management, self-esteem, patience, positive attitudes, pro-social behaviors, academic performance, and remaining drug free
  • Some participants also felt their families and their relationships with their families changed for the better
qualitative findings ii
Qualitative Findings II
  • Participants felt staff gave them support, hope, and skills to deal with their problems
  • Participants enjoyed the learning and experiences they acquired
  • When asked what was difficult about working with staff, participants mentioned lack of consistency and organization
  • Other concerns related to thelocation and living conditions of the home
limitations of findings
Limitations of Findings
  • Small sample size
  • “Selection bias” due to follow-up survey completion rate
  • Cultural sensitivity of required measures
  • Social desirability
summary i
Summary I
  • Substantial decreases in AOD use at all follow-ups and reduced impact of AOD use at both 6- and 12-month follow-ups.
  • Increasing improvements in high-risk behaviors at each follow-up.
  • Although decreases in enrollment in school, there was increased school functioning for youth still in school and increased engagement in work for other youth. Qualitative data also suggests some improvement in academics.
summary ii
Summary II
  • While some increases in psychological/emotional problems revealed, decreases in external behavior problems also revealed. By 12 months, improvements shown in both internal and external behavior.
  • Increases in self-efficacy and cultural pride also shown at all follow-ups.
  • Although family functioning scales showed only slight improvements, qualitative data suggests some improvements.
  • Improvements in living conditions and number of youth receiving various types of treatment.
where are we now
Where Are We Now?
  • Next Steps
  • Barriers
t s eliot
T. S. Eliot

“We shall not cease from exploration

And the end of all our exploring

Will be to arrive where we started

And know the place for the first time.”

T.S. Eliot

thank you
Thank You

Senator Daniel Inouye

Mayor Harry Kim (Hawai`i County)

Billy Kenoi

Char Shigemura

All Hawai`i Treatment Providers and Educators

Richard Kim, Ph.D., The Catalyst Group, LLC

mahalo
Mahalo

The end