Implementing Evidence-Based Practices

1. Implementing Evidence-Based Practices The Addiction Technology Transfer Center Network Funded by Substance Abuse and Mental Health Services Administration

2. 1. Systems change model Definitions Principles Strategies Activities Steps 2. Case study 3. Discussion Overview

3. 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 Includes

4. Barriers Can Include • Administrative philosophy • Organizational policy • System structure • Unclear literature • Agency staff • Client population

5. ???? So, how do you decide what to do?

6. Principles Strategies Activities Steps The Change Book

7. Change Initiatives Must Be • Relevant • Clear • Multifaceted • Bi-directional • Timely • Credible • Continuous The Principles

8. Don’t Forget the Last Three • Multifaceted • Continuous • Bi-directional The Principles

9. Creating Your Blueprint The Ten Steps

10. 1. Identify the problem 2. Organize a team 3. Identify an outcome 4. Assess your organization 5. Assess your audience Ten Steps of Effective Change Initiatives The Steps

11. 6. Identify the approach 7. Design action and maintenance plans 8. Implement the plans 9. Evaluate your plans 10. Revise your plans Ten Steps of Effective Change Initiatives The Steps

12. Administrative/structural Bi-directional dialogue Information dissemination Education Person to person Evaluation Types of Activities

13. Systems Change: A Case Study

14. 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

15. 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

16. VOA Women’s ProgramNo Arrests After One Year • Completed treatment 1999 - 48% • Did not complete 1999 - 26%

17. VOA Women’s ProgramNo Arrests After One Year • Completed treatment 1999 - 48% 2001 - 86% • Did not complete 1999 - 26% 2001 - 67%

18. Our Change Process - Lessons Learned Stage of Change Action Principle

19. Our Change Process - Lessons Learned Stage of Change Action Principle

21. 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.D Patricia Mac Kenna, M.A. 416-539-9300 vandieten@aol.com Moving On

22. Our Change Process - Lessons Learned Stage of Change Action Principle

23. Our Change Process - Lessons Learned Stage of Change Action Principle

24. In Summary

25. 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

26. 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

27. Final Tips • 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

28. Implementing Evidence-Based Practices The Addiction Technology Transfer Center Network Funded by Substance Abuse and Mental Health Services Administration