As a behavioral health provider, you know that delivering programs in the real world is one of the most rewarding and difficult jobs we can do. Every client and family is unique, and clients we serve do not often fit within a specific category of problem area. A common challenge faced by providers in delivering evidence-based interventions is difficulty tailoring interventions to fit with our clients’ needs and preferences. Another common problem, that occurs regardless of intervention approach, is how to manage problems that arise during the course of treatment.
As wise friend has said many times, “stick with the plan.” So how does this apply to delivering therapeutic services?
The first approach to take is to try the intervention as it is written or as it is intended to be used. Modifications should be considered if the initial approach does not produce the desired outcomes. And, as we have talked about before, there are ways to be flexible while maintaining fidelity to the selected approach. However, it is quite common for youth or families to experience continued or new problems or concerns during treatment. How do we address these concerns within evidence-based approaches?
First, can you anticipate likely challenges that youth or families you work with might encounter? For example, might feelings of anxiety get worse before they get better? Might difficult or challenging behavior increase before it decreases? Talking about these possibilities at the beginning of treatment can be helpful to prepare clients for what lies ahead. Honest conversations early in the treatment process about the intervention you are delivering and what a client can expect can be helpful if and when challenges arise.
When challenges or concerns do arise, you might ask yourself if the crisis or problem at hand is an example of the issue you are trying to treat. If so, how can you use this current situation within the context of treatment delivery? If the situation is a new concern, should the plan for treatment be revisited? Is the treatment approach originally considered still the best way to proceed? Should additional assessment be considered to inform a new direction for treatment? Should a referral be made for a different type of service?
Regardless of the intervention being used, or the challenges that may arise, having honest conversations, preparing ahead for possible challenges, and addressing issues or concerns as soon as they appear may be the best course of action for both families and providers.