There are some exciting events happening at the Center of Excellence. We recently hosted a training for a group of both public and private providers in a modular approach to treatment called Managing and Adapting Practice (MAP); the next several posts will be dedicated to better understanding of this approach to treatment.
As I noted in an earlier post, Dr. Bruce Chorpita and Dr. Eric Daleiden, along with their colleagues, examined a large number of effective child mental health treatments used in clinical trials and identified the most common clinical strategies. These common elements are thought to be the active ingredients in treatment and help us to understand what works to help address problems such as (but not limited to) anxiety, depression, behavior or conduct problems, and traumatic stress. This information has been formalized into the MAP system.
As noted by Dr. Chorpita, the MAP system was designed to address a concrete problem encountered in modern behavioral healthcare—improving outcomes and quality of care. MAP originated in the Hawaii’s Child and Adolescent Mental Health Division (CAMHD), a system of care serving youth with intensive mental health needs (Daleiden, Chorpita, Donkervoet, Arensdorf, & Brogan, 2006). The goal was to improve services to all youth and families served by the system and to complement existing, well-established evidence-based interventions.
This precursor of MAP included three strategies: (a) dissemination of knowledge resources that inform providers about the array of EBTs with supporting evidence for specific target problems or diagnoses, (b) performance measurement, and (3) use of feedback tools (Daleiden & Chorpita, 2005). A four-year open trial of statewide implementation of this MAP precursor yielded a doubling of the rate of change on a measure of functioning (an effect size of .87), shortened treatment episodes (i.e., by 40-60%), and 40% the cost per unit change.
In 2009, MAP, in its current form, was introduced into Los Angeles County (LAC) through a county-wide initiative spurred by the Department of Mental Health to implement more than 50 EBTs. Analysis of outcome data for more than 1,100 youth treated with MAP within a 2-year period demonstrated significant improvement over time, as indicated by large effect sizes (e.g., d = .76; Southam-Gerow et al., 2014). It is now the most widely used service in LAC, accounting for approximately 40% of all Prevention and Early Intervention Services. MAP has been in use in a variety of configurations in service systems around the country and the world since 2003.
The work of the first cohort of providers in training to become MAP Therapists here in South Carolina is underway. Future posts will provide additional information on the MAP system and Center plans in this area.