In a recent post, I wrote about The Families First Prevention Services Act and the associated Title IV-E Prevention Services Clearinghouse. The Clearinghouse is live, is reviewing multiple programs for potential inclusion, and can be found here.
This Act has energized discussions about adoption of evidence-based programs and interventions. One important question that systems or organizations ask when considering adoption of evidence-based behavioral health interventions is, “Which program should we select?” However, we may not be asking the right question. The better question might be, “Which combination of evidence-based programs and practice elements from these programs is likely to help us achieve our desired results for the largest number of youth and families in need?”
Dr. Adam Bernstein and colleagues have written a thoughtful article demonstrating the need for combining evidence-based programs with practice elements derived from these effective interventions in order to reach the largest number of youth in need. (See Bernstein et al., 2015, Building an Evidence-Informed Service Array: Considering Evidence-Based Programs as Well as Their Practice Elements, Journal of Consulting and Clinical Psychology, 83,6, 1085-1096.)
In real world settings, it is becoming more common for systems to consider adoption of a number of programs when contemplating services to an entire population. For example, to meet the diverse needs of children, youth, and families, the Los Angeles County Department of Mental Health provided training in six evidence-based programs and practices (see Southam-Gerow et al., (2014). MAPping Los Angeles County: Taking an Evidence-Informed Model of Mental Health Care to Scale, Journal of Clinical Child & Adolescent Psychology, 43(2), 190-200).
While having an array of programs at a community level is critical, the story may be different when we consider individual providers. Recent research suggests that at the provider level, we are most likely to be able to effectively implement only one or two evidence-based interventions or programs. Thus, as systems plan for implementation of effective interventions and supports, adoption of evidence-based interventions along with a system to deliver specific practice elements distilled from evidence-based interventions may be needed to extend provider capacity without harming integrity of service delivery.