“What does it take to become ‘evidence-based’?”

By: Dr. Cheri Shapiro, Director

I recently was asked a great question about a new program started by an organization: “What does it take to become ‘evidence-based’?”

Starting a program for children, youth, families, or parents begins with a need and a good idea.  The next steps include a number of important decisions:

  • Who the program is for? (Well-defined target population.)
  • What the program intends to accomplish? (Goals or outcomes.)
  • What does the program contain? (Content.)
  • How will the program will be delivered?
  • Who will deliver the program?
  • How will the program be paid for?

These questions are just a start!

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Database makes program search easier

By: Dr. Cheri Shapiro, Director

Today’s post is all about lists, lists, and more lists!  I have written a few times about the lists or registries of evidence-based interventions that are available to guide organizations, providers, and policymakers in exploration and selection of potential programs.  Today, I add one more to the “list of lists” — the Results First Clearinghouse from The Pew Charitable Trusts.

Designed for policymakers, The Results First Clearinghouse Database brings together information from multiple national clearinghouses in order to make the search for programs easier.  A color system is used for rating programs based on the strength of supporting evidence that also acts as a “crosswalk” from other rating systems (e.g. those used by NREPP or Blueprints).   And, searches result in a downloadable database!

Happy hunting!

How can caregivers find the best EBT provider?

By: Dr. Cheri Shapiro, Director

When children, youth, or families are struggling, finding a provider who can offer scientifically supported methods of support or treatment is only a part of the solution.  We need to find providers that we respect, that we are comfortable with, and that we have confidence in. As a wise colleague has said, “It’s all about the relationship.”

Seeking treatment for a child or adolescent mental health or substance use problem is hard.  Taking the first step can involve asking people we know for recommendations, searching the internet for providers, calling local treatment providers, or talking to those who have had similar challenges.  The next step can be even harder — making that first visit.  What should you look for then?

Changing behaviors is hard work, and it may take a few tries to find the right treatment provider.  Many providers offer the opportunity for a short first visit, just to make sure that they can offer the type of service that you might need. In some cases, you may be able to speak with the provider over the phone.  In other cases, you may need to schedule a first appointment and meet the provider at that time.

So what are you looking for during these first visits?  Someone that you feel comfortable with, that you can imagine working with over a period of weeks or possibly months.  You want someone that you feel is supportive, because there will be times when treatment is hard to do.  It’s important to find someone who listens well, and communicates clearly about what kind of treatment will be provided, why this approach may work, and what other approaches are available.  Also, the practitioner should be someone who can talk about how you will know if treatment is working or not.  As a parent or caregiver, we want to trust that the provider can help us and believe that change is possible, knowing that it will take work on our part.

Finally, try not to wait until the problem is so big that it seems overwhelming.  Reach out sooner rather than later and look for the right match.

SAMHSA creates new EBI resource center

By: Dr. Cheri Shapiro, Director

In an earlier post, I wrote about the ending of the contract for NREPP by SAMHSA.  Today, we have important information about a new Evidence-Based Practices Resource Center that SAMHSA has created. (Read the press release on this new resource here.)

This new Resource Center is designed to provide tools and support for implementation of evidence-based practices.  Topic areas include opioid specific resources, resources for substance use prevention, treatment, and recovery, as well as resources for serious mental illness and other mental health issues.  The information can be targeted to specific audiences, including clinicians, patients, policy makers, and others.

I encourage you to check out this important new tool that can help us reach our goal of providing scientifically-supported interventions to the families that we serve!

Why assessment is critical at every stage of treatment

By: Dr. Cheri Shapiro, Director

In an earlier post, I spoke about the role of assessment in treatment.  In delivering evidence-based interventions for social, emotional, or behavioral challenges in youth, most intervention manuals, guidelines, or protocols call for some type of assessment of presenting concerns, usually at the beginning and end of treatment.  One rationale is to have a better understanding of exactly what the challenges are when you begin, and to know if you were successful at the end.

However, there is a lot that happens between the “beginning” and the “ending” of treatment, and there are many ways to find out how treatment is progressing.  One approach is to use a measurement tool at each session, or, every few sessions, in order to understand what gains have been made or what challenges remain, and to track for new problems that could arise.  For example, short instruments designed to assess symptoms of anxiety, stress, or substance use can be given frequently during treatment (such as the Beck Depression Inventory).  Other measures may ask about more generally how a client is feeling (such as the Outcome Rating Scale).  Yet other measures are designed to track the therapist-client relationship (such as the Session Rating Scale).

Importantly, we cannot always rely on our professional opinion to know when or if a client is improving.  Keeping an open mind and inquiring along the way – by collecting data from and with our clients – can help us be more effective in treatment planning and delivery.  The families we serve are our most important collaborators in the process, and their progress is the ultimate driver of our work.

Why communication is key for all providers

By: Dr. Cheri Shapiro, Director

Recently, I have encountered important clinical questions regarding types of treatments.  More specifically, many clients are receiving care by medical professionals as well as mental health or substance use treatment providers.  Medication and psychosocial treatments commonly go hand in hand; in fact, for some conditions, a combined treatment approach (here specifically defined as combining medication and psychosocial interventions) has been found to be most effective for improving overall functioning.  Examples include ADHD and early stage schizophrenia, among others.

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