In September 2011, the North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services administered a web-based survey to provider agencies to determine the extent to which evidence-based practices (EBPs) for children and adults with mental health, substance abuse, and intellectual and developmental disabilities were being implemented and monitored across the State. Emails were sent to 215 provider agencies. Of this number, 88 responded for a 40.9% response rate (111 provider agencies did not respond, and delivery failed for 16).
The 88 provider agencies indicated that they served the following populations:
- Adult mental health: 66 provider agencies (75.0%)
- Child mental health: 74 provider agencies (84.1%)
- Adult substance abuse: 49 provider agencies (55.7%)
- Child substance abuse: 40 provider agencies (45.5%)
- Adult intellectual and developmental disabilities: 16 provider agencies (18.2%)
- Child intellectual and developmental disabilities: 15 provider agencies (17.2%)
Of the 66 provider agencies that offered adult mental health EBPs, 15 offered integrated dual diagnosis treatment (IDDT), 13 assertive community treatment, 9 family psychoeducation, 9 peer support, 8 self-management, 7 clubhouses, 3 medication algorithm for bipolar disorders, 3 medical algorithm for schizophrenia, and 3 supported employment.
Of the 74 provider agencies that offered child mental health EBPs, 34 offered Cognitive Behavioral Therapy (CBT) for depression, 29 CBT trauma, 28 CBT anxiety, 13 Dialectical Behavior Therapy, 11 Seeking Safety, 11 Child-Parent Psychotherapy, 8 Parent-Child Interaction, 5 Multi-Systemic Therapy, 4 Teaching Family Model, 3 Functional Family Therapy, and 2 Incredible Years.
Of the 49 provider agencies that offered adult substance abuse EBPs, 24 offered Motivational Interviewing, 10 Relapse Prevention, 8 Dialectical Behavior Therapy, 7 Matrix Model, 7 IDDT, 5 Contingency Management, 5 SBIRT (Screening, Brief Intervention, and Referral To Treatment), 5 Motivational Enhancement Therapy, 4 Medication-Assisted Treatment, 4 Buprenorphine, 3 Acceptance and Commitment Therapy, and 1 Seeking Safety.
Of the 40 provider agencies that offered child substance abuse EBPs, 21 offered Motivational Interviewing, 15 Trauma-Focused CBT, 11 Seven Challenges, 8 Cannabis Youth Treatment, 5 Strengthening Families, 3 Adolescent Community Reinforcement Approach, 3 Family-Centered Therapy, 3 LifeSkills Training, 3 Brief Strategic Family Therapy, 2 Functional Family Therapy, 1 Multi-Systemic Therapy, and 1 Towards No Drug Abuse.
A review of the data related to regular fidelity monitoring indicated that in general, less than 50% of the provider agencies conducted fidelity assessment on any EBP across the disabilities. Rates for provider agencies providing clinical supervision and conducting quality assurance were higher but dependent on the individual EBP.