On January 24, 2014, the North Carolina Practice Improvement Collaborative met to learn from speakers providing personal experiences in implementing evidence-based practices in the public system. Arthur Evans, Ph.D., Commissioner, Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, was the keynote speaker and exemplified the theme of this year’s topic, Improving Outcomes: Improving Lives. He emphasized the importance of implementing evidence-based practices (EBPs) to improve the likelihood of achieving positive clinical outcomes and the need to implement them with fidelity and in the context of the local community. He gave examples of EBP implementation initiatives in Philadelphia and concluded with ten lessons learned from these initiatives.
Cheryl Sharp, Special Advisor for Trauma Informed Services at the National Council for Community Behavioral Health, emphasized the pervasiveness of trauma (i.e., 56% of Americans have experienced at least one of the Adverse Childhood Experiences, or ACEs; http://www.cdc.gov/ace/ and www.ACEstoohigh.com) and the need to understand trauma and its impact on later life. She outlined the principles of a trauma-informed approach at both the provider and organization levels: safety; trustworthiness and transparency; collaboration and mutuality; empowerment; and voice and choice.
Eight team members of the Robeson County Bridges for Families Program presented. Sherri Green, Ph.D. gave an overview and noted that the program is a product of collaboration at both the State and local levels. At the State level is a core management team that facilitates decision making about administration, fiscal management, and data sharing. The local implementation team then presented the various aspects of the program. Judge Stan Carmical and Valerie Comrie provided the perspective of the family drug treatment court (FDTC) in terms of best court practices. Shirley Williams addressed the implementation of two evidence-based treatment interventions, Seeking Safety and the Matrix Model. LaTasha Murray focused on the evidence-informed prevention model, the Strengthening Families Program. Ghee Blain Johnson represented social services, and Amy Cox highlighted Guardian ad Litem. McLean Pollock presented on the evaluation of EBP implementation and of the collaborative. Even though the sample size was small and it is a program evaluation, not a research study, the preliminary findings indicated that FDTC families are engaged with child welfare longer and have less maltreatment recurrence and that families in this type of program are more stable.
Lorna Moser, Ph.D., Center for Excellence in Community Mental Health in the Department of Psychiatry, University of North Carolina School of Medicine provided a history of Assertive Community Treatment (ACT) and the perspective that it is a platform that reflects changes in emphases, targets, and technologies. Dr. Moser iterated that “treatment should align with chosen outcomes” and be recovery oriented. She then discussed the Tool for Measurement of ACT (TMACT), an instrument used to assess fidelity to the ACT model that she and her colleagues have been developing. She concluded by discussing the roll-out of ACT in the State and the key role that the Division of Mental Health has played.
Eighty-one individuals, representing family members, state agencies, LME-MCOs, provider agencies, and universities attended the event. Forty-five completed an evaluation of the meeting.