DISPELLING THE MYTH THAT EBPS ARE TOO NARROWLY TARGETED: MST AS A - - PowerPoint PPT Presentation

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DISPELLING THE MYTH THAT EBPS ARE TOO NARROWLY TARGETED: MST AS A - - PowerPoint PPT Presentation

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DISPELLING THE MYTH THAT EBPS ARE TOO NARROWLY TARGETED: MST AS A CASE EXAMPLE FOR BROAD OPPORTUNITY Ashli J. Sheidow, PhD, Oregon Social Learning Center Elisabeth Cannata, PhD, Wheeler Clinic Chanel Hildebrand, LCSW, Wheeler Clinic Discussant:

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DISPELLING THE MYTH THAT EBPS ARE TOO NARROWLY TARGETED: MST AS A CASE EXAMPLE FOR BROAD OPPORTUNITY

Ashli J. Sheidow, PhD, Oregon Social Learning Center Elisabeth Cannata, PhD, Wheeler Clinic Chanel Hildebrand, LCSW, Wheeler Clinic Discussant: Rosalyn Bertram, PhD, University of Missouri-Kansas City

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AN ADOLESCENT EBP FOR COMMUNITY BEHA VIORAL HEALTH: A RESEARCH PERSPECTIVE

Ashli J. Sheidow, PhD Oregon Social Learning Center (OSLC), Eugene, OR Contact: ashlis@oslc.org

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Acknowledgements

  • Thanks to the various agencies for financial support:
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Overview

  • Review of treatments for adolescents behaviors
  • Disruptive behavior
  • Substance abuse
  • Multisystemic Therapy (MST)
  • Delivery of this Evidence-Based Practice (EBP) in the “real

world”

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Adolescent conduct problems

  • What percentage of juvenile offenders in the U.S. receive an

evidence-based treatment?

  • A. 5%
  • B. 50%
  • C. 85%
  • Conduct-related problems are #1
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Comprehensive review

  • 48 years of research
  • 7,216 abstracts
  • >400 papers reviewed
  • 86 empirical publications

covering 50 unique treatment protocols

  • McCart, M. R. & Sheidow, A. J. (2016).

Evidence-based psychosocial treatments for adolescents with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 45, 529-563. PMCID: PMC27152911

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Review results

  • Well-Established Treatments
  • Multisystemic Therapy (MST) (Henggeler et al., 2009)
  • Treatment Foster Care Oregon (TFCO), formerly Multidimensional

Treatment Foster Care (MTFC) (Chamberlain, 2003)

  • Probably Efficacious Treatments
  • Functional Family Therapy (FFT) when highly adherent (Alexander, Pugh,

Parsons, & Sexton, 2000)

  • Aggression Replacement Training + Positive Peer Culture (Equipping

Youth to Help One Another [EQUIP]) (Gibbs, Potter, & Goldstein, 1995)

  • Solution-Focused Group Program (Shin, 2009)
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Adolescent substance abuse

  • Hogue, A., Henderson, C. E.,

Ozechowski, T. J., & Robbins, M. S. (2014). Evidence base on outpatient behavioral treatments for adolescent substance use: Updates and recommendations 2007–2013. Journal of Clinical Child and Adolescent Psychology, 43, 695-720.

  • Family-Based Ecological

Treatments

  • MST & FFT are on both lists
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Multisystemic Therapy (MST)

  • The research base
  • Prevent out-of-home placement
  • Home-based
  • 3-5 month treatment duration
  • Team of 2-4 therapists and a supervisor
  • 4-6 cases/therapist
  • 24/7 availability
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Ecological Model of Problem Conceptualization

Youth Family Peers School Neighborhood Community

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Final Pop Quiz

  • Where is the best place to get yummy food in Tampa?
  • A. La Teresita Restaurant
  • B. Pipo’s Café
  • C. Columbia Cafe
  • D. Mandy’s Restaurant
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EBPS AS OPPORTUNITY: PROVIDER PERSPECTIVE

Elisabeth Cannata, PhD, Vice President Community-Based family Services & Practice Innovation Wheeler Clinic, Plainville, CT

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Connecticut Service System

  • Since 2000 call to action, a continued commitment to provide

interventions that :

  • Keep children and teens in their homes and communities
  • Promote strengths and strengthen families
  • Investment in broad statewide dissemination of an array of

evidence-based or promising practice treatment models

  • Multiple models
  • Multi-system support
  • Investment in infrastructure to sustain rigor
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  • Founded in 1968
  • Commitment to meeting community need
  • Over 900 employees, 27 locations, over 100

programs across lifespan and service continuum:

  • Prevention
  • Behavioral Health and Addiction Treatment
  • Child welfare/foster care
  • Care coordination
  • Special education
  • Justice
  • Integrated Healthcare

About Wheeler

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  • Recognized as a leader in rigorous implementation
  • f EBPs and partnerships to support model

expansion for promising practices

  • In area of research-supported in-home family

treatment:

  • Multisystemic Therapy
  • Multidimensional Family Therapy
  • Brief Strategic Family Therapy
  • IICAPS

About Wheeler

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MST Expanding Opportunity at an Organizational Level to Better Serve Communities:

  • Accountability:
  • Offering treatments with proven track record
  • Clinician responsible for client engagement
  • Rigorous QA focused on model fidelity
  • Lessons about how we collect and review client data
  • Implementation Science
  • Clinician development
  • Network Connections
  • Consultant feedback and support – expands support to clinicians
  • Connection to provider community
  • Opportunity to identify community challenges/solutions
  • Generate data to inform community needs
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MST Expanding Opportunity to Promote Change Within Communities

Ecological approach of MST:

  • Inherent focus on community variables that contribute to

delinquency

  • Clinicians focus on connecting families to supports in

their natural ecology and confronting barriers

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BROAD SCOPE OF INTERVENTION WITH MST: CLINICIAN PERSPECTIVE

Chanel Hildebrand, LCSW, Wheeler Clinic, Plainville, CT

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“Finding the Fit”

Behavior of concern Family School Peers Individual Community

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Addressing Interactions Between Person and Environment

  • Parents and youth may identify problematic relationships with

police, anti-social peers, or members of the community as primary contributing factors that reinforce maladaptive behaviors.

  • Parents often identify living in communities with high crime,

low positive linkages with police, low community resources and school based services as primary areas of concern for their

  • adolescents. MST clinicians develop direct interventions to

foster and cultivate improved relationships between clients and these entities in ways that are appropriate and specific to that family.

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Connecting Families In the Community

  • Building trusting relationships with law enforcement
  • Advocating for more community policing and outreach with local police

departments

  • Police athletic leagues
  • Police explorers programs
  • Gang outreach
  • Increasing collaboration with schools and probation
  • Increasing community responsiveness and positive action
  • Increasing youth involvement in community pro-socials
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Case Examples

http://image.timesheraldonline.com/storyimage/NH/20150623/NEWS/150629952/AR/0/AR-150629952.jpg&maxh=400&maxw=667

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Contact information:

ecannata@wheelerclinic.org ashlis@oslc.org childebrand@wheelerclinic.org MST White Paper: Combatting Racial Disparity in the Juvenile-Justice System with MST is available at: https://cdn2.hubspot.net/hubfs/295885/white_papers/Comb atting_Racial_Disparities.pdf