The Evidence-Based Practice Institute (EBPI) is a partnership between the University of Washington and the Washington State Healthcare Authority (HCA), housed at CoLab. We promote the use of evidence-based practices in Washington State through training, research, workforce development, and data sharing. EBPI was initially established as an independent institute in 2007 by the Washington State Legislature House Bill 1088, with the goal of strengthening the quality of public children’s behavioral healthcare. Now, EBPI is housed under the broader umbrella organization of CoLab and continues to serve as a statewide resource to promote high quality mental health services for children and youth in Washington State.
Patient Population: Children
Cultural adaptation of WHO’s Caregiver Skills Training program for Mongolian parents of autistic children
In Mongolia, there are virtually no services or professionals who can provide any related services for autistic children and their families. In response to these disparities of autism care in many countries, the WHO developed the Caregiver Skills Training (CST), which is a training program that teaches basic behavior management skills that are often needed for caregivers of autistic children. Although CST can be widely disseminated among Mongolian families, it has not been translated or adapted to fit the needs of Mongolian caregivers due to logistical difficulties and costs. This project aims to: (a) conduct rigorous cultural adaptation and translation of the CST materials, and (b) demonstrate community-academic partnership and a model for global collaboration in autism intervention research
Developing a pediatric telebehavioral health consultation model for emergency departments
As rates of pediatric mental health emergencies have skyrocketed over the last decade – and even more so since the Covid-19 pandemic – the number of youth staying in emergency departments (EDs) and medical units while awaiting inpatient psychiatric care or stabilization (i.e., “boarding”) has reached unprecedented levels. The massive surges in patient volume, coupled with widespread staff shortages and lack of staff expertise in treating mental health, are overwhelming ED and hospital resources. This causes dangerous or even life-threatening delays in care for youth populations in greatest need of medical and psychiatric treatment. Prolonged ED stays not only delay necessary mental health care, but they can cause additional trauma and distress for youth already in crisis. While the boarding crisis affects all hospitals and EDs, it poses an even greater challenge to community EDs that lack on-site mental health specialists and/or pediatric providers.
To address the boarding crisis, this project will pilot a model in which a multidisciplinary team of mental health clinicians at Seattle Children’s Hospital provides telebehavioral health consultation to community EDs in Western Washington to guide care for youth who are boarding. The primary goals of this model are (1) to improve timeliness of mental health care and reduce length of stay for youth boarding in community EDs, and (2) to support ED staff in providing more developmentally appropriate and evidence-informed mental healthcare. The Seattle Children’s team will provide case consultation to ED providers and staff, including support with decisions about hospitalization, medication treatment, behavioral interventions and case management services. The team will also deliver practical trainings to community ED staff to build their internal capacity to care for boarding youth. If this initiative is successful, additional funding could expand ED telebehavioral health consultation services statewide, with a focus on rural communities.
Evidence synthesis for policy program
Using a scoping review approach, CoLab is systematically looking for reviews and authoritative sources to guide a model for value-based care for pediatric behavioral health. Our review approach was informed by guidelines for scoping reviews and rapid evidence reviews. The initial goal of this project was systematically looking for reviews and authoritative sources to guide a model for value-based care for pediatrics and mental health. Then, we would compile and synthesize the literature to see if there are any value-based models that would appear to be most effective for pediatric behavioral health care.
Embedded clinical coaching
Using an embedded clinical coaching framework, the Evidence Based Practice Institute (EBPI)/CoLab is promoting the development of quality care expertise within behavioral health agencies to reduce the cost and improve the speed of clinical workforce training. The goal of this project is to move principles of effective behavioral health care more quickly into practice, and to foster agency resilience to workforce turnover. This project is part of a broader Leadership Initiative for Quality.
To develop and eventually implement an embedded clinical coaching model, EBPI/CoLab partnered with multiple organizations in Washington to determine priorities and gather feedback. Through these partnerships, EBPI/CoLab identified key characteristics of an effective clinical coaching model, and incorporated stakeholder feedback to ensure scalability and adaptability. This coaching model includes the development of an asynchronous training for new clinicians, an embedded peer consultation structure, and competency checks through clinician-submitted videos. Through this novel embedded coaching structure, organizations can retain internal expertise and better support a shifting workforce.
Supervisor tools for quality
The Supervisory Tools for Quality initiative recognizes the integral role that clinical supervisors play in supporting behavioral health clinicians’ use of effective practices in community mental health agencies, and aims to leverage this role to improve the scale up and sustained use of quality behavioral health services. Specifically, this project is focused on the development of cost effective, easy to use, and practical strategies to elevate supervision practices. This project is part of a broader Leadership Initiative for Quality.
This initiative involved partnering with supervisors to form a Supervisor Advisory Team. This team worked to provide practical and tangible supports to supervisors in order to improve delivery of quality and effective behavioral health services, and ultimately strengthen outcomes for economically and racially marginalized children and adolescents. This advisory group included experienced supervisors in behavioral health organizations across the state. Geographic regions represented included Bellingham, Bellevue, Lakewood, Spokane, Walla Walla, and Yakima. To date, we have completed three Supervisor Advisory Team meetings.
Expanding culturally responsive care for children and families in Washington State
The Expanding Culturally Responsive Care initiative, a new project funded through a 2022 Washington State legislative proviso, aims to strengthen the lived experience behavioral health workforce and create a culturally responsive care curriculum for statewide implementation in Medicaid-serving organizations. This initiative was developed in response to Washington State’s urgent need for more culturally responsive, effective public behavioral health services–services that many families do not currently have access to. Ideally, this initiative will allow for more families to receive care that promotes true healing, mental health wellness and health equity. Curriculum and strategy development will be done through a participatory, collaborative co-design process with broad ranging input from across the state, and will center community voice, transparency, and accountability throughout all stages of the process. This project is part of a broader Leadership Initiative for Quality.
COVID-19 Student Survey
This project involved an anonymous needs assessment for 6th through 12th graders in Washington to collect data on what students thought was going well, what challenges they had encountered, and what their needs were as schools replied to largely in-person instruction following a largely virtually year because of the COVID-19 pandemic.
Exploring mechanisms of change in a pilot trial of the RUBI Program in educational settings
The purpose of this study is to: 1) compare schools randomized to the RUBIES intervention or a usual-care in-service training on teacher burnout and disruptive behavior in children with autism spectrum disorder; and 2) test RUBIES’ mechanisms of change (knowledge and skills) on teacher (burnout), child (disruptive behavior), and implementation outcomes (fidelity).
Initial efficacy trial of a group-based implementation strategy designed to increase teacher delivery of evidence-based prevention programs
The purpose of this project is to test the effects of BASIS-T (Beliefs and Attitudes to Support Implementation in Schools – Teachers) on the implementation and student outcomes of evidence-based prevention programs (EBPP) via a hybrid type 3 implementation-effectiveness trial. Failing to address individual-level motivational factors of implementers is especially costly, as individual behavior change is ultimately required for successful EBPP implementation, even when organizational factors such as evidence-informed policy, supportive leadership, and effective training are in place. Hybrid type 3 trials allow for testing the effects of implementation strategies, as well as observing the reproducibility of particular EBPPs — in this case, CHAMPS, a universal classroom management program for improving student social, behavioral, and academic outcomes.
