Patient Population: Children

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.

A Research Institute for Implementation Science in Education (RIISE) to address the “Last Mile” in education

Longstanding gaps between science and practice in schools have contributed to a persistent “last mile” problem in which education research consistently fails to reach the individuals for whom it was intended. Implementation research is an emerging scientific study in education of methods to promote the systematic uptake of research findings and evidence-based programs and practices into routine services. The purpose of this three-year methods training grant is to increase the number of education scholars with expertise in conceptualizing, designing, and executing implementation research studies. We propose to establish a Research Institute for Implementation Science in Education (RIISE) that will provide training and mentorship to increase human intellectual capital devoted to implementation research study design in education and build a network of implementation scientists devoted to bridging the “last mile.”

Development and testing of a research-based Tier 3 Wraparound model for schools

This project will adapt the defined, research-based, Wraparound care coordination model for youth with complex behavioral health needs to the education environment, including training curricula, installation protocols, fidelity measures, and other components. The project will initially convene national experts and local stakeholders who will review and aid in iterative refinement of materials, followed by a small-scale pre-post pilot, and culminating in a small-scale randomized pilot study comparing proximal and distal outcomes for 60 students in 6 elementary schools assigned to the “Tier 3 Wraparound” protocol versus services as usual.

Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment

Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.