1. Infusing Evidence-Informed Treatment Into Current Practice
J.R. Griffin, LCSW

2. Typical Clinical Supervision and Staff Meetings
Structure/Format
Frequency
Focus
Supervision Model
Group vs. Individual; How often of each; Clinical vs. Administrative vs. Venting/Support

3. Typical Clinical Training
In-services
One-day trainings
Licensing required courses
Few times a year
How often use what learned in these trainings?

4. Typical Clinical Practice
Common philosophies of graduate schools
Entry-level therapists
“Eclectic Approach”
Ecosystems, strengths, empowerment practice, “stay informed of EBP” (school teaches strengths-based/solution focused); some hint of CBT, focused on theory more than practice field placements

5. Impact of “Treatment as Usual”
Outcomes and Productivity
Billing
Morale
Family’s lives
Line staff are most valuable asset
Everything we measure comes from the client interactions – why so nonchalant about it?

6. EBT Shared Traits Structured and Purposeful Adherent to Model
Therapeutic Relationship
Differs from traditional “family engaging”
Regular training via consultation and/or supervision

7. EBT v. Supervision As Usual
Family-focused
Supervisor as teacher
Direct and supportive feedback
Consistent clinical training
Model adherence
Purposeful
Individual and group
Demographics, time of drop, e.g.
Planning
Direct observations
Model adherence extremely important, these are structured models. Repetitive at times; Generalize clinical feedback to all case; session planning/structured

8. FFT Supervision Group 1x/week Individual 1x/week + Phone Calls
2-4 cases/week
Individual 1x/week + Phone Calls
Entire caseload, if possible
Regular Phone Calls with Consultant

9. Implementing EBT - Where to Start?
Size and makeup of agency workforce
Who to train?
Primary populations served, in what setting
Data driven
Dig deep and be creative
Budgetary Considerations
Ability to implement more than one, education level; primary clientele drives what we want (CBT most broad)

10. FFT Training Project High Time in Program (TIP) Low Completion Rates
132 Days in 2013
Low Completion Rates
Never higher than 67% from

11. FFT Training Project, cont’d
Outcomes on Closed Families
85% of families maintaining progress 3 months post-treatment (no further legal involvement and remaining in the home)
90%+ on all other contracted outcomes
Post Externship Data
Site lead = 81% completion, 104 days TIP
Therapist R = 67% completion, 118 days TIP
Rest of team = 62% completion, 140 days TIP
Project Description
Replicate externship
Emphasis on observation, feedback, and coaching
All other attempts had failed, e.g., staffing cases at certain points, treatment pacing

12. Project Outcomes (August 2016)
Level of Service
Completion Rate
Time in Program
Outcomes
Pre
- 83% in 2013
- 91% in 2014
Never higher than 67%
140 days from
85% positive 3 months post
92% no legal involvement
Post
96% in 2015
100% last 6 months 2015
78% 2nd half of 2014
81.4% in 2015
84.5% 2nd half of 2015
115 days in 2014
113 days in 2015
94% positive 3 months post
97% no legal involvement
2016 YTD
n/a – therapist on leave (prorated = %)
88.1%
From Feb-June, completed 28 In a row, 40/42 (95%)
116 days
97% positive 3 months post
- 100% no legal involvement

13. Project Take-Homes Train the trainer model
- One time training = One time cost = Sustainable
Incorporated into program practice
Regular videotaping and observations
New hire midway through project
Data to justify grant was not an outcome or measurable

14. Important Considerations
Agency Culture
Current Workforce
Readiness for change
Who to train?
Hiring
Budget
Future of the field
Train the trainer = supervisors, agency leaders in order to be able to train new staff; hiring staff open to critical feedback/not eclectic, but will make change. Future is EBT

15. Local EBT available CBT DBT www.beckinstitute.org
Training available for organizations
Frequent one day trainings
DBT
Training available in multiple EBT
One day trainings available
Contact trainer

16. Local EBT Available TF-CBT PCIT www.tfcbt.musc.edu www.pcit.org
10 CEUs possible
PCIT
Free 10 hour web-course on providing PCIT

17. Local EBT Available
California Clearinghouse on Evidence-Based Treatments
Includes guides on selecting and implementing EBT
Your Agency
Supervisions and staff meetings
Continuing Education

18. Summary Agency’s Most Valuable Asset Questions and Comments
J.R. Griffin, LCSW
x. 750
Families are the main reason