1. Beck Initiative Winter 2011 Regina Xhezo 1 The Beck Initiative “A Partnership in Care Planning and Positive Change” Winter 2011 Project Overview

2. Beck Initiative Winter 2011 Regina Xhezo 2 What is The Beck Initiative? A public academic partnership between UPENN & DBH/MRS to make the Evidence Based Practice (EBP) of Cognitive Therapy (CT) available to all persons in recovery throughout DBH/MRS’ network of providers in the City of Philadelphia

3. Beck Initiative Winter 2011 Regina Xhezo 3 Major Goals of The Beck Initiative To promote the sustained implementation of CT Establishing CT as a standard practice of care To improve outcomes for persons in recovery To improve the professional lives of therapists To conduct program evaluation to examine outcomes

4. Beck Initiative Winter 2011 Regina Xhezo 4 Major Goals Continued… To utilize the evidence-based practice of CT Result in one of the first large-scale implementation of an evidence-based psychotherapy in a public mental health system To serve as a model for other large mental health systems

5. Beck Initiative Winter 2011 Regina Xhezo 5 4 Levels of Transformation Level 1: Client transformation through an evidence based practice promoting recovery Level 2: Staff transformation through teachings of recovery-oriented treatment Level 3: Provider transformation through agency- wide dissemination Level 4: System transformation through network- wide dissemination

6. Beck Initiative Winter 2011 Regina Xhezo 6 Building a CT Community

7. Beck Initiative Winter 2011 Regina Xhezo 7 Beck Initiative Model Overview Part 1: 22 workshop hours on fundamentals of CT Part 2: 6 months of ongoing consultation with PENN, including: session tape review, group & 1:1 consultation, ongoing didactics Part 3: Ongoing agency peer led CT consultation group Part 4: CT model growth within the agency overtime

8. Beck Initiative Winter 2011 Regina Xhezo 8 Training Model Components Competency Rating by CT Rating Scale (CTS) Certification eligibility as a “Skilled Cognitive Therapist in a Community Mental Health Setting” Training similar to graduate level class Record and share CT sessions for feedback Start with 4-5 CT training cases ⃗ Build CT amongst caseload Long-term commitment to learning & practicing CT model Key importance of ongoing fidelity to CT model

9. Beck Initiative Winter 2011 Regina Xhezo 9 Post-Training Program Components Agency’s Internal Ongoing CT Group PENN & CBH Continued Support Submit Group Audio For Feedback Submit Group Summary Reports

10. Beck Initiative Winter 2011 Regina Xhezo 10 Current Status of The Beck Initiative Completing 4 th year of implementation 15 agencies: CT community partners 140 clinicians across network trained in CT Web-Based CT training available Current training in special populations, CT for: outreach workers & case managers who work with the chronically homeless population Child & Adolescent Expansion Project currently underway with 6 network providers

11. Beck Initiative Winter 2011 Regina Xhezo 11 Population Targets to Date SchizophreniaLGBT Community Latino Community HomelessnessSubstance Abuse School Setting RTF Forensics Depression Anxiety Outpatient Inpatient Suicidal Ideation Axis II Adults Adolescents Children

12. Beck Initiative Winter 2011 Regina Xhezo 12 Preliminary Training Outcomes Overall, 84% therapists achieved competence (CTS=40+) Practicum Model (n=19): 79% competent Individual Feedback Model (n=37): 87% competent 93% scored over a 35 by their final session Change pre- to post-training M= 16 (sd=10) Change from first score to highest score M=19 (sd=7)

13. Beck Initiative Winter 2011 Regina Xhezo 13 Preliminary Training Outcomes (n=38)

14. Beck Initiative Winter 2011 Regina Xhezo 14 Major Publications & Appearances Hong Kong Delegates Pres. Oct 08 DBHMRS Exec Mgmt Pres Jan 09 Phila. Alliance Annual Conf. Pres. Apr 09 Temple’s College of Health Physicians Apr 09 Psychiatry Online Publication Oct 09 ABCT Annual Conf. In NY Pres. Oct 09 Professional Psychology: Research & Practice Journal Publication Oct 09 World Congress of Beh. & Cog. Therapy Jun 10 APA Annual Conf. San Diego, CA Aug 10

15. Beck Initiative Winter 2011 Regina Xhezo 15 Online Publication : Psychiatric Services Oct 09

16. Beck Initiative Winter 2011 Regina Xhezo 16 Acknowledgement To Our Partners  John F. Kennedy MHMR  Horizon House  Parkside Recovery  Sobriety Through Outpatient  PATH, Inc  Warren E Smith  Community Treatment Teams  Wedge Medical  Consortium  NE Community Mental Health Center  Silver Springs  Comhar, Inc  Children’s Crisis Treatment Center  Northern Home for Children  Intercultural Family Services On Behalf of The Beck Initiative Team, special thanks to our community partners in the DBHMRS network for their continued commitment and dedication:

17. Beck Initiative Winter 2011 Regina Xhezo 17 Contacts For more information regarding The Beck Initiative, please contact: Regina Xhezo, MS Beck Initiative Operations Specialist, CBH regina.xhezo@phila.gov 215-413-8582