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Providers successfully negotiate the challenges of evidence-based practice implementation

September 30, 2009
by Gary A. Enos, Editor
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Barbara Jessing recalls the time when her addiction services agency’s approach to treatment resembled a moving target. Every time Heartland Family Service program sites in Nebraska and Iowa experienced staff turnover, newly arriving professionals would seem to take the treatment program in a different direction.





“I couldn’t say what our treatment program was at that time. It was more about who worked here at any given time,” says Jessing, Heartland’s clinical director.





Today, the organization is being held as a model of evidence-based practice implementation, steeped in a formalized process of quality improvement. Heartland’s Iowa operation is one of several treatment organizations honored in September as part of the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) 2009 Science and Service awards. This recognition by SAMHSA highlights the effort of service providers that have succeeded in translating the results of effectiveness research into everyday clinical practice that improves client outcomes.





In Heartland Family Service’s case, the recognition was several years in the making, growing out of a realization that it once had been trying to adapt an alcohol treatment model to clients dealing with the complexities of methamphetamine addiction. Jessing explains that a quality improvement team that included some of the clinicians who would be responsible for implementing a new treatment model researched meth treatment approaches and identified the Matrix Model as their best option.





“This was our first serious effort to implement an evidence-based practice on this scale,” Jessing says. “The Matrix Model was the only evidence-based practice we could find on the use of stimulants.”





The outpatient Matrix Model, emphasizing factors such as family involvement in patient education as well as immediate engagement of clients in relapse management strategies, yielded important dividends for the agency. It saw client retention in treatment groups, in a population with significant cognitive impairment, jump by an average of 30.5% after the Matrix Model was implemented agency-wide.





Heartland was one of seven treatment organizations honored by SAMHSA in Science and Services’ substance abuse treatment and recovery support services category. Another organization that received recognition was Connecticut Renaissance, Inc., which implemented Multi-Dimensional Family Therapy as a wraparound, family-focused approach for at-risk adolescents referred to the agency from the state’s juvenile justice or family service systems.





“Most of our adolescent programs are evidence-based,” says Greg Hilgert, who formerly served as a supervisor in the agency’s Multi-Dimensional Family Therapy program. Staff buy-in to evidence-based practice implementation began to occur at Connecticut Renaissance after employees realized that this process wasn’t designed in a punitive fashion to “catch” staff engaging in ineffective practices, Hilgert says.




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