Starin Amy C, Atkins Marc S, Wehrmann Kathryn C, Mehta Tara, Hesson-McInnis Matthew S, Marinez-Lora A, Mehlinger Renee
a Institute for Juvenile Research , University of Illinois Chicago.
J Clin Child Adolesc Psychol. 2014;43(2):169-78. doi: 10.1080/15374416.2013.848772. Epub 2013 Oct 31.
In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.
2005年,伊利诺伊州心理健康管理局发起了一项倡议,旨在缩小儿童心理健康系统研究与实践之间的差距。一个利益相关者咨询委员会制定了一项计划,通过政策和项目倡议来推进循证实践。为实现这一目标,制定了一种多层次方法,其中包括政策变革、利益相关者教育和临床医生培训。本文重点介绍在对实施研究进行审查后设计的循证培训过程。培训包括面对面的教学课程以及对6组社区临床医生进行每月两次的电话督导,每组临床医生接受为期12个月的培训。培训内容最初包括认知行为疗法和行为家长培训,多年来已根据共同要素概念调整为一种实践模式。基于提供者和家长报告的评估表明,与第1至4组的常规治疗对照组以及第5至6组护理90天后的全州儿童总体相比,接受培训的临床医生治疗的儿童总体上显示出更好的结果。结果表明,循证培训组主要产生了中度到强效的效果。将一个大型的全州性公共儿童心理健康系统转向更有效的服务是一个复杂而漫长的过程。这些结果表明,伊利诺伊州社区心理健康提供者的循证实践培训在积极影响儿童层面的功能结果方面取得了一定程度的成功。这些发现也影响了州政策,即使在经济困难时期,也致力于投入资源继续推进该倡议。