Network favorite, Child Health and Development Institute of Connecticut (CHDI), was awarded a five-year, $2 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to extend trauma-focused services to young children in Connecticut. The grant will fund CHDI's Early Childhood Trauma Collaborative initiative to improve knowledge about childhood trauma among Connecticut's early childhood workforce and increase access to trauma-focused evidence-based practices for children ages birth to 7 and their families.
"Reconciliation" has become a buzzword, as key GOP leaders eye it as a potential mechanism to repeal the ACA and enact changes in tax and spending policies. In fact, we could see not one but two budget reconciliations in the next calendar year if Congress is successful in enacting a CR through March as both FY17 and FY18 will still provide opportunities to pass a budget. The Center on Budget and Policy Priorities released two helpful primers to help you understand what the tool is and how it could be used to repeal the ACA.
The U.S. Departments of Health and Human Services, Housing and Urban Development, and Education released an interagency policy statement on early childhood homelessness. As this new infographic shows, in the United States, infancy is the age at which individuals are most likely to enter shelter or transitional housing, followed by ages one to five, and homelessness during pregnancy and in the early years is harmful to children’s development.
The statement, announced at the National Association for the Education of Homeless Children and Youth conference, recommends ways early childhood and housing providers at the local and state levels can collaborate to better meet the needs of pregnant women and families with young children who are experiencing or at risk of homelessness. In addition to highlighting recent research and resources, the statement offers the following recommended action steps:
- Supporting a two-generation approach to meeting the needs of parents and young children experiencing homelessness.
- Enhancing integration of early childhood programs and systems with local homeless assistance systems’ “coordinated entry” processes.
- Improving, leveraging, and sharing data on early childhood homelessness.
The document offers specific recommended strategies and actions for early childhood providers, as well as for Continuum of Care, shelter, and housing providers in each of these three areas.
Mobile behavioral health technology
Designed to Make Your Life Easier
Let us take a moment to demonstrate the effectiveness of the KnKt'd Behavioral Health Platform (App/Cloud/Provider Web Portal).
About the KnKt’d Platform
KnKt’d is a software platform for better connecting providers and consumers/clients on a daily basis. The system is completely person-centered and designed to be collaborative at all levels. It is an app that collects daily information from the consumer/clients via push notifications not unlike social media. It is a website that displays wellness of consumers/clients daily (with the click of the mouse) and an internal system SMS (text) communication tool. Lastly, it is a system for daily data on consumers/clients that will provide better outcomes and treatment focus. It will also provide data to funders of programs (State, Federal and grant resources).
Send us an email and we'll schedule your demo right away!
Effectively taking treatment out of the office, in-between appointments and into people’s lives!
- Reduce clinician caseload burdens
- Track daily wellness
- Track treatment outcomes
- Help justify treatment approaches and produce clean billing
- Increase treatment engagement
- Lengthen the treatment reach of your clinicians
- Reduce crisis calls and interventions
- Reduce no call no show rates
- Increase treatment session effectiveness
- Better serve populations in rural, frontier and underserved areas
- And KnKt’d offers so much more!
~ An important opportunity from our colleagues at the Oregon Social Learning Center ~
November is the last month to sign up, so get in touch soon! Join over 120 counselors and therapists nationwide who are learning to use Contingency Management (CM), an evidence-based addiction treatment for adolescents.
We are seeking counselors/therapists to participate in a study evaluating a training and support program that helps professionals use CM. This family-focused, outpatient substance abuse treatment uses behavior management and cognitive-behavioral approaches to treat adolescent addiction. CM can be a standalone treatment or an adjunct to existing clinic-based mental health treatments.
The study funding from NIDA covers the entire cost of the web-based training, training materials, and ongoing expert consultation, as well as $20 per focus group. A minimum of 15 continuing education units will be available for free. Participants will be trained in CM, will receive a certificate certifying their training, and will need to use CM to treat adolescent substance use/abuse and provide feedback to the researchers about their experience using it.
November is the end of sign-up, so spread the word and get in touch soon if you are interested!
Learn more about the study here. As well, you are encouraged to contact Jaime Houston-Mulligan with questions:
The University of Washington (UW) School of Medicine (SoM; Department of Psychiatry and Behavioral Sciences), in partnership with the College of Education (CoE), has an opening for a one-year research fellowship (job code 0445), with possible renewal for a second year. Foci of the fellowship include school- based mental health, clinical research methodology, implementation science, and educational equity (details below). The successful candidate will have an appointment in the Department of Psychiatry and Behavioral Sciences and will work closely with faculty in the CoE. The recruited fellow will have a strong interest in (1) effective strategies for implementing evidence-based and culturally-responsive mental health practices in public schools; (2) development of effective, feasible, culturally-responsive, and contextually-appropriate assessment and intervention practices in the education sector; (3) integration of mental health and schools at multiple levels/tiers of service delivery (i.e., universal, selected, and indicated); (4) enhancing school mental health data collection and use capacities (e.g., via screening, measurement-based care, and the application of data-driven decision making models); and/or (5) care coordination models in education and community settings for diverse youth, and those with complex needs. The successful candidate will be expected to be actively pursuing an academic career that emphasizes one or more of these areas.
The position will be housed within the School Mental Health Assessment, Research, and Training (SMART) Center (http://education.uw.edu/smart) and will allow the fellow to work closely with core Center faculty (Drs. Aaron Lyon, Eric Bruns, Michael Pullmann, Carol Davis, Mylien Duong, Jill Locke, Janine Jones, and Elizabeth McCauley) on a variety of federally- and locally-funded projects. Current projects focus on: (a) brief, school- based interventions to prevent or address behavioral health problems and promote academic engagement; (b) measurement of school organizational variables that affect implementation; (c) assessment and intervention to reduce racial disproportionality in student discipline; (d) pre-implementation intervention to improve uptake of evidence-based practices; (e) development of an integrated/collaborative care model for the education sector, and (f) school-based mental health service system development. The SMART Center represents a unique collaboration between SoM and CoE faculty, intended to facilitate more effective and integrated approaches to research and technical assistance surrounding quality improvement in school-based mental/behavioral health. The successful applicant will play a major role in ongoing research, grant writing, manuscript preparation, and consultation/technical assistance activities conducted by the Center.
Applicants must have completed a Ph.D. (or foreign equivalent) in Clinical, Community, School, or Educational Psychology or a related discipline – such as Special Education or Social Work – from an accredited academic program. The UW is a leading research university and provides an exciting scholarly environment and opportunities for interactions with faculty across disciplines with a strong emphasis on multiculturalism. Seattle is a vibrant and ethnically diverse community. Appointments will be made for one year, with a second year re- appointment expected based on a review of progress. We anticipate that the fellowship will be available July 1, 2017, although a start date as late as September 1, 2017 is possible. The current stipend for first year fellows is commensurate with the standard National Institutes of Health rate and is eligible for benefits. A description of UW benefits is available at http://www.washington.edu/admin/benefits/.
To apply, please email (1) a detailed letter of interest describing qualifications and experience; (2) curriculum vitae; (3) two examples of scholarly writing; and (4) names/contact information for at least three references to Aaron Lyon, Ph.D., email@example.com, Department of Psychiatry and Behavioral Sciences, University of Washington. For full consideration, applications must be received by December 1, 2016.
University of Washington is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, protected veteran or disabled status, or genetic information.
The following is a preliminary synopsis of implementation research being conducted by the
Center on Trauma and Children.
Successful implementation of evidence-based practices (EBP) is enhanced by active support for the intervention and training process by agencies, as well as practitioner openness to EBP.
The high value and promotion of evidence-based practice (EBP) has yielded a number of training opportunities for practitioners. Unfortunately, all of this training has not always translated into availability of those evidence-based interventions to clients in need. In addition, there is evidence that a one-time training is insufficient to ensure fidelity of implementation of EBP's, and that ongoing learning, supervision and coaching is beneficial (Institute for Healthcare Improvement, 2003). Application of implementation science to the human services has been a natural consequence.
A number of factors predictive of successful implementation have been identified in the literature. It is clear that it is not only the presence of these factors, but the interactions between them that influences adoption of these practices (Fixsen, et al, 2009; Damschroder et al, 2009; Aarons et al, 2011). A recent multi-year project conducted by the Center on Trauma and Children trained more than 90 providers from 22 organizations in two evidence-based interventions for adolescents using a Learning Community training model. This model provided face-to-face training as well as ongoing coaching, supervision, assessment and support through a Learning Community which included regularly scheduled online calls and supervision sessions.
Preliminary findings point to several components which contributed to successful implementation of these interventions. Successful implementation has two facets:
- completion of the learning collaborative
- and sustained utilization of the intervention with clients.
Five factors have been identified in this sample as important to successful training and implementation:
The level of support from the agency as manifested by the support from the trainee's supervisor.Those organizations where the supervisor was aware of the training and had direct contact with training organizers had greater success in their clinician participant completing the training and utilizing the implementation with clients.
Direct supervisor involvement in the learning community was associated with greater likelihood of the clinician completing training and sustainability.
Trainees housed in organizations that supported participation in the ongoing coaching, supervision and training by providing time to attend Learning Community calls, compete paperwork and review supervisory tapes; temporary release from direct service demands to attend training; and financial reimbursement for expenses incurred to attend training activities.
Organizations that assisted trainees in identifying appropriate clients for the intervention were also correlated with higher rates of success among trainees. This involved solicitation of referrals from community partners, and in-agency identification and referral of appropriate clients to the trainees.
Trainees who reported a higher level of openness to evidence based practice achieved higher levels of completion and implementation sustainability. This was measured on the Attitudes Toward EBP subscale of the Evidence Based Practice Questionnaire (EBPQ; Upton & Upton, 2006).
These findings demonstrate the significance of both individual trainee and organizational characteristics in the successful implementation of evidence based treatments following training. Further exploration of the relationship between individual attitudes towards evidence based practice and organizational climate and culture should be pursued as there is some evidence that organizational culture influences individual attitudes (Aarons & Sawitzky, 2006).
Aarons, G.A., Hurlburt, M. & McCue Horwitz, A. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4-23. DOI: 10.1007/s10488-010-0327-7
Aarons, G.A. & Sawitzky, A.C. (2006). Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychological Services 3(1), 61-72. DOI: 10.1037/1541-1518.104.22.168
Damschroder, L.J., Aron, D.C., Keith, R.E., Kirsh, S.R., Alexander, J.A. & Lowery, J.C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 7(4). DOI: 10.1186/1748-5908-4-50.
Fixsen, D.L., Blase, K.A., Naoom, S.F. & Wallace, F. (2009). Core implementation components. Research on Social Work Practice, 19(5), 531-40,DOI: 10.1177/1049731509335549
Institute for Healthcare Improvement. (2003). The Breakthrough Series: IHI's Collaborative Model for Achieving Breakthrough Improvement.IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement. (Available on www.IHI.org)
Upton, D. & Upton, P. (206). Deveopment of an evidence-based practice questionnaire for nurses. Journal of Advanced Nursing, 53(4), 454-8. DOI: 10.1111/j.1365-2648.2006.03739.
University of Kentucky Center on Trauma and Children
859-218-6901 | http://www.uky.edu/ctac
“When new infections among young Black gay men increase by nearly 50 percent in three years, we need to do more to show them that their lives matter.” - President Barack Obama, World AIDS Day 2011
Washington, DC – NASTAD (National Alliance of State and Territorial AIDS Directors) is excited to announce the launch of a new online training platform, HisHealth.org, to help doctors, nurses, and medical professionals identify and unlearn racial biases that create barriers to good care and elevate the quality of healthcare for Black gay men and other Black men who have sex with men.
The barriers for Black gay men in search of medical care are high. Even though most medical providers want to give good care, only 1 in 3 doctors know about PrEP (pre-exposure prophylaxis) – a groundbreaking HIV-prevention medication. Many doctors aren’t versed in providing quality care for LGBTQ people, and research indicates implicit bias has led to subpar care for Black Americans. “His Health” provides accredited in-depth training for medical professionals, while sharing profiles of the nation’s best sexual health care programs for Black gay men.
“Finding a good doctor as a Black gay man with HIV is incredibly difficult,” said Terrance Moore, Deputy Executive Director at NASTAD. “Research shows that implicit bias stops many doctors from providing high-quality care to Black Americans. Add to that a lack of understanding about the sexual health care needs of LGBTQ patients, and many men I know would rather stay home. That’s why this new tool is so important – we can help healthcare providers fight implicit bias and provide better care.”
HisHealth.org is a dynamic training tool that:
Provides free accredited and expert-led continuing education courses that fulfill requirements medical professionals need to maintain their medical licensure.
Offers portraits of innovative models of care, including Project Silk, a CDC funded, Pittsburgh- based recreational safe space and sexual health center rooted in house ball culture and Connecting Resources for Urban Sexual Health, a sexual health clinic created by and for LGBTQ youth of color.
Gives easy access to evidence-based resources to support the delivery of high-quality, culturally affirming healthcare services for Black gay men.
“There is a lot of discussion right now about implicit bias and police brutality in the U.S. – but the truth is, this is a huge challenge for healthcare providers as well,” said Omoro Omoighe, Associate Director of Health Equity at NASTAD. “We know doctors and nurses desperately wish to offer culturally affirming healthcare that is stigma-free to Black LGBTQ patients. With the advent of His Health, they now have the tools necessary to tackle implicit bias and feel more confident in their ability to uplift the standard of care for Black gay men while maintaining their licensure to practice medicine.”
The His Health platform was developed for and by Black gay men and their healthcare providers, in partnership with NASTAD and the Health Resources Services Administration’s HIV/AIDS Bureau (HRSA/HAB) in response to the high HIV rates among Black gay men.
~ By Shefali Luthra ~
PAWTUCKET, R.I. — Dustin French, 29, had four drug overdoses in the span of a year. “I was dead on arrival to the hospital,” he said of his last heroin overdose, which happened in April. “I woke up … and I didn’t feel like myself. I could tell this time I was really dead.”
Now, he says, he’s 100 days clean. He lives with his girlfriend. And he has three sons: an 8-year-old, a 2-year-old and a 1-year-old.
He credits his turnaround to a relationship he launched in the emergency department with a “peer recovery specialist” — someone who had herself struggled with addiction. She was there, he said, “when nobody else was.”
Stories like French’s have led policymakers — here in Rhode Island and in other states — to embrace a road to recovery led by people who have traveled it. It’s a growing effort to address the nation’s burgeoning opioid epidemic.
Here’s how the idea, still in its infancy, works: During overdose patients’ emergency department stays, they are introduced to a “peer recovery coach.” Patients trust these coaches, with whom they share common experiences. Coaches then stay in touch after discharge, meeting patients regularly to help navigate the path toward sobriety and resolve issues such as housing, food stamp applications, court obligations or job searches.
The model is gaining traction because millions of Americans are estimated to abuse opioids, an epidemic that’s behind billions of dollars in hospitalization costs. States want to train these workers, fund them and integrate them into the health system. Even so, they have to cross numerous logistical hurdles if they want the strategy to pay off.
So far, French has received active follow-up care, both from his coach and from AnchorED, the organization that operates Rhode Island’s peer recovery program.
Now, he has a job cleaning kitchen equipment. He is studying for his commercial driver’s license.
“Anything I needed, she was always there,” he said of his coach. “That program saved my life.”
The Anchor bulletin board includes postings with information on job openings, educational opportunities and other support meetings and wellness programs the center offers — for instance, recovery programs focused on veterans, or yoga classes. (Shefali Luthra/KHN)
Rhode Island – where, since 2009, more than 1,000 people have died from painkiller or heroin overdoses — is taking a lead. This summer, the state committed to assigning a peer coach to every hospital emergency department and footing the bill. Other states, such as New York, New Jersey, Wisconsin, Maryland, Pennsylvania, Massachusetts and Delaware, are experimenting with ways to place and pay for peer coaches in their ERs, though programs vary in size and evolution. The National Governors Association has also come out in favor of the mode.
States hope to keep patients healthier and improve their own finances. The cost of a phone call with a peer coach, the logic goes, is less than that of a return trip to the ER. Many addiction patients are covered by Medicaid, the federal-state health plan for low-income people.
But it’s a gamble to see whether lay people — whose main asset is that shared experience with patients — could be part of the secret sauce to curbing painkiller and heroin abuse. And challenges persist. These include getting more insurance plans to cover the service and devising payment structures in which they can easily do that; certifying and training peers; and the big one, finding definitive evidence that the peer coaches help.
“There is barely any research,” noted Dr. Manish Sapra, associate chief of clinical affairs, network hospitals and affiliates for Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center, which has a peer recovery pilot program. Despite growing interest, “there are no randomized controlled trials to show peer recovery efforts or peer support have as big an effect as what we’re hoping.”
Intuitively, it makes sense. Peers who have navigated addiction are more relatable, experts said. They can spend an hour with patients, compared to the emergency doctor who, on a hectic Friday night, may only have a few minutes to discuss treatment. And, perhaps most importantly, they offer living proof that recovery is possible.
“When you’re struggling through this issue — however you got there — you often feel like there’s no hope, there’s no end to this and you’re alone,” said Dale Klatzker, president of The Providence Center, which operates AnchorED.
But if advocates want this model to stick, they need to prove peers provide more than just comfort. States want to know the service actually improves health outcomes for people with addiction. Insurers want to know they will save money if they cover this coaching model and the related services, such as helping clients in court or accompanying them to therapy.
That’s why Maryland, which is working to expand its state-sponsored program, is starting to collect data on whether patients improve and what services the counselors help them get. The state hopes to track whether this intervention is cost-effective, by cutting the number of patients who return to the emergency room. Similar research is underway in Rhode Island and Massachusetts.
“Producing robust research to support [its] effectiveness … is critical,” said Colleen Barry, a professor of health policy at Johns Hopkins University, who co-directs its Center for Mental Health and Addiction Policy Research.
Donna Price, 57, has been a peer recovery specialist at Anchor for just over a year. She has been in recovery for heroin abuse for about 20 years, she said. Now, she’s one of the coaches who visits overdose patients at local emergency departments. (Shefali Luthra/KHN)
And there are other hurdles. States have to figure out how to credential coaches. Some are developing certification programs that including training in motivational interviewing, navigating community resources, building rapport and understanding how addiction and recovery work.
Part of the challenge is ensuring counselors meet certain standards without making them seem less authentic and relatable to patients — like a junior clinician. Many hospitals also have strict rules about whether their employees can have a criminal background, which further limits the pool.
“We want to hire people with lived [addiction] experience, and the reality is most people with that will have a criminal record,” Dr. Sarah Wakeman, medical director of the substance use disorder initiative at Massachusetts General Hospital’s Center for Community Health Improvement, which has piloted the model.
Recruiting is another issue. In Rhode Island, AnchorED employs about 22 peers to serve the state. Each has a caseload of maybe 40 clients at once. But that hardly meets the need, said George O’Toole, who manages the peer recovery program. And that’s in a small state, with about a dozen hospitals. Other states trying to emulate the model have to scale up.
Consider New York. “Everything’s at such a different scale. But [Rhode Island’s] approach makes sense,” said Robert Kent, general counsel for New York State’s Office of Alcoholism and Substance Abuse Services.
Meanwhile, the counselors also need to be established in their own recovery and be willing to work in the program, which can be emotionally taxing and time-consuming.
And then patients don’t always buy in, warned Dr. Gary Bubly, medical director for the Miriam Hospital Emergency Department in Providence. His department has “heavily used” peer coaches. The symptoms of withdrawal can be so unpleasant that, even after an overdose, patients may reject any treatment path.
But the potential outweighs these complications, advocates said. “If there is one thing I can look at in my career and say, ‘That was a good thing,’ — this will be it,” said Rebecca Boss, Rhode Island’s acting director of behavioral healthcare, developmental disabilities and hospitals. She helped develop the program.
Take French, the AnchorED patient. He calls these early recovery months transformative.
“These people understand addiction, and they’re going to meet you where you’re at. Whether you’re using or not — they’re going to help you.”
The Clay Center for Young Healthy Minds at Massachusetts General Hospital (MGH) announced that Dr. Gene Beresin, executive director of The Clay Center, has been named senior advisor on adolescent psychiatry for Students Against Destructive Decisions (SADD) and their teen driving study in collaboration with Liberty Mutual Insurance.
"We're thrilled to welcome Dr. Beresin to our organization," said Dawn Teixeira, SADD’s president and CEO. "His passion for the community, coupled with his extensive knowledge of child psychiatry, makes him the ideal person for this role. Together, we will continue to work toward empowering teens and their families to make healthy decisions that will make the roads safer for all."
SADD is the nation's leading youth peer-to-peer education, prevention and activism organization dedicated to the health and safety of young people. SADD has for a long time partnered with Liberty Mutual Insurance on its Teen Driving Study, the most recent iteration of which focused on the impact of app usage.
To complement the more traditional, quantitative research, this year’s study incorporated implicit association testing (IAT), which has been used for the past 20 years to measure unconscious bias. For the first time ever, the study sought to capture not just what teens say, but also what they feel and believe in the moment. And, ultimately, this is what drives their behavior.
The research showed that while 95% of the teens surveyed acknowledged that the use of apps behind the wheel is dangerous, 68% admitted to still using them while driving. And, 80% noted on the IAT that navigation and music apps are “not distracting,” “important,” and “fun.” They also saw them as critical “utilities” that are a necessity while driving.
Dr. Beresin from The Clay Center for Young Healthy Minds offers five tips for parents to address distracted driving:
Talk with your teenagers. It’s always wise to engage in dialogues about road safety—even years before your kids get behind the wheel. Make sure these conversations don’t just touch upon what your kids think, but what they feel in the moment when it comes to certain situations.
Focus your conversation on what causes distractions. Sure, apps have use. But, can they be used in such a way that does not result in distraction? For example, could you program your navigation app to talk to you, or set up your music playlist ahead of time?
Keep the phone out of reach. 73% of teens in Liberty Mutual Insurance and SADD’s study reported that their phones were close to them. See if instead your kids can hide their phones, or give them to a friend. Proximity is far too great a temptation!
Set limits and consequences. We know that teens respond to expectations and consequences. Take texting for example: while the survey showed that 27% of teens still text while driving, that number has dropped dramatically from previous years. This is probably due to the laws and fines concerning texting and driving that have been put in place. While there are not yet legal ramifications for app use, parents can establish their own consequences.
Use a contract. Liberty Mutual Insurance and SADD have created a teen driving contract (hyperlink: https://www.libertymutual.com/auto/car-insurance-for-teens/teen-driving-contract) that serves as both a conversation-starter about safe driving habits, as well as a customizable agreement between parent(s) and child. Not only does it enable teens to take greater ownership over their safety, it holds them AND you mutually accountable for your behavior. The message for you as a parent or caregiver is this: Don’t just do what I say, do what I do!
In addition to being the executive director of The Clay Center, Beresin is a full professor of psychiatry at Harvard Medical School (HMS), and senior educator in child and adolescent psychiatry at MGH. He received a B.A. in music from Princeton University and an M.A. in philosophy, along with his M.D. from the University of Pennsylvania. He has more than 30 years of experience, and has won a number of local and national teaching awards, including the Parker J. Palmer "Courage to Teach" Award in 2002, given annually by the Accreditation Council of Graduate Medical Education to 10 program directors from all medical specialties.
Beresin has consulted on a variety of television shows, including ER, Law and Order SVU and the Emmy Award-winning HBO children's specials Goodnight Moon and Other Sleepytime Tales (2000), Through a Child's Eyes: September 11, 2001 (2003) and Classical Baby (2005). He was also co-producer of a section of the Parent Resource Center for ABCNews.com. Beresin has published numerous papers and chapters on a variety of topics, including graduate medical education, mental health and media, eating disorders, personality disorders, and child and adolescent psychiatric treatments.
As senior advisor, Beresin will be leading a number of workshops on mental health and learning challenges. In addition to the workshops, Beresin will also be providing high-level input on the development and refinement of SADD's teen driving research, as well as promoting the study through articles and interviews.
You can learn more about Dr. Beresin and the work of the Clay Center here.