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Welcome
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Trauma Focused Cognitive Behavioral Therapy
(TF-CBT) Implementation
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Todd Sosna, Ph.D.Children’s Institute, Inc.
May 28, 2014
A Program of the
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatmentand the
Administration on Children, Youth and FamiliesChildren’s Bureau
Office on Child Abuse and Neglect
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Our Speaker
This webinar features Dr. Todd Sosna, Senior Vice President for Program Evaluation and Improvement at Children’s Institute, Inc., a non-profit agency providing services to more than 20,000 at-risk children and families annually, in the Los Angeles, California area.
http://www.childrensinstitute.org/
Agenda
• Implementation of TF-CBTo Overview
o Implementation Challenges
o Training Protocol
o Adaptations
• Measuring the Fidelity of TF-CBT
• Measuring the Impact and Outcomes of TF-CBTo Establishing and Sustaining a Program
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Implementation of TF-CBT
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General Overview
• Optimal client outcomes requires access to responsive and effective services (EBPs)
• Implemented (and sustained) with integrity
– Implementing with integrity requires key organizational supports• Administrative oversight/champion
• Planning
• Thorough training
• Practice-specific supervision
• Monitoring and evaluation
• Commitment and persistence
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Implementation Challenges
• Selecting a suitable model• Thoughtful and comprehensive planning• Engaging staff and supervisors• Arranging for thorough training/accreditation• Arranging for practice specific supervision• Managing attrition/arranging for replacement
training
Implementation Challenges
• Managing referrals• Monitoring and supporting fidelity (Brief
Practice Checklist)• Tracking program outcomes (CIMH
performance report)• Competing initiatives/priorities• Developing/communicating realistic expectations
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Real World Behavior
• Knowing something• Being able to do something• Actually doing something
• Teaching• Practicing• Creating incentives for using
OUTCOMES(% of Participants who Demonstrate Knowledge, Demonstrate
new Skills in a Training Setting, and Use new Skills in the Classroom)
TRAININGCOMPONENTS
KnowledgeSkill
DemonstrationUse in the Classroom
Theory and Discussion
10% 5% 0%
..+Demonstration in Training
30% 20% 0%
…+ Practice & Feedback in Training
60% 60% 5%
…+ Coaching in Classroom
95% 95% 95%
Joyce and Showers, 2002 As presented by Karen Blasé at CIMH planning meeting 2007
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National Accreditation
• https://rtfweb.wpahs.org/tfcbt/Default.aspx• All eight steps must be met to achieve
certification:• Master’s degree or above in a mental health
discipline
• Professional licensure in home state
• Completion of TF-CBTWeb
National Accreditation
• Participation in a live TF-CBT training (two days) conducted by a treatment developer or an approved national trainer; or Live training in the context of an approved national, regional, or state TF-CBT Learning Collaborative of at least six months duration in which one of the treatment developers or a graduate of our TF-CBT Train-the-Trainer (TTT) Program has been a lead faculty member
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National Accreditation
• Participation in follow-up consultation or supervision on a twice a month basis for at least six months or a once a month basis for at least twelve months. The candidate must participate in at least nine out of the twelve consultation or supervisory sessions. This consultation must be provided by one of the treatment developers or a graduate from our TTT program. ; or Active participation in at least 3/4 of the required cluster/consultation calls in the context of an approved TF-CBT Learning Collaborative;
National Accreditation
• Completion of three separate TF-CBT treatment cases with three children or adolescents with at least two of the cases including the active participation of caretakers or another designated third party
• Use of at least one standardized instrument to assess TF-CBT treatment progress with each of the above cases;
• Taking and passing TF-CBT Therapist Certification Program Knowledge-Based Test.
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Adaptations to TF-CBT
• What kind of adaptations have been made to TF-CBT? – Cultural adaptations
– International
– Others
Monitoring the Fidelity of TF-CBT
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Monitoring Fidelity
• Brief Practice Checklist– Completed by therapist following each session
– Reviewed during training
– Reviewed in practice‐specific supervision
• Audio tape reviews
Monitoring Fidelity
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Measuring the Impact and Outcomes of TF-CBT
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Tracking Outcomes
• Client level reports
Sharing with clients is encouraged!
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Tracking Outcomes
• Program level reports
Reports and Studies
• Trauma Focused Cognitive Behavioral Therapy CIMH Community Development Teams -Aggregate Program Performance Dashboard Report
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Establishing a Program
• Designate an administrator/manager lead to champion learning and using the model
• Develop a concrete intervention-specific implementation plan– Understand the model– Prepare staff, managers, referrals, oversight– Understand and plan for training/accreditation
and replacement training– Set realistic expectations
Establishing a Program
• Engage providers/staff and supervisors based on a full understanding of the intervention requirements
• Focus on fidelity from the outset• Use the full training protocol
• Start to use the model soon after training• Initiate program performance evaluation from
the outset• Maintain momentum (expect and plan for
interrupted progression)
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Sustaining a Program
• Ongoing oversight and support by an administrative champion
• Regular intervention-specific supervision
• Routine fidelity monitoring and outcomes
• Program performance evaluation
• Commitment to replacement training and consultation as needed
• Dedication of time and money to training activities
Questions and Discussion
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Save the Date
Our next webinar in the Evidence Based Practice Implementation Webinar Series:
Implementation of Nurturing Program for Families in Substance Abuse Treatment and Recovery
June 24, 2:00pm - 3:30 pm ET• The webinar features Terri Bogage, MSW, LICSW, the
Director of Family and Children’s Services and Dianna Christmas, MPH, Parent-Child Services Coordinator at the Institute for Health and Recovery (IHR).
• To register, please go to: https://www1.gotomeeting.com/register/518314232
National Center for Substance Abuse and Child Welfare
(NCSACW)
http://www.ncsacw.samhsa.gov/
Contact Information
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FOR RESOURCES andMATERIALS FROM THIS WEBINAR
Please visit our website:
http://www.cffutures.org/
For questions specific to this webinar please contact:Marianna Corona, LCSW
Research AssociateChildren and Family Futures