Evidence-Based Practices Symposium

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1 Evidence-Based Practices Symposium Monday-Tuesday, June 6-7, 2011 Crowne Plaza Anaheim

2 Welcome to CiMH's Annual Evidence-Based Practices Symposium Monday-Tuesday, June 6-7, 2010 at the Crowne Plaza Anaheim Hotel CiMH has been actively promoting the adoption of children's evidence-based mental health practices for a number of years now and began convening annual symposiums as one key strategy for supporting ongoing model adherence. The symposiums have targeted practitioners, supervisors and managers who are implementing evidence-based practices and have included keynote addresses and workshops focusing on advances in research and practice, enhancing clinical skills, and building organizational infrastructure to support these programs. This year we will be convening a single symposium that will include tracks specific to the following intervention models: Aggression Replacement Training Functional Family Therapy Multidimensional Treatment Foster Care Trauma Focused Cognitive Behavioral Therapy In addition, there will be workshops on topics including outcome measures, health care reform, and understanding community-defined evidence practices. Dr. Stanley Huey, Associate Professor of Psychology and American Studies and Ethnicity at the University of Southern California, will be opening the Symposium with a keynote on the appropriateness of evidence-based practices for culturally diverse clients. Dr. Huey will talk about his research and service system implications. His primary research topics include psychotherapy effects with children and adolescents, culture-responsive treatments for ethnic minorities, and psychotherapy mechanisms that lead to clinical change. In addition, keynotes and workshops for each practice specific track will be conducted by the following distinguished national trainers: Mark Amendola, L.S.W, B.C.D., Executive Director of Perseus House and national Master Trainer Robert Oliver, Ed.D., Chief Educational Officer for Perseus House, and national Master Trainer Michael S. Robbins, Ph.D., Senior Scientist at the Oregon Research Institute, and FFT Inc., Research Director Holly Barrett Waldron, Ph.D., Senior Scientist at the Oregon Research Institute Kim Mason, L.C.S.W, FFT National Supervisor J.P. Davis, Sr. Program Consultant and national trainer with TFC Consultants, Inc. Kim Bronz, Ph.D., Site Consultant and national trainer with TFC Consultants, Inc., Assistant Professor at Johns Hopkins Bloomberg School of Public Health, researcher and national TF-CBT trainer Please see the following agenda for workshop descriptions, times and locations.

3 AGENDA DAY 1 EVIDENCE-BASED PRACTICES SYMPOSIUM June 6, am 1pm REGISTRATION 1:00 2:15 WELCOME, INTRODUCTIONS AND OVERVIEW OF EBP SYMPOSIUM LEARNING OBJECTIVES Pam Hawkins, Senior Associate, California Institute for Mental Health Todd Sosna, Ph.D., Deputy Director, California Institute for Mental Health EVIDENCE BASED PRACTICES SYMPOSIUM KEYNOTE ADDRESS Dr. Stanley Huey, Associate Professor of Psychology, American Studies and Ethnicity, University of Southern California EVIDENCE BASED PRACTICES FOR CULTURALLY DIVERSE CLIENTS Dr. Huey will present on the appropriateness of evidence-based practices for culturally diverse clients. He will talk about his research and corresponding service system implications. His primary research topics include psychotherapy effects with children and adolescents, culture-responsive treatments for ethnic minorities, and psychotherapy mechanisms that lead to clinical change. 2:15 2:30 BREAK 2:30 3:30 SESSION 1 FFT FFT KEYNOTE: STATE OF THE SCIENCE AND PRACTICE IN FFT: CURRENT RESEARCH, CLINICAL SPECIALIZATIONS, AND ONGOING ACCOUNTABILITY Michael S. Robbins, Ph.D. The clinical and research base for FFT continues to expand with new projects addressing a range of clinical populations, such as gang-involvement, substance use, depression and trauma, in diverse clinical settings (including re-entry, justice, psychiatric, child welfare and mental health). This presentation will provide an overview of these developments, with a focus on providing information about clinical accommodations and adaptations that have been made to the FFT model to address the unique issues encountered with specific populations in unique service delivery contexts. New research projects are also reviewed to demonstrate efforts to keep FFT at the cutting-edge of evidence-based practices for youth and families. An underlying theme throughout this presentation is on our ongoing efforts to enhance accountability to achieve successful outcomes with youth and families. QUALITY ASSURANCE IN AGGRESSION REPLACEMENT TRAINING Mark Amendola, L.S.W., B.C.D., and Robert Oliver, Ed.D. This session will focus on model fidelity and model adherence as it relates to quality assurance and quality improvement. The session will also focus on transfer of skills for youth. Concrete suggestions for transferring, or generalizing, skills in real world environments will be offered. Spirit of Goldstein Award recognition of those agencies demonstrating exemplary implementation and outcomes for Aggression Replacement Training in California.

4 2:30 3:30 DAY 1, SESSION 1, continued TF CBT PRACTITIONERS SESSION TF CBT ADVANCED TOPICS FOR THERAPISTS, P 1 This workshop will focus on strategies for addressing emergent concerns that interfere with progress in using the TF-CBT model. Strategies for clients who have experienced multiple traumas will be discussed as well as gradual exposure strategy. Mazatlan A2 INTEGRATING INDIVIDUAL AND FAMILY THERAPY ACROSS THE TEAM The primary focus of the track, which will continue across all of the sessions, will be on integrating individual and family therapy across the team. These will be highly interactive sessions, and participants are strongly encouraged to bring case examples. The trainers will also discuss how to generate an treatment plan using the information from the Parent Daily Report (PDR). The workshop is intended for practitioners and the agency clinical director. MAKING EVIDENCE-BASED PRACTICES WORK INNOVATIVE SOLUTIONS FOR MENTAL HEALTH PROFESSIONALS Luba Botcheva, Ph.D. In this workshop, we will demonstrate innovative tools and products developed by Sociometrics Corporation with NIH funding to systematically address barriers to implementing EBPs in real world settings. Using examples from our mental health and substance abuse effective program series, we will discuss the methods by which EBPs are evaluated, selected, packaged for easy use by practitioners, and disseminated. We will also elaborate on the different types of training and ongoing technical assistance offered to practitioners to address challenges in implementation and adaptation. 3:30 3:45 BREAK 3:45 5:00 SESSION 2 FFT SITE SUPERVISORS SESSION RE ICULATING THE CORE PRINCIPLES OF SUPERVISION Michael Robbins, Ph.D. We are continuing to refine our supervision procedures to facilitate the competent delivery of FFT with youth and families served in community settings. This presentation will cover several areas of the supervision process in FFT, including: a) an overview of the goals and assumptions of supervision, b) a review of the core principles of supervision in FFT, and c) a focus on how to match leadership styles to the unique needs of individuals and groups. FFT PRACTITIONERS SESSION Mazatlan C1 MANAGING THE INTEGRATION OF FFT INTO CLINICAL AGENCIES AND USING DATA TO ENHANCE OUTCOMES Kim Mason, L.C.S.W. Integrating evidence-based practices into agencies that provide comprehensive services can be challenging. We will discuss specific strategies that have been useful in providing FFT where agencies have significant needs for sequencing multiple interventions and managing wrap-around services. The presentation also focuses on helping therapists to understand the importance of using data to enhance supervision and successful outcomes with families. Specifically, we provide evidence from our State of Florida FFT implementation project that shows how data has been used to systematically improve FFT processes and outcomes over the past few years. This presentation will discuss the difficulties in integrating evidence-based services in agencies that provide comprehensive services. Specific strategies therapists can use to assist their agency and stakeholders in understanding FFT will be discussed. Day 1 Agenda, continued

5 3:45 5:00 DAY 1, SESSION 2, continued KEYNOTE: NEW TRENDS IN AGGRESSION REPLACEMENT TRAINING Mark Amendola, L.S.W., B.C.D., and Robert Oliver, Ed.D. This session will focus on new trends for Aggression Replacement Training. The session will also focus on the core content of the new Aggression Replacement Training curriculum, the Prepare Curriculum, as well as advances in the field of Aggression Replacement Training and new research trends. TF CBT - PRACTITIONERS SESSION TF CBT ADVANCED TOPICS FOR THERAPISTS, P 2 This workshop will focus on the developmentally appropriate strategies for TF-CBT psychoeducation and relaxation when working with young children. Some of the strategies to be discussed are cognitive coping and reprocessing strategies, as well as advanced strategies for conducting TF-CBT conjoint sessions with caregivers. Mazatlan A2 INTEGRATING INDIVIDUAL AND FAMILY THERAPY ACROSS THE TEAM (CONTINUED) The primary focus of the track, which will continue across all of the sessions, will be on integrating individual and family therapy across the team. These will be highly interactive sessions, and participants are strongly encouraged to bring case examples. The trainers will also discuss how to generate an treatment plan using the information from the Parent Daily Report (PDR). The workshop is intended for practitioners and the agency clinical director. LEADERSHIP TO SUPPORT EVIDENCE-BASED AND INNOVATIVE PRACTICES Greg Aarons, Ph.D. Leading change is not an easy task, and leading the implementation of evidence-based practices presents a special set of challenges for mental health agencies. Implementation research suggests effective leadership on the part of practice or change champions, in the context of an organizational culture and climate supportive of evidence-based practices, is a critical driver of successfully implementing and sustaining research informed practices. This workshop will feature lessons from the Leadership and Practice (LEAP) program, developed by investigators at the University of California, San Diego, that provide curricula, training and coaching to support implementation of evidence-based practices. Effective leadership strategies will be presented, along with specific ways to create an organizational climate supportive of evidence-based practices. 5:00 END OF DAY ONE NOTES

6 AGENDA DAY 2 EVIDENCE-BASED PRACTICES SYMPOSIUM June 7, :00am 10:00 CONTINENTAL BREAKFAST 8:30 9:30 PROGRAM PERFORMANCE OUTCOMES Todd Sosna, Ph.D. Dr. Sosna will review data from recent program performance and outcome evaluation reports for, FFT,, and TF-CBT, highlighting the populations served, services provided, and outcomes attained. 9:30 9:45 BREAK 9:45 11:00 SESSION 3 FFT SITE SUPERVISORS SESSION THE NUTS AND BOLTS OF SUPERVISION IN FFT Michael Robbins, Ph.D. Building on the refinements described in first Supervision presentation, the focus of this session will be on the specific procedures and activities of the supervision process in FFT. We will provide an overview of how to achieve the goals of supervision and will provide recommendations for how to select cases for fidelity review. In addition, this presentation will include information about how to structure questions to complete fidelity ratings and to plan for upcoming sessions during each phase of FFT. This session will conclude with a ½ hour interactive discussion to address specific challenges faced by site supervisors. FFT PRACTITIONERS SESSION Mazatlan C1 ADVANCED ISSUES IN THE BEHAVIORAL CHANGE PHASE Kim Mason, L.C.S.W. Developing and implementing comprehensive behavior change plans is one of the most common challenges therapists face in implementing FFT. The focus of this presentation will be to enhance therapists understanding of behavior change strategies and to provide specific examples of behavior change techniques that may be useful across a range of cases. In doing so, we will also focus on how to effectively match behavior change techniques to relational functions, how to determine the skill deficits/strengths of a family, and how to develop a detailed behavior change plan. AGENCY TRAINER SESSION PROFICIENCY STRATEGIES FOR AGENCY TRAINERS Mark Amendola, L.S.W., B.C.D. Practitioners must demonstrate substantial proficiency to be eligible to be trained as an Agency Trainer. This session will focus on the role of the Agency Trainer in model adherence and quality assurance, by focusing on how to continue to maintain fidelity after the formal training is completed. The session will also focus on barriers of model adherent training as well as all of the components of training and consultation necessary to ensure fidelity to the model. TF CBT KEYNOTE TF CBT AROUND THE WORLD: EXAMPLES FROM ZAMBIA, TANZANIA AND CAMBODIA This workshop will focus on the common traumas in low-resource countries, such as Zambia and Cambodia. The workshop will discuss adaptations and accommodations to the TF-CBT model as well as qualitative and quantitative outcomes associated with TF- CBT in these low-resource countries.

7 9:45 11:00 DAY 2, SESSION 3, continued Mazatlan A2 INTEGRATING INDIVIDUAL AND FAMILY THERAPY ACROSS THE TEAM (CONTINUED) MEASURES 1: AGGRESSION REPLACEMENT TRAINING Todd Sosna, Ph.D., Deputy Director, California Institute for Mental Health Key outcome measures used in Aggression Replacement Training () will be reviewed. Aspects related to administration, scoring, and clinical utility will be highlighted. 11:00 11:15 BREAK 11:15 12:30 SESSION 4 FFT STRATEGIES FOR ADDRESSING INTERNALIZING SYMPTOMS IN SUBSTANCE ABUSING YOUTH WITH CO OCCURRING DEPRESSION Holly Barrett Waldron, Ph.D., Michael S. Robbins, Ph.D. FFT strategies for working with youth with co-occurring substance use and depression have been developed and evaluated through research examining the optimal FFT service delivery methods. Evidence shows FFT is associated with an array of positive outcomes, such as increases in treatment engagement and retention and reductions in adolescent substance use, depression and problem behaviors. This presentation will describe a reciprocal model for understanding the co-occurrence of substance use and depression and how these disorders contribute to the maintenance of one another. We will present characteristics often observed in families of youth with co-occurring substance abuse and depression and discuss strategies for motivating families and creating a positive context for change. Specific behavior change techniques will be presented, including: 1) linking emotions, thoughts, and behaviors, 2) strategies for increasing pleasant events, 3) stress reduction techniques, 4) self-control and self-reinforcement strategies, 5) identifying and challenging unrealistic thoughts, 6) changing negative thoughts to positive thoughts, and 7) overcoming fears and obstacles. The course of treatment and tips for sequencing behavior change topics will also be discussed. FACILITATOR SESSION P 1: ADVANCED TOPICS FOR FACILITATORS Mark Amendola, L.S.W., B.C.D. This session will focus on an overview of the core components of Aggression Replacement Training as well as specific changes to the Anger Control Curriculum. SkillStreaming is the interpersonal skills training approach, consisting of modeling, role play, performance feedback and transfer training. Several evaluations of its efficacy revealed high levels of skill acquisition but more modest levels of skill transfer and maintenance. Adding Anger Control Training (what not to do) to SkillStreaming (what to do) plus Moral Reasoning Training (why to do it) yielded Aggression Replacement Training, shown to result in substantially improved transfer/maintenance effects, including major reductions in recidivism among delinquent youth on parole. TF CBT SUPERVISORS SESSION P 1: TF CBT ADVANCED TOPICS FOR SUPERVISORS This workshop will focus on the parallel process in conducting TF-CBT group clinical supervision. Discussion will include setting up a group supervision agenda and an outline for case presentations as well as use of the TF-CBT fidelity checklists. INTEGRATING INDIVIDUAL AND FAMILY THERAPY ACROSS THE TEAM (CONTINUED)

8 11:15 12:30 DAY 2, SESSION 4, continued MEASURES 2: TRAUMA FOCUSED COGNITIVE BEHAVIORAL THERAPY Margaret Faye, Ph.D. Key outcome measures used in Trauma Focused - Cognitive Behavioral Therapy (TF-CBT) will be reviewed. Aspects related to administration, scoring, and clinical utility will be highlighted. HEALTH CARE REFORM Mazatlan C1 Todd Sosna, Ph.D., Deputy Director, California Institute for Mental Health Dr. Sosna will focus on the key provisions of Health Care Reform as well as the organizational capacities that will be expected of behavioral health providers as we embark on Health Care Reform. The key features of collaborative care models for integrating primary care and behavioral health will also be presented. 12:30-1:45 LUNCH 1:45 3:00 SESSION 5 FFT STRATEGIES FOR ADDRESSING INTERNALIZING SYMPTOMS IN SUBSTANCE ABUSING YOUTH WITH CO OCCURRING DEPRESSION (continued) FACILITATOR SESSION P 2 Mark Amendola, L.S.W., B.C.D. TF CBT SUPERVISORS SESSION P 2: TF CBT ADVANCED TOPICS FOR SUPERVISORS This workshop will focus on supervision strategies to address vicarious trauma as well as using of role-playing and the cognitivebehavioral triangles in supervision. Discussion will also focus on strategies for engaging and supporting a therapist who struggles with use of the model. INTEGRATING INDIVIDUAL AND FAMILY THERAPY ACROSS THE TEAM (CONTINUED) SUSTAINABILITY Pam Hawkins, Senior Associate, California Institute for Mental Health This workshop will focus on the role and importance of an administrative champion for sustainability of evidence-based practices, as well as the role and importance of a practice specific clinical supervision for sustainability. The role and importance of a program performance evaluation for sustainability will also be discussed. MENTAL HEALTH SERVICES FOR THE CHILD WELFARE SYSTEM Mazatlan C1 Todd Sosna, Ph.D., Deputy Director, California Institute for Mental Health This workshop will focus on the strategies for collaborating or teaming between mental health practitioners and child welfare social workers. Material on strategies for developing trauma sensitive treatment plans, and selecting evidence-based treatment models appropriate to mental health disorders experienced by children in the child welfare system will be discussed. END OF DAY TWO

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