Lessons learned while building a trauma-informed public behavioral health system in the City of Philadelphia

Evaluation and Program Planning

Volumn 59, Issue , 2016, Pages 21-32

  Beidas, Rinad S ^a   Adams, Danielle R ^a   Kratz, Hilary E ^a   Jackson, Kamilah ^b   Berkowitz, Steven ^a   Zinny, Arturo ^b   Cliggitt, Lauren Pilar ^c   DeWitt, Kathryn L ^a   Skriner, Laura ^a   Evans, Arthur ^a,d  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

^b Department of Behavioral Health and Intellectual disAbilities Services   (United States)

^c Hall Mercer   (United States)

^d Department of Behavioral Health and Intellectual disAbility Services ^*  (United States)

Author keywords

Evidence based practices; Implementation science; Trauma informed system

Indexed keywords

BEHAVIORAL RESPONSE; HEALTH SERVICES; IMPLEMENTATION PROCESS; PUBLIC HEALTH; SAFETY; YOUNG POPULATION;

PENNSYLVANIA; PHILADELPHIA; UNITED STATES;

ADOLESCENT; ADOLESCENT HEALTH; CHILD; CHILD HEALTH; COGNITIVE THERAPY; FEMALE; HEALTH PERSONNEL ATTITUDE; HEALTH SERVICES RESEARCH; HUMAN; IN SERVICE TRAINING; INSURANCE; MALE; MEDICAID; MENTAL DISEASE; MENTAL HEALTH SERVICE; ORGANIZATION AND MANAGEMENT; PENNSYLVANIA; PROCEDURES; PROGRAM DEVELOPMENT; PROGRAM EVALUATION; PSYCHOMETRY; PSYCHOTRAUMA; PUBLIC HEALTH; STATISTICS AND NUMERICAL DATA; UNITED STATES;

ADOLESCENT; ADOLESCENT HEALTH; ATTITUDE OF HEALTH PERSONNEL; CHILD; CHILD HEALTH; COGNITIVE THERAPY; FEMALE; HUMANS; INSERVICE TRAINING; INSURANCE CLAIM REVIEW; MALE; MEDICAID; MENTAL DISORDERS; MENTAL HEALTH SERVICES; ORGANIZATIONAL CASE STUDIES; PHILADELPHIA; PROGRAM DEVELOPMENT; PROGRAM EVALUATION; PSYCHOLOGICAL TRAUMA; PSYCHOMETRICS; PUBLIC HEALTH; UNITED STATES;

EID: 84980452623     PISSN: 01497189     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.evalprogplan.2016.07.004     Document Type: Article

References (74)

1. Aarons, G.A., Sawitzky, A.C., Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychological Services 3 (2006), 61–72.
2. Aarons, G.A., Glisson, C., Hoagwood, K., Kelleher, K., Landsverk, J., Cafri, G., Psychometric properties and U.S. National norms of the evidence based practice attitude scale (EBPAS). Psychological Assessment 22 (2010), 356–365.
3. Aarons, G.A., Hurlburt, M., Horwitz, S.M., Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health 38 (2011), 4–23.
4. Aarons, G.A., Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS). Mental Health Services Research 6 (2004), 61–74.
5. Aarons, G.A., Ehrhart, M.G., Farahnak, L.R., Sklar, M., Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation. Annual Review of Public Health 35 (2014), 255–274.
6. Aarons, G.A., Fettes, D., Willging, C., Gunderson, L., Garrison, L., Phillips, J., Work life and attitudes toward a specific evidence-based practice. NIMH conference on mental health services research, publishing, Bethesda, MD, 2014.
7. Achara-Abrahams, I., Evans, A.C., King, J.K., Recovery-focused behavioral health system transformation: A framework for change and lessons learned from Philadelphia. Kelly, J.F., White, W.L., (eds.) Addiction recovery management: Theory, research, and practice, 2011, Humana Press, New York, NY, 187–208.
8. Beidas, R.S., Kendall, P.C., Training therapists in evidence-vased practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology 17 (2010), 1–30.
9. Beidas, R.S., Marcus, S., Aarons, G.A., Hoagwood, K.E., Schoenwald, S., Evans, A.C., et al. Predictors of community therapists’ use of therapy techniques in a large public mental health system. JAMA Pediatrics 169 (2015), 374–382.
10. Beidas, R.S., Marcus, S., Wolk, C.B., Powell, B., Aarons, G.A., Evans, A.C., et al. A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practices in a publicly-funded mental health system. Administration and Policy in Mental Health and Mental Health Services Research, 2015.
11. Bloom, S.L., Bennington-Davis, M., Farragher, B., McCorkle, D., Nice-Martini, K., Wellbank, K., Multiple opportunities for creating sanctuary. Psychiatric Quarterly 74 (2003), 173–190.
12. Chadwick Center for Children and Families, Assessment-based treatment for traumatized children: A trauma assessment pathway (TAP). 2009, Author, San Diego, CA.
13. Chaffin, M., Friedrich, B., Evidence-based treatments in child abuse and neglect. Children and Youth Services Review 26 (2004), 1097–1113.
14. Chambers, D.A., Glasgow, R.E., Stange, K.C., The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science, 8, 2013, 117.
15. Cohen, J.A., Mannarino, A.P., Interventions for sexually abused children: Initial treatment outcome findings. Child Maltreatment 3 (1998), 17–26.
16. Cohen, J.A., Mannarino, A.P., Disseminating and implementing trauma-focused CBT in community settings. Trauma Violence & Abuse 9 (2008), 214–226.
17. Cohen, J.A., Deblinger, E., Mannarino, A.P., Steer, R.A., A multisite: Randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry 43 (2004), 393–402.
18. Cohen, J.A., Mannarino, A.P., Knudsen, K., Treating sexually abused children: 1 year follow-up of a randomized controlled trial. Child Abuse & Neglect 29 (2005), 135–145.
19. Cohen, J.A., Mannarino, A.P., Deblinger, E., Treating trauma and traumatic grief in children and adolescents. 2006, Guilford Press, New York, NY.
20. Cohen, J.A., Mannarino, A.P., Perel, J.M., Staron, V., A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry 46 (2007), 811–819.
21. Curran, G.M., Bauer, M., Mittman, B., Pyne, J.M., Stetler, C., Effectiveness-implementation hybrid designs: Combining elements of clinical effectiveness and implementation research to enhance public health impact. Medical Care 50 (2012), 217–226.
22. Cusack, K.J., Frueh, B.C., Brady, K.T., Trauma history screening in a community mental health center. Psychiatric Services 55 (2004), 157–162.
23. DeCandia, C.J., Guarino, K., Clervil, R., Trauma-informed care and trauma-specific services: A comprehensive approach to trauma intervention. 2014, American Institute for Research, Washington, DC.
24. Deblinger, E., Mannarino, A.P., Cohen, J.A., Runyon, M.K., Steer, R.A., Trauma-focused cognitive behavioral therapy for children: Impact of the trauma narrative and treatment length. Depression and Anxiety 28 (2011), 67–75.
25. Drahota, A., Meza, R.D., Brikho, B., Naaf, M., Estabillo, J.A., Gomez, E.D., et al. Community-academic partnerships: A systematic review of the state of the literature and recommendations for future research. The Milbank Quarterly 94 (2016), 163–214.
26. Edmunds, J.M., Read, K.L., Ringle, V.A., Brodman, D.M., Kendall, P.C., Beidas, R.S., Sustaining clinician penetration, attitudes and knowledge in cognitive-behavioral therapy for youth anxiety. Implementation Science, 9, 2014, 89.
27. Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine 14 (1998), 245–258.
28. Finkelhor, D., Turner, H., Ormrod, R., Hamby, S.L., Violence, abuse: And crime exposure in a national sample of children and youth. Pediatrics 124 (2009), 1411–1423.
29. Fitzgerald, M.M., TF-CBT knowledge questionnaire. 2012, Institute of Behavioral Science, Boulder, CO.
30. Foa, E.B., Hembree, E.A., Cahill, S.P., Rauch, S.A., Riggs, D.S., Feeny, N.C., et al. Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology 73 (2005), 953–964.
31. Ford, J.D., Racusin, R., Daviss, W.B., Ellis, C.G., Thomas, J., Rogers, K., et al. Trauma exposure among children with oppositional defiant disorder and attention deficit-hyperactivity disorder. Journal of Consulting and Clinical Psychology 67 (1999), 786–789.
32. Frueh, B.C., Cousins, V.C., Hiers, T.G., Cavenaugh, S.D., Cusack, K.J., Santos, A.B., The need for trauma assessment and related clinical services in a state-funded mental health system. Community Mental Health Journal 38 (2002), 351–356.
33. Ganju, V., Implementation of evidence-based practices in state mental health systems: Implications for research and effectiveness studies. Schizophrenia Bulletin 29 (2003), 125–131.
34. Giaconia, R.M., Reinherz, H.Z., Silverman, A.B., Pakiz, B., Frost, A.K., Cohen, E., Traumas and posttraumatic stress disorder in a community population of older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 34 (1995), 1369–1380.
35. Gillespie, C.F., Bradley, B., Mercer, K., Smith, A.K., Conneely, K., Gapen, M., et al. Trauma exposure and stress-related disorders in inner city primary care patients. General Hospital Psychiatry 31 (2009), 505–514.
36. Glisson, C., James, L.R., The cross-level effects of culture and climate in human service teams. Journal of Organizational Behavior 23 (2002), 767–794.
37. Glisson, C., Schoenwald, S.K., Kelleher, K., Landsverk, J., Hoagwood, K.E., Mayberg, S., et al. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Administration and Policy in Mental Health and Mental Health Services Research 35 (2008), 124–133.
38. Grasso, D.J., Webb, C., Cohen, A., Berman, I., Building a consumer base for trauma-focused cognitive behavioral therapy in a state system of care. Administration and Policy in Mental Health 40 (2013), 240–254.
39. Green, B.L., Trauma history questionnaire. Measurement of Stress, Trauma, and Adaptation 1 (1996), 366–369.
40. Guarino, K., Soares, P., Konnath, K., Clervil, R., Bassuk, E., Trauma-informed organizational toolkit. 2009, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Daniels Fund, National Child Traumatic Stress Network, and W.K. Kellogg Foundation, Rockville, MD.
41. Hanson, R.F., Gros, K.S., Davidson, T.M., Barr, S., Cohen, J., Deblinger, E., et al. National trainers' perspectives on challenges to implementation of an empirically-supported mental health treatment. Administration and Policy in Mental Health 41 (2014), 522–534.
42. Horowitz, K., Weine, S., Jekel, J., PTSD symptoms in urban adolescent girls: Compounded community trauma. Journal of the American Academy of Child and Adolescent Psychiatry 34 (1995), 1353–1361.
43. Isett, K.R., Burnam, M.A., Coleman-Beattie, B., Hyde, P.S., Morrissey, J.P., Magnabosco, J., et al. The state policy context of implementation issues for evidence-based practices in mental health. Psychiatric Services 58 (2007), 914–921.
44. Jensen-Doss, A., Hawley, K.M., Understanding barriers to evidence-based assessment: Clinician attitudes toward standardized assessment tools. Journal of Clinical Child & Adolescent Psychology 39 (2010), 885–896.
45. Jensen-Doss, A., Hawley, K.M., Understanding clinicians’ diagnostic practices: Attitudes toward the utility of diagnosis and standardized diagnostic tools. Administration and Policy in Mental Health 38 (2011), 476–485.
46. Knudsen, H.K., Johnson, J.A., Roman, P.M., Retaining counseling staff at substance abuse treatment centers: Effects of management practices. Journal of Substance Abuse Treatment 24 (2003), 129–135.
47. Ko, S.J., Ford, J.D., Kassam-Adams, N., Berkowitz, S.J., Wilson, C., Wong, M., et al. Creating trauma-informed systems: Child welfare, education, first responders, health care: Juvenile justice. Professional Psychology-Research and Practice 39 (2008), 396–404.
48. Lipschitz, D.S., Rasmusson, A.M., Anyan, W., Cromwell, P., Southwick, S.M., Clinical and functional correlates of posttraumatic stress disorder in urban adolescent girls at a primary care clinic. Journal of the American Academy of Child and Adolescent Psychiatry 39 (2000), 1104–1111.
49. Luthra, R., Abramovitz, R., Greenberg, R., Schoor, A., Newcorn, J., Schmeidler, J., et al. Relationship between type of trauma exposure and posttraumatic stress disorder among urban children and adolescents. Journal of Interpersonal Violence 24 (2009), 1919–1927.
50. Middlebrooks, J.S., Audage, N.C., The effects of childhood stress on health across the lifespan. 2008, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GA.
51. Mor Barak, M.E., Nissly, J.A., Levin, A., Antecedents to retention and turnover among child welfare, social work, and other human service employees: What can we learn from past research? A review and metanalysis. Social Service Review 75 (2001), 625–661.
52. Nadeem, E., Gleacher, A., Beidas, R.S., Consultation as an implementation strategy for evidence-based practices across multiple contexts: Unpacking the black box. Administration and Policy in Mental Health and Mental Health Services Research 40 (2013), 439–450.
53. Nakamura, B.J., Selbo-Bruns, A., Okamura, K., Chang, J.M., Slavin, L., Shimabukuro, S., Developing a systematic evaluation approach for training programs within a train-the-trainer model for youth cognitive behavior therapy. Behaviour Research and Therapy 53 (2014), 10–19.
54. National Center for Children in Poverty, Facts about trauma for policymakers: Children's mental health. 2007, Columbia University, Mailman School of Public Health, New York, NY.
55. Osterberg, L.D., Jensen-Doss, A., Cusack, K.J., de Arellano, M.A., Diagnostic practices for traumatized youths: Do clinicians incorporate symptom scale results?. Community Mental Health Journal 45 (2009), 497–507.
56. Powell, B.J., McMillen, J.C., Proctor, E.K., Carpenter, C.R., Griffey, R.T., Bunger, A.C., et al. A compilation of strategies for implementing clinical innovations in health and mental health. Medical Care Research and Review 69 (2012), 123–157.
57. Powell, B.J., Beidas, R.S., Stewart, R.E., Wolk, C.B., Rubin, R.M., Matlin, S.L., et al. Applying the policy ecology framework to Philadelphia's behavioral health transformation efforts. Administration and Policy in Mental Health and Mental Health Services Research, 2016.
58. Proctor, E.K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., Mittman, B., Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research 36 (2009), 24–34.
59. Reding, M.E., Chorpita, B.F., Lau, A.S., Innes-Gomberg, D., Providers’ attitudes toward evidence-based practices: Is it just about providers, or do practices matter, too?. Administration and Policy in Mental Health and Mental Health Services Research 41 (2014), 767–776.
60. Saunders, B.E., Berliner, L., Hanson, R.F., Child physical and sexual abuse: Guidelines for treatment. 2004, National Crime Victims Research and Treatment Center, Charleston, SC.
61. Scaccia, J.P., Cook, B.S., Lamont, A., Wandersman, A., Castellow, J., Katz, J., et al. A practical implementation science heuristic for organizational readiness: R = MC. Journal of Community Psychology 43 (2015), 484–501.
62. Schell, S.F., Luke, D.A., Schooley, M.W., Elliott, M.B., Herbers, S.H., Mueller, N.B., et al. Public health program capacity for sustainability: A new framework. Implementation Science, 8, 2013, 15.
63. Shonkoff, J.P., Boyce, W.T., McEwen, B.S., Neuroscience, molecular biology: And the childhood roots of health disparities building a new framework for health promotion and disease prevention. Journal of the American Medical Association 301 (2009), 2252–2259.
64. Sigel, B.A., Benton, A.H., Lynch, C.E., Kramer, T.L., Characteristics of 17 statewide initiatives to disseminate trauma-Focused cognitive-Behavioral therapy (TF-CBT). Psychological Trauma-Theory Research Practice and Policy 5 (2013), 323–333.
65. Silverman, W.K., Ortiz, C.D., Viswesvaran, C., Burns, B.J., Kolko, D.J., Putnam, F.W., et al. Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child and Adolescent Psychology 37 (2008), 156–183.
66. Stirman, S.W., Kimberly, J., Cook, N., Calloway, A., Castro, F., Charns, M., The sustainability of new programs and innovations: A review of the empirical literature and recommendations for future research. Implementation Science, 7, 2012.
67. Stumpf, R.E., Higa-McMillan, C.K., Chorpita, B.F., Implementation of evidence-based services for youth: Assessing provider knowledge. Behavior Modification 33 (2009), 48–65.
68. The Pew Charitable Trusts, Philadelphia 2013: the state of the city. 2013, The Pew Charitable Trusts, Philadelphia, PA.
69. The Pew Charitable Trusts, Philadelphia 2015: the state of the city. 2015, The Pew Charitable Trusts, Philadelphia, PA.
70. The Research and Evaluation Group at the Public Health Management Corporation, Findings from the Philadelphia urban ACE survey. 2013, The Public Health Management Corporation.
71. Weisz, J.R., Chorpita, B.F., Palinkas, L.A., Schoenwald, S.K., Miranda, J., Bearman, S.K., et al. Testing standard and modular designs for psychotherapy treating depression, anxiety: And conduct problems in youth: A randomized effectiveness trial. Archives of General Psychiatry 69 (2012), 274–282.
72. Woltmann, E.M., Whitley, R., McHugo, G.J., Brunette, M., Torrey, W.C., Coots, L., et al. The role of staff turnover in the implementation of evidence-based practices in mental health care. Psychiatric Services 59 (2008), 732–737.
73. Woody, J., Anderson, D., D'Souza, H., Baxter, B., Schubauer, J., Dissemination of trauma-focused cognitive-behavioral therapy: A follow-up study of practitioners’ knowledge and implementation. Journal of Evidence-Informed Social Work 00 (2015), 1–13.
74. de Arellano, M.A., Lyman, D.R., Jobe-Shields, L., George, P., Dougherty, R.H., Daniels, A.S., et al. Trauma-focused cognitive-behavioral therapy for children and adolescents: Assessing the evidence. Psychiatric Services 65 (2014), 591–602.