EBP Exchange - UMB School of Social Work

This op ed in the Baltimore Examiner builds on an article in the New York Times of about a week ago indicating that NYC had done well by youth and the budget as a result of expanding the use of Multisystemic Therapy (although they don’t call it by that name, that’s what I understand it was) and Multidimensional Treatment Foster Care. MD is now calling for more evidence based services. I am not knowledgeable enough to know what will come of this initiative but the fact that op-eds and agency Secretaries are using the term “evidence-based practice” in MD is continued reason for us to grapple with what it means, how to train ourselves to deliver it, and how to implement it here.

At the same time, I hardly think that the evidence is so strong that the claims of the ope-ed title are going to be broadly met with the wider use of MST and MFTC.  These are the best programs we have but their testing has been fairly modest.  The underlying randomized clinical trials and the recent expansion to NYC are positive (although the implementation in NYC was not rigorously evaluated, as far as I know) and promising but the headline is a bit strong.  (This may not be the fault of the author of the op-ed as headline writers march to their own drummers.)

This is not a brand new review (it was posted in mid 2007) but for those interested in this topic and those who have not read Campbell reviews, this is a valuable resource to know about, http://www.sfi.dk/sw53242.asp.  Another interesting and recent review you will find on the home page for Campbell is a late 2007 review on CBT in residential care programs with a finding that these are effective in reducing recidivism. Some subjects are not yet reviewable–as you will see if your read the review about treatment foster care because there is simply not enough high quality research. That is the responbility of all of us–researchers, program managers and providers, and funders to correct!  If we can shoot down our own spy sattelites, we can complete more randomized clinical trials!

 These reviews are considered state-of-the-art with regard to research syntheses, although they are not without critics. John Eckenrode, from Cornell, recently prepared a detailed response to a review of home-visiting programs that contained a long list of what are clear errors–a table full of them.  His email to me about that is worth quoting and reading, “I am attaching the Cochrane reviews and our latest draft of our response as well as a table of errors we found.  Hope this is helpful.  It is an instance that helps remind us that Cochrane/Campbell reviews, while very valuable, are not infallible and should be combined with other sources of information when making decisions about the evidence.”

Back on February 11, a post on Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) was published which looked at Trauma-Focused Cognitive Therapy as treatment to address the biopsychosocial needs of children experiencing symptoms of post traumatic strees disorder (PTSD) or other internalizing and externalizing problems releated to traumatic experiences in their life.

 Here is a related video on the subject:

According to School of Social Work Associate Professor Kathryn Collins, the video presents “Accurate information that covers all of the important components. His only snafu was to only site one text for children who have been sexually abused. By citing only this text, he missed giving credit to all three of the developers of TF-CBT (Cohen, Mannarino, and Deblinger) see: http://www.psychiatrictimes.com/p040952.html

The recently released Administration and Policy in Mental Health Services Research has 12 articles related to conceptualizing, measuring, and evaluating efforts to implement evidence-based children’s mental health services. This work, developed by the McArthur Research Network on Youth Mental Health includes a wide range of interesting papers including one on the implementation of Functional Family Therapy in NY; a national survey of the infrastructure of children’s mental health centers that can help ascertain barriers and opportunities for implementation, and additional description of Bruce Chorpita’s work on the elements of children’s mental health interventions (previously discussed on this blog).  It’s a very strong issue.