From Theory to Practice: One Agency’s Experience with Implementing an Evidence-Based Model

Abstract

As evidence-based practice is becoming integrated into children’s mental health services as a means of improving outcomes for children and youth with severe behavioral and emotional problems, therapeutic foster care (TFC) which is a specialized treatment program for such youth, is one of few community-based programs considered to be evidence-based. “Together Facing the Challenge” (TFTC) which was developed as a component of a randomized trial of TFC has been identified as an evidence-based model. We describe the experiences reported by one of the agencies that participated in our study and how they have incorporated TFTC into their on-going practice. They highlight key implementation strategies, challenges faced, and lessons learned as they moved forward towards full implementation of TFTC throughout their agency.

Barriers and Facilitators for a Collaborative International Physical Therapist Residency Program in Nairobi, Kenya

“…This allowed the instructor to give a variety of examples of concepts and decreased the uncertainty of the information provided in online materials. Murray et al ( 9 ) suggest that understanding the “why” of evidence-based practice improves the implementation of new approaches. The interaction and efforts of instructors to provide that “why” was described as a facilitating factor in gaining understanding of concepts and skills.…”

The need to do it all: Exploring the ways in which treatment foster parents enact their complex role

“…The only other currently recognized evidence-supported model of TFC, Together Facing the Challenge (TFTC) (Farmer, et al, 2009; Farmer, et al, 2010; Murray, et al, 2010; Murray, et al, 2014; Murray, et al, 2015), explicitly recognizes the dual roles required of treatment parents, but remains firmly grounded in behavioral approaches to intervention. In an attempt to recognize some of the complexities of the role treatment parents play, TFTC incorporates domains in its training and supervision that expand the role to emphasize more relational aspects.…”

“…TFTC also explicitly recognizes the importance of helping youth (and the agencies/sectors that serve them) think about long-term plans and trajectories, rather than just focusing on current behavior, functioning, and crisis minimization. It also directly addresses the importance of incorporating activities that bring “family fun” to the forefront and helping the treatment parent prioritize their own well-being and “taking care of self,” both as an approach to reduce burnout and to model for youth the importance of healthy lifestyles and choices (Murray, et al, 2010; Murray, et al, 2014). Despite this attempt to broaden and recognize the multiple domains and demands that treatment parents must address, nearly 75% of TFTC training is devoted to developing competence in behavioral approaches to address problem behaviors (Murray, et al, 2015).…”

Measuring fidelity of empirically‐supported treatment foster care: Preliminary psychometrics of the together facing the challenge—fidelity of implementation test (TFTC‐FIT)

“…Hence, TFTC provided more intensive training in behaviour management approaches to more effectively manage foster youths' problem behaviour and encourage positive behaviour. TFTC is described in detail elsewhere (Murray et al, ; Murray, Culver, Farmer, Jackson, & Rixon, ). In brief, the training consisted of an initial two‐day training with TFC supervisors to introduce them to the curriculum that would be used with the treatment parents and to help them become comfortable with the material so that they could co‐facilitate training with treatment parents and work individually with their caseload of treatment parents on homework assignments between weekly group treatment parent training sessions.…”