In California, the Children and Youth Behavioral Health Initiative (CYBHI) was created to develop improved systems to help children and their families improved behavioral health services. It has several initiatives it is developing. One of these is its Round 5 plan to scale up evidence-based interventions (EBIs) and community-defined practices (CDPs). The CYBHI is available for the public to participate in and listen to as interested parties. One of the challenges is to determine which practices should be used. Both EBIs and CDPs have their pros and cons.
EBIs can be defined as “practices or programs that have peer-reviewed, documented empirical evidence of effectiveness. Evidence-based interventions use a continuum of integrated policies, strategies, activities, and services whose effectiveness has been proven or informed by research and evaluation.” The key element for EBIs is that they have research studies, many of which use an experimental vs. control group to determine the effectiveness of the practice. Then the study is published and reviewed by other professionals or researchers to verify the information, while other institutions may replicate the study to determine its effectiveness. While EBIs have a sound research basis, they may not represent the desired population. In an article, BMC Medicine indicated six potential biases in evidenced-based medicine. Applied to behavioral health, the concern may be the subjects chosen may not reflect the desired population for the practice or the necessary interventions that may apply to them. The other factor of EBIs is to keep their use strictly confined to the practice’s parameters. As with medications that have a specific purpose, EBIs must adhere to their target population, fidelity, and be sustainable.
With CDPs, the approach is somewhat different. Rather than starting with the research and defining the population, CDPs or community-defined evidence begins with the population and discovering what works for them. One of the major reasons for using CDPs is that many EBIs are not researched with people of color. CDP practices are “developed specifically to address the unmet needs and strengths of a cultural group; they are rooted in the community’s worldview and its historical and social contexts.” While the practice does not necessarily have wide-ranging utility among multiple communities, it has specific benefits for its limited communities.
How does the CYBHI best balance the use of EBIs and CBPs when California is a culturally and geographically diverse state? Not only are many ethnicities present in the state (many of whom are underserved and need better access to care), but disparity also exists between rural vs. urban counties. One approach is to allow each county to determine the best mix of EBIs and CBPs. The disadvantage of a larger organization making these decisions is that they are doing so from a macro level of the state and may not understand the differences between Alameda vs. San Diego Counties, between Yolo and Modoc. When decisions are made at the local level, with guidance from the state, the balance of decision-making provides the best match of services.
Got questions? We've got answers.
PRAXES is a nationwide behavioral health software, consulting, and training company. No one in the behavioral health industry has a better reputation, and if you give us the chance, we’ll show you why! At PRAXES, our services improve the efficiency and structure of behavioral health agencies serving children and families nationwide. PRAXES brings over 45 years of administrative and clinical expertise. With more than 100 client companies nationwide, we offer the expertise to advance the quality of behavioral health services. We accomplish these goals through our new clinical decision software, our training of best practices, and helping companies meet regulatory standards. At PRAXES, we believe in being creative and fostering new ways to serve children and their families. Our vision is to empower the families our agencies serve with skills that not only improve their functioning, but help them to thrive in their everyday lives. When you give us the chance, you’ll be connected directly to our friendly staff, so you can expect immediate attention to your inquiry. So, don’t wait, call now!
Dan Thorne has unique perspectives on the field of mental health. As a clinician, he has had over 40 years of experience working with clients in the Southern California area. After obtaining his Bachelor’s degree from the University of California at Irvine, he worked with children in the Orange County Juvenile Hall. Here he honed his earliest techniques on at-risk children. After that, he obtained his Master’s degree in Counseling from California State University, Fullerton.
In the 1990’s, Dan turned his attention to the clinical and administrative side of behavioral health organizations. For three years, he was the Assistant Administrator of Starting Point, a chemical dependency facility in Costa Mesa, CA. In 2001, he took an opportunity to be the Director of Harbor View Community Services Center in Long Beach. When he arrived, the Center had only 80 clients and 13 staff. When he left, there were over 400 clients and 75 staff. Dan created several programs through their contract with the Los Angeles County Departments of Mental Health and Child and Family Services. Under his guidance, Harbor View became one of the leading providers of children’s services in Los Angeles County.
While improving the results of the client’s parents at the Center, Dan reflected on his experiences as a parent. His children themselves had special needs such as mental and intellectual challenges, and Dan knew the toll it takes on the parent. In order to help the child, the parent has to be healthy. From this concept, he created his parenting program. After years of refining it, teaching it to his staff at the Center, and then taking the results and comments from these efforts, he became the developer of the current PRAXES program. It is a culmination of Dan’s personal trials and tribulations as a parent along with empirical results and research of over 40 parenting programs.
Our vision at PRAXES is to advance the strength of parents and caregivers of children with special needs (mental health, intellectual, or physical) through education, support, and empowerment. Thus, they can live healthy and functional lives while caring for the child.
Apogee is a clinical decision software designed to help behavioral health practitioners with their treatment and patient engagement. It provides evidence-based and research-based components. Not only do they consist of elements from such practices as Cognitive Behavior Therapy, Seeking Safety, Dialectical Behavior Therapy, Motivational Interviewing, Functional Behavior Analysis, but also the Intensive Models for Parents, Youth, and Children.
PRAXES has over 30 years of accreditation experience. We know what it takes to get your organization accredited. Whether it’s Joint Commission, CARF, or COA, our team can provide an evaluation of your current status and review the standards which need improvements. We will assist you with the policies, documentation, and training required to be accredited.
All Rights Reserved | Praxes