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Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-03-2008 | Original Paper

The Adoption and Implementation of an Evidence Based Practice in Child and Family Mental Health Services Organizations: A Pilot Study of Functional Family Therapy in New York State

Authors: James L. Zazzali, Cathy Sherbourne, Kimberly Eaton Hoagwood, Deborah Greene, Michael F. Bigley, Thomas L. Sexton

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 1-2/2008

Abstract

Numerous challenges persist in providing evidence-based treatments to children and families in community-based settings. Functional Family Therapy (FFT), one such evidence-based treatment, is a family prevention and intervention program for adolescents with conduct disorder or oppositional defiant disorder. This paper presents pilot data in support of a conceptual framework explaining the adoption and implementation of FFT in a small sample of family and child mental health services organizations in New York State. The conceptual framework is grounded in the diffusion of innovations and the organizational behavior literatures, as well as previously published accounts of the adoption and implementation of evidence-based treatments in mental health. Pilot study data demonstrated that factors associated with the adoption of FFT included: The program fitting with the mission of the organization, as well as the organization having a strong interest in evidence-based treatments. Once a decision to adopt FFT was made, the degree to which it fit with organizational characteristics (e.g., available resource sets, organizational structure, and culture) influenced the ease with which it was implemented. Implications for the adoption and implementation of other evidence-based treatments are discussed.

For two of the organizations included in the sample, an additional administrator was interviewed because the original key respondent said the additional administrator was likely to have important information about the adoption and implementation of the FFT program.

Due to resource constraints and the limited number of interviews, only one RAND researcher coded the interviews. It is recommended that future tests of the framework include reliability tests using two or more coders.

Alexander, J. F., & Sexton, T. L. (2002). Functional family therapy: A model for treating high-risk, acting-out youth. In: F. W. Kaslow (Ed.), Comprehensive handbook of psychotherapy (Vol. 4, pp. 111–132). New York, NY, USA: Integrative/eclectic, 22, 602.

Alexander, J. F., & Parsons, B. V. (1973). Short-term behavioral intervention with delinquent families: Impact on family process and recidivism. Journal of Abnormal Psychology, 81(3), 219–225.PubMedCrossRef

Barnoski, R. (2003). Outcome evaluation of Washington State’s research-based programs for juvenile offenders. Washington State Institute for Public Policy. Available at: www.wsipp.wa.gov.

Crawford, P., Brown, B., Anthony, P., & Hicks, C. (2002). Reluctant empiricists: Community mental health nurses and the art of evidence-based praxis. Health and Social Care in the Community, 10(4), 287–298.PubMedCrossRef

Daft, R. L. (2000). Organization theory and design (7th ed). South Western College Publishing.

D’Aunno, T., Vaughn, T., & McElroy, P. (1999). An institutional analysis of HIV prevention efforts by the nation’s outpatient drug abuse treatment units. Journal of Health and Social Behavior, 40, 175–192.PubMedCrossRef

DiMaggio, P. J., & Powell, W. W. (1991). Chapter 3: The Iron cage revisited: Institutional isomorphism and collective rationality. In W. W. Powell, & P. J. DiMaggio (Eds.), The new institutionalism in organizational analysis (pp. 63–82). Chicago: University of Chicago Press.

Drake, R. E., Goldman, H. E., Leff, H. S., et al. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services, 52(2), 179–182.PubMedCrossRef

Elliott, D. S. (Ed.). (1998). Blueprints for violence prevention. University of Colorado, Center for the Study and Prevention of Violence. Boulder, CO: Blueprints Publications.

Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.

Glisson, C. (2000). Organizational climate and culture. In R. J. Patti (Ed.), The handbook of social welfare management. Thousand Oaks, CA: Sage Publications.

Glisson, C. (2002). The organizational context of children’s mental health services. Clinical Child and Family Psychology Review, 5(4), 233–253.PubMedCrossRef

Goldman, H. H., Ganju, V., Drake, R. E., Gorman, P., Hogan, M., Hyde, P. S., et al. (2001). Policy implications for implementing evidence-based practices. Psychiatric Services, 52(12), 1591–1597.PubMedCrossRef

Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly, 82(4).

Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., Kyriakidou, O., & Peacock, R. (2005). Storylines of research in diffusion of innovation: A meta-narrative approach to systematic revie. Social Science and Medicine, 61(2), 417–430.PubMedCrossRef

Hage, J., & Aiken, M. (1969). Routine technology, social structure, and organization goals. ASQ, 10, 366–376.CrossRef

Hannan, M., & Freeman, J. (1984). Structural inertia and organizational change. American Sociological Review, 49, 149–164.CrossRef

Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (1998). Multisystemic treatment of antisocial behavior in children and adolescents. New York and London: Guilford Press.

Hoagwood, K., Burns, B. J., Kiser, L., Ringelsel, H., & Schoenwald, S. K. (2001). Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52(9), 1179–1189.PubMedCrossRef

Jerrell, J. M., & Ridgely, M. S. (1999). Impact of robustness of program implementation on outcomes of clients in dual diagnosis programs. Psychiatric Services, 50(1), 109–112.PubMed

Kanter, R. M. (1988). When a thousand flowers bloom: Structural, collective and social conditions for innovation in organizations. Research in Organizational Behavior, 10, 169–211.

Levine, S., & White, P. (1961). Exchange as a conceptual framework for the study of interorganizational relationships. Administrative Science Quarterly, 5, 583–601.CrossRef

McHugo, G. J., Drake, R. E., Teague, G. B., & Xie, H. (1999). Fidelity to assertive community treatment and client outcomes in the New Hampshire dual disorders study. Psychiatric Services, 50(6), 818–824.PubMed

Meyer, J. W., & Rowan, B. (1991). Chapter 2: Institutionalized organizations: Formal structure as myth and ceremony. In W. W. Powell, & P. J. DiMaggio (Eds.), The new institutionalism in organizational analysis (pp. 41–62). Chicago: University of Chicago Press.

Nohria, N., & Gulati, R. (1996). Is slack good or bad for innovation? Academy of Management Journal, 39, 1245–1264.CrossRef

Pfeffer, J., & Salancik, G. R. (1978). The external control of organizations: A resource dependence perspective. New York: Harper and Row.

Provan, K., Sebastian, J., & Milward, H. (1996). Interorganizational cooperation in community mental health: A resource-based explanation of referral and case coordination. Medical Care Research and Review, 53(1), 94–119.PubMed

Rogers, E. M. (1995). Diffusion of innovations (4th ed.). New York: Free Press.

Roggenkamp, S. D., & White, K. R. (2001). Is hospital case management a rationalized myth? Social Science and Medicine, 53, 1057–1066.PubMedCrossRef

Rosenheck, R. (2001a). Stages in the implementation of innovative clinical programs in complex organizations. The Journal of Nervous and Mental Disease, 189(12), 812–821.PubMedCrossRef

Rosenheck, R. A. (2001b). Organizational process: A missing link between research and practice. Psychiatric Services, 52(12), 1607–1612.PubMedCrossRef

Schoenwald, S. K., Sheidow, A. J., Letourneau, E. J., et al. (2003). Transportability of multisystemic therapy: Evidence for multilevel influences. Mental Health Services Research, 5(4), 223–239.PubMedCrossRef

Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52(9), 1190–1197.PubMedCrossRef

Scott, W. R. (2003). Organizations: Rational, natural, and open systems (5th ed.). Upper Saddle River, NJ: Prentice-Hall.

Sexton, T. L., & Alexander, J. F. (2002). Family-based empirically supported interventions. Counseling Psychologist, 30(2), 238–261.CrossRef

Sexton, T. L., & Alexander, J. F. (2003). Functional family therapy: A mature clinical model. In T. Sexton, G. Weeks, & M. Robbins (Eds.), Handbook of family therapy. New York, NY: Brunner/Routledge.

Sexton, T. L., & Alexander, J. F. (2005). Functional family therapy for externalizing disorders in adolescents. In J. Lebow (Ed.). Handbook of clinical family therapy (pp. 164–194). NJ: Wiley.

Shortell, S. M., Zazzali, J. L., Burns, L. R., Alexander, J. A., Gillies, R. R., Budetti, P. P., et al. (2001). Implementing evidence-based medicine: The role of market pressures, compensation incentives and culture in physician organizations. Medical Care, 39(7), I-62–I-78.

Simpson, D. D. (2002). A conceptual framework for transferring research to practice. Journal of Substance Abuse Treatment, 22(4), 171–182.PubMedCrossRef

Stirman, S., Crits-Christoph, P., & DeRubeis, R. (2004). Achieving successful dissemination of empirically supported adult psychotherapies: A synthesis of dissemination theory. Clinical Psychology: Science and Practice, 11, 343–359.CrossRef

Thompson, J. (1967). Chapter 5: Technology and structure. Organizations in Action, 51–65.

Valente, T. W., & Davis, R. L. (1999). Accelerating the diffusion of innovations through the use of opinion leaders. The Annals of the American Academy, 566, 55–67.CrossRef

Westphal, J. D., Gulati, R., & Shortell, S. M. (1997). Customization or conformity? An institutional and network perspective on the content and consequences of TQM adoption. Administrative Science Quarterly, (42), 366–394.

Title: The Adoption and Implementation of an Evidence Based Practice in Child and Family Mental Health Services Organizations: A Pilot Study of Functional Family Therapy in New York State
Authors: James L. Zazzali
Cathy Sherbourne
Kimberly Eaton Hoagwood
Deborah Greene
Michael F. Bigley
Thomas L. Sexton
Publication date: 01-03-2008
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 1-2/2008
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-007-0145-8

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