Stars Behavioral Health Group (SBHG)
Launches Outcomes Initiative
During the past year, Stars Behavioral Health Group programs across California
began keeping track of client progress from enrollment throughout services
and at discharge. All programs are now using a version of a new tool called
the Client Outcomes Report (COR) that gathers information about whether the
children, youth, young adults, or adults we serve are living safely in home
or family-like settings, attending and progressing in school or vocationally,
improving in their health and mental health, and out of trouble with the law.
Data from these reports are beginning to become available and provide information
that complements other tools, including standardized measures already in use
in the programs, such as the Child and Adolescent Functional Assessment Scale
(CAFAS). In addition to this overarching approach to outcomes, we are also
conducting highly focused specialty evaluations of specific services and evidence-based
practices.
For
technical report click here
Star View Children and Family Services (SV-CFS)
Helps Clients Improve in Functioning
Measurements of global functioning of the children and youth served by the
very large Star View Children and Family Services outpatient program show
modest but statistically significant improvements over time in treatment.
Some client and service characteristics are associated with greater levels
of improvement, including early age of enrollment (prevention is better!),
school-based services, and medium (as opposed to either very short or very
long) lengths of stay in services. Positive findings based upon global measures
of functioning are also supported by measurements that look at specific areas
of functioning such as with respect to school, home, behavior towards others,
and moods or emotions. Preliminary information (based upon a small sample)
about an evidence-based practice in use in SV-CFS with particular youth and
families indicate that they are are making very large gains in functioning
across multiple life domains.
For
technical report click here
Starlight Community Treatment Facility (SL-CTF)
Reduces High Risk Behaviors of Adolescents
Staff in our secure, high-end residential programs that provide board and
care, intensive treatment, and schooling for youth with very high risk and
often dangerous behaviors (e.g., assault and self-harm) are making every effort
to reduce the incidence of risk behaviors, and the use of restrictive interventions
in managing this behavior. A number of quality improvement efforts to this
end have been undertaken by Starlight Community Treatment Facility in San
Jose. These include safety contests with incentives and rewards for youth
who learn to handle problems without violence, the introduction of specific
evidence based therapy groups, and increased engagement, dialogue and debriefing
regarding behavioral incidents and youth preferences regarding interventions.
These efforts are paying off. A study was conducted to assess whether there
is a reduction in risk behaviors and uses of restrictive interventions (protective
restraint and seclusion) among youth over their course of treatment at Starlight.
The findings show that there are such declines and they are both of good magnitude
and statistically significant.
For
technical report click here
Therapeutic Behavioral Services (TBS)
Commences Tracking Outcomes
A number of SBHG programs provide Therapeutic Behavioral Services (TBS)
which is a type of behavioral coaching. Youth enrolled in TBS might have histories
of psychiatric hospitalization or out-of-home placement or may be at risk
of losing their current home or placement because of serious behavioral problems.
The behaviors can be helped by 1:1 coaching in which the youth learns replacement
behaviors and alternative coping skills, and the caregiver learns how to reinforce
positive behaviors. This past year we began to track service utilization,
treatment goals and outcomes of individual TBS youth more closely and have
some initial data available as to whether the youth are able to avoid hospitalizations,
remain stably with family or in placement, or move to a lower level of care
by discharge.
For technical
report click here
Oasis Mental Health Rehabilitation Center (MHRC)
Adult Clients’ Experience Improvement in Independent Living Skills
Oasis uses the SBHG Independent Living Skills Scale (ILSS) for both clinical
assessment and outcome tracking during services and upon discharge of clients
from the Mental Health Rehabilitation Center (MHRC). Ratings taken at the
time of admission to the MHRC show that while clients vary in their independent
living skills, they can all benefit from being at Oasis. The analyses of ILSS
data also reveal that, for Oasis clients, medium and long lengths of stay
yield more improvement in functioning on nearly all of the ILSS subscales
than does a short length of service. The program has specific curriculum and
interventions that clients can take advantage of while at Oasis, including
the widely respected best practice of Wellness Recovery Action Planning (W.R.A.P.)
which provides a framework for rehabilitative services. Clients not able to
make optimal use of Oasis’ services with only a short stay (less than
90 days) will show less improvement in their independent living skills.
For technical report
click here
TEAMMATES (TM)
Tracks Wraparound Fidelity to Improve Services
Independent assessments of the delivery of wraparound services by Star View
Children and Family Services’ TEAMMATES (TM) program compared to the
wraparound model are now being conducted on a regular basis using the Wraparound
Fidelity Index (WFI) along with other SBHG total quality management procedures.
The WFI assesses fidelity to the wraparound model from the multiple perspectives
of the youth, caregiver, and the TM Resource Facilitator. To date, WFI (version
3.0) data for a small sample of clients have been collected by a trained field
researcher and the initial data indicate high levels of fidelity of TEAMMATES’
services with respect to many items across most wraparound elements. TEAMMATES’
current areas of strength (90% or better endorsement) include themes related
to the active participation of caregivers on the team; staff respect for family
beliefs, traditions, culture, and the youth; and, the presence of core wraparound
service processes (Plan of Care, Safety Plans, etc). TEAMMATES’ areas
for improvement that are being worked on by the program include youth themes
such as team participation and community involvement, agency partner (social
workers, teachers, etc) participation at team meetings, and the development
of natural supports that will continue beyond formal services.
For
technical report click here
Copeland, M.E., Wellness Recovery Action Planning, Published by Peach
Press, PO Box 301 W. Dummerston, VT, 05357. www.mentalhealthrecovery.com.
Wraparound Fidelity Index (WFI). Copyright 2002 Burchard, JD., University
of Vermont. Used with written permission from the Wraparound Evaluation and
Research Team, Suter, J., Force, M., E Bruns, E., Leverentz-Brody, K., Burchard,
JD, & Mehrtens, K., August 2003. Available only through the authors at
http://www.uvm.edu/~wrapvt/.
