Organizational Readiness in Child Clinics

New York State Office Of Mental Health, Albany NY

Investigators

Abstract

DESCRIPTION: The New York State Office of Mental Health (OMH) is actively implementing several evidence-based practices (EBPs) for children and adolescents in school health and outpatient mental health clinics with the goal of improving the quality of care. These initiatives include training, supervision and monitoring of Functional Family Therapy (FFT) in 15 outpatient clinics; trauma-related cognitive-behavioral therapies (CBT) related to the events of 9/11 in 10 school health clinics; Interpersonal Therapy (IPT) for depression in 7 school-based health clinics (SBHCs); and medication management for ADHD within the same SBHCs. In all, 200 clinicians and 6,000 children, youth, and families will be affected by these initiatives within the year. Yet, research and policy debates suggest strongly that efforts to deploy EBPs into service systems may fail if insufficient attention is paid to features of the organizational context into which these new technologies are being implemented. This application seeks to strengthen the opportunities for creating sustainable change by developing a framework, typology and methods for examining key features of organizational context-- particularly organizational readiness--that are likely to influence the effective and efficient integration of EBPs into child service systems. Three aims are proposed to develop this model and methods. Aim 1 is to develop a conceptual framework and preliminary typology for assessing organizational readiness to adopt new practices by convening a group of experts representing State cabinet policymakers; organizational theorists/researchers; developers of the clinical models referenced above; families and consumers; and clinic directors from school health and outpatient clinics. Aim 2 is to refine the framework and typology by conducting a series of 6 structured focus groups with 36-48 clinicians, families, and youth from the clinics where the selected models are currently being implemented. Aim 3 is to test the utility of the framework and typology of organizational readiness in pilot studies with a subset of 20 of New York State's child and adolescent provider organizations. The products from these activities will enable the State to implement more efficient, empirically derived, and theoretically grounded strategies for deploying EBPs into child and adolescent service systems.