Evidence-Based Practices: Shaping Mental Health Services Toward Recovery

Implementation Resource Kit User's Guide

How to Use the Resource Kit Materials—An Implementation Plan

Effective implementation of evidence-based practices is best achieved by using the materials with a structured complementary consultative and training program. As part of this project, a number of evidence-based practices implementation centers have been established throughout the country. For more information on these centers, go to www.mentalhealthpractices.org.

A brief description of a basic implementation plan that includes these supports is provided below. See the Implementation Tips for Mental Health Programs Leaders and Implementation Tips for Public Mental Health Authorities for more detailed suggestions regarding the implementation of Family Psychoeducation.

Consensus building
Build support for change

identify key stakeholders
provide information to all stakeholders
develop consensus regarding a vision for the practice at your agency
convey a vision and a commitment to all stakeholders

Enthusiasm for the implementation of the evidence-based practice can be generated by communicating how the practice benefits consumers and family members.

Use implementation resource materials:

Distribute information materials to the key stakeholder groups.
Hold informational meetings with key stakeholder groups. Have opinion leaders within the different stakeholder groups co-host these meetings. Include a viewing of the introductory videotape. An introductory PowerPoint presentation can be used to structure the informational meeting.

Developing an implementation plan
An action plan

identify an agency implementation leader
establish an implementation steering team that includes representatives from all stakeholder groups
secure a consultant from an EBP implementation institute
develop an implementation plan

Responsibilities of the implementation leader and implementation steering team include identifying and utilizing personnel, resources, and processes (administrative support and system changes) needed to support the evidence-based practice; an assessment of training needs; and development of an implementation timeline.

Consultants from EBP implementation centers can work with public mental health authorities and program leaders to inform them about the practice, to evaluate an agency's or system's commitment to change, and to assess current realities of financial incentives, staffing, and structure.

By developing partnerships with community organizations including peer support programs, consumer and family advocacy groups, police, homeless shelters, food banks, department of vocational rehabilitation, and others depending on the specific practice, the implementation leader and the implementation steering team can most effectively develop support for the practice. These groups may contribute to the development of an implementation plan.

Use of implementation resource materials:

Implementation Tips for Public Mental Health Authorities is designed for individuals at the municipal, county, or state mental health authority.
Implementation Tips for Mental Health Program Leaders is designed to be shared with the individuals in an agency that make and carry out decisions about the local resources and processes. This includes people who have responsibility for program management, training, policy development, program standards, data management, and funding.

Enacting the implementation
Making it happen

involve agency personnel at all levels to support the implementation
host a "kick-off" training where all stakeholders receive information about the practice
host a comprehensive skills training for agency personnel who will be providing the practice
arrange opportunities to visit programs that have successfully implemented the practice
work with an implementation center for off-site support for the practice
review current agency outcome measures relative to the practice and modify outcome data to monitor the practice. Learn how to make use of outcome measures in clinical practice and supervision
work with a consultant/trainer to learn how to use the fidelity scale to identify strengths and weaknesses in the implementation effort

Trainers can work with the agency to offer an initial or "kickoff" training for all stakeholders. The trainer can then provide comprehensive skills training for those personnel within the agency who will be providing the practice. The trainers may offer to visit the program at least one day per month for the first six months, then one day every other month for the next six months, for ongoing training, consultation, supervision as needed by the program. The trainer may also be available on a weekly basis for phone consultation.

Use of implementation resource materials:
Many agencies find it useful for the implementation leader and agency staff to familiarize themselves with the structure and processes of the practice by visiting an existing program. Before a site visit, the implementation leader and clinical supervisor(s) should review:

Information for Practitioners and Clinical Supervisors
Information for Mental Health Program Leaders
Implementation Tips for Mental Health Program Leaders
Workbook for Practitioners and Clinical Supervisors

Materials that support training and clinical supervision

Workbook for Practitioners and Clinical Supervisors
Practice demonstration videotapes
PowerPoint training presentation (available from the West Institute)

Trainers may also serve as consultants to the administrators of the program. This includes demonstrating the usefulness of outcomes data as a clinical feedback tool. See Monitoring Client Outcomes.

Monitoring and evaluation
Sustaining change: How to maintain and extend the gains

establish a mechanism for continuous feedback regarding how the practice is being provided in an agency
publicize outcome improvements from the practice
use fidelity scales to monitor the practice implementation

Monitoring and evaluation occur in several ways. First, the use of consultants to provide side-by-side, ongoing consultation during the first one to two years of the program is very helpful. Consultants who are experienced in the practice can recognize problems and recommend changes to address them.

Use of implementation resource materials:
It is useful for programs to become comfortable early on with the measures that will be used for monitoring and evaluating the delivery of the practice: outcome measures and the fidelity scale. The information collected can be used not only to identify areas that are problematic, but also to identify areas of excellence. See General Organizational Index. Feedback from these measures may be used to promote and strengthen clinical and programmatic effectiveness.

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