Combining Evidence-based Practices for Improved Behavioral Outcomes: A Demonstration Project
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ORIGINAL PAPER
Combining Evidence-based Practices for Improved Behavioral Outcomes: A Demonstration Project Thomas J. Blakely • Susan Bruggink • Gregory M. Dziadosz • Margaret Rose
Received: 25 August 2010 / Accepted: 18 September 2012 / Published online: 30 September 2012 Ó Springer Science+Business Media New York 2012
Abstract This article describes a demonstration project carried out by a special team at a mental health agency serving adults with a serious psychiatric condition. The project consisted of combining the evidence-based practices of cognitive therapy, Motivational Interviewing and Stages of Change with Social Role Theory and the Chronic Care Model that were the organizing concepts of the agency’s assessment and treatment program. Measures of the results of clients’ improved mental health and social functioning indicated the successful use of this combination. Keywords Combination Evidence-based practices Demonstration
Introduction This narrative reports a demonstration by a special team of staff that used a combination of Cognitive Therapy (CT) (Beck 1995), Motivational Interviewing (MI) (Miller and Rollnick 2002 and Stages of Change (SOC) (Prochaska et al. 1992) with the Chronic Care Model (CCM) (Wagner et al. 2001) and Social Role Theory (SRT) (Thomas and Feldman 1964). The latter two were the organizing concepts of the agency’s established assessment and treatment program serving adults with a serious psychiatric condition entitled community treatment and rehabilitation (CT&R) (Blakely At the time of the initial submission of this article the authors were with Touchstone innovare’ that merged with Cherry Street Services on October 1, 2011. T. J. Blakely (&) S. Bruggink G. M. Dziadosz M. Rose Cherry Street Health Services, 100 Cherry St. S.E., Grand Rapids, MI 49503, USA e-mail: [email protected]
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and Dziadosz 2003). The purpose of the demonstration was to determine whether the agency’s staff use of this combination was effective in increasing clients’ social functioning. An IRB application was submitted. The response was that IRB approval was not necessary since this was a program evaluation. Agency administrative staff decided to adopt CT about 6 months before the demonstration based on recognition of its being an effective treatment model for psychiatric conditions (Beck 1976; NAMI 2011). Some clinical supervisors were sent to the Beck Institute in Philadelphia. As part of the training these staff completed a program of expert review of their taped sessions with clients to become adept practitioners of cognitive therapy. CT was the central practice concept for this demonstration as it is a process of collaborating with clients to identify and examine their patterns of learned beliefs, interpretations, and automatic thoughts about themselves and others. Clients were guided to consider possible alternative interpretations of situations in their lives based on evidence. An increased awareness about how thoughts have a direct impact on emotions, along with behavioral experime
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