Strategies for implementing evidence-based practices in routine mental health settings.
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Evidence-Based Medicine↗
Biomedical subjects
William C Torrey
Publications and source records attributed to William C Torrey.
Responding to blood-borne infections among persons with severe mental illness.
The Five-Site Health and Risk Study estimated prevalence rates of blood-borne infections, including the human immunodeficiency virus (HIV), hepatitis B, and hepatitis C, and addressed risk factors and correlates of infection among persons with severe mental illness. In this final article of the special section in this issue of Psychiatric Services, the authors review public health recommendations and best practices and discuss the implications of these results for community mental health care of clients with severe mental illness. Standard public health recommendations could be modified for use by community mental health providers. In addition, expansion of integrated dual disorders treatments and improving linkage with specialty medical care providers are recommended.
Community Mental Health Services↗
Implementing evidence-based practices for people with severe mental illness.
Persons with severe mental illnesses (SMI) often lack access to effective treatments. The authors describe the Implementing Evidence-Based Practices (EBPs) Project, designed to increase access for people with SMI to empirically supported interventions. The EBP Project aims to improve access through development of standardized implementation packages, created in collaboration with different stakeholders, including clinicians, consumers, family members, clinical supervisors, program leaders, and mental health authorities. The background and philosophy of the EBP Project are described, including the six EBPs identified for initial package development: collaborative psychopharmacology, assertive community treatment, family psychoeducation, supported employment, illness management and recovery skills, and integrated dual disorders treatment. The components of the implementation packages are described as well as the planned phases of the project. Improving access to EBPs for consumers with SMI may enhance outcomes in a cost-effective manner, helping them pursue their personal recovery goals with the support of professionals, family, and friends.
Employment, Supported↗
The challenge of implementing and sustaining integrated dual disorders treatment programs.
Integrated dual disorders treatment programs for people with severe mental illness and co-occurring substance use disorder have been implemented in a variety of community mental health center sites across the U.S. and in several other countries over the past 15 years. Consumers who receive services from programs that offer integrated dual diagnosis treatments that are faithful to evidence-based principles achieve significant improvements in their outcomes. Unfortunately, not all programs that attempt implementation are successful, and the quality of high-fidelity programs sometimes erodes over time. This article outlines implementation strategies that have been used by successful programs. As a general rule, success is achieved by involving all major participants (consumers, family members, clinicians, program leaders, and state or county mental health authorities) in the process and attending to the three phases of change: motivating, enacting, and sustaining implementation.
Community Mental Health Services↗
Implementing dialectical behavior therapy.
Dialectical behavior therapy (DBT) is a cognitive-behavioral approach to treating borderline personality disorder. Early empirical results are promising, although they are not sufficient to establish DBT as an evidence-based practice in community settings. Nevertheless, the treatment has been widely implemented by mental health authorities, program leaders, and clinicians. The authors describe DBT's four stages of treatment, the functional areas addressed, and the treatment modes used as well as the reasons for the appeal of DBT to practitioners. They review barriers encountered by those who have implemented the model and present strategies that have been developed to overcome the barriers.
Cognitive Behavioral Therapy↗