Effective and Scientific Implementation of EBP Initiatives in Community Corrections: Motivational Interviewing, Progression Matrix, and B.SMART,

Chad DilworthValarie SchamperAlexandra Walker

2 Steps to Traditional Implementation

1.Train2.Pray

Funding History

FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 FY08

12 Month 0.144 0.134 0.146 0.152 0.154 0.164 0.183 0.167 0.146

24 Month 0.239 0.265 0.257 0.239 0.239 0.278 0.293 0.281 0.268

5.0%

15.0%

25.0%

35.0%

45.0%

55.0%

65.0%

75.0%

85.0%

95.0%

Recidivism Data in Community CorrectionsTerminations from FY00 Through FY08

Reci

divi

sm R

ate

Effective Programs

Effective Implementation

Outcomes that Benefit Individuals and Society

1.0

0.0

0.0

X

Formula for Success

• Paper – nothing really changes

• Process – procedures change, not outcomes

• Performance – procedures & outcomes change

Fixsen et al. (2005). Implementation Research: A Synthesis of the Literature.

Implementation Types

3 Levels of Implementation• Paper Level – creating new policies and procedures about

the EBP– 80-90% of the people dependent innovations in business

stop at the paper level (Rogers, 2002)

• Process Level – EPB is in agency policy and procedure and other official processes (training, supervision, etc).– Training is didactic only– Supervision is uninformed by training, etc

• Performance Level – EBP is deeply integrated into organizational culture and outcomes/results are seen as a result

• Letting it happen– Recipients are accountable

• Helping it happen– Recipients are accountable

• Making it happen– Purposeful use of implementation practices and

science– Implementation teams are accountable

Based on Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004

Implementation Science

Using Implementation Science to implement EBPs in an effective and sustainable way to produce outcomes

Syringe and Serum The science for the innovation is different than

the science for the preparation for when, where, how, and with whom the innovation is used

Implementation Science

The serum is like the innovation The syringe is like Implementation Science

Implementation Science

Systems Intervention

Facilitative Administration

Decision Support Data System

Coaching

Training

Selection

Technical Adaptive

Fidelity Measurement

STAFF COMPETENCY

DRIVERS

ORGANIZATION SUPPORT DRIVERS

LEADERSHIPDRIVERS Adapted from ©Fixsen & Blase,

2007

Face to Face Coaching

MI 101 Training

Face to Face Coaching

MI 102 Training

The EPIC Process

Face to Face Coaching

Phone Coaching Face to Face Coaching

Tape Submission

The EPIC Process

Communities of Practice

Implementation Strategy for EBP in Community Corrections

EBPS IN COMMUNITY CORRECTIONS

Implementation is a PROCESS, not an EVENT(Stages of Implementation)

1. Exploration2. Installation3. Initial Implementation4. Full Implementation5. Innovation6. Sustainability

Progression Matrix

BSMART

Expected Timelines(Pending Review from EBP Steering Committee)

Progression Matrix B.SMART• 3-5 Programs at a time• 2 Months of Planning (Prior

to Installation)• 3 Months of Installation• Internal coaching/fidelity

measurement

• Start now• Finish in Fall/Winter of 2014

• 3-5 Programs at a time• 3 Months of Planning (Prior

to Installation)• 3 Months of Installation• Internal coaching/fidelity

measurement

• Start Spring 2014• Finish in Spring/Summer of

2017

THE PROGRESSION MATRIX

Implementation Team• Teams are sustainable; each member has a role

• A group that knows the innovations, implementation, and improvement cycles very well.

• Will develop plans and processes to ensure the successful implementation of an innovation

• The Team will meet regularly, planning and revising occurs at all stages of the implementation to ensure the implementation is being done effectively and adapting to changes in the environment and available resources.

Progression Matrix – Planning Phase

• 1.5 day training with implementation team– Review drivers– Develop plan that addresses each area– Work through a case plan– Begin revision of level system– Schedule coaches trainings– Review coaching and fidelity checklist– Sugai’s Law

Sugai’s LawFor every 1 new initiative, stop 2 current ones

Progression Matrix – Planning Phase

• Implementation Team work at the program– Revise level system and any related policies– Train staff– Inform clients– Develop coaches– Sugai’s Law– Case plan development – practice– Updating orientation materials

Progression Matrix – Planning Phase

• .5 day training – 3-4 weeks later– Present revised level system for feedback– Discuss training, coaching and switch over

schedule– Problem solving

Progression Matrix – Planning Phase

• Between .5 day training and initial installation (flipping the switch)– Deciding which current clients will be placed on

matrix– Switching existing clients over– Providing coaching and feedback to CMs– Finalize staff training process– Finish informing clients and answering questions

Progression Matrix – Initial Installation

• Flip that switch! - Day one of the PM– All new clients placed on the PM – Existing clients switched over to PM with updated

case plans

And now for the hard part!!

• Regular coaching and feedback• Review fidelity and implementation measures• Identifying roadblocks and challenges• Practice-Improvement Cycle• Support from leadership

• TEASE: Go to presentation on lessons learned from EPIC for a more detailed discussion of the challenges of moving from initial to full implementation

Behavioral Shaping Model and Reinforcement Tool

B.SMART

B.SMART – Exploration Phase

• 3 focus groups– Over 100 stakeholders• All levels of participants – from line level staff to

administration, board members and referral agencies

• 4 Regional Working Groups– Southern, Western, Metro-Central, Metro-North

• Statewide Steering Committee– One chair and two vice chairs from each region– Probation, Parole and DCJ

• Regional Working Group (RWG) Meetings– Reviewed existing sanction and incentive models– Reviewed the literature/research on sanctions and

incentives– Developed concept models for both– Created lists of behaviors to sanction and

incentivize

B.SMART – Exploration Phase

B.SMART – Exploration Phase

• Statewide Steering Committee (SSC) Meetings– Met monthly throughout 2012– Set criteria for models using the literature

• Adoption of the 7 principles for managing offender behavior• Sanctions and incentives not tied together• Inclusive of staff at all levels• Simple

– Reviewed concept models created by RWG– Finalized both a sanctions and incentives model

for testing and piloting

Where are we today?

• Began testing sanctions at one facility (CCTC) on July 1st

• Hope to begin full pilot of B.SMART (both sanctions and incentives) in five programs in the spring of 2014

B.SMART Installation Plan

• 3-5 Programs at a time• 3 Months of Planning (Prior to Installation)• 3 Months of Installation• Internal coaching/fidelity measurement

• Start Spring 2014• Finish in Spring/Summer of 2017