NIATx Essential Tools: The Walk-through That Almost Never Happened

Mat Roosa, LCSW-R
NIATx Coach

During the early days of NIATx, I was working for an agency, and decided to do a walk-through of the intake process at a community residential program for people with co-occurring mental illness and substance use disorders. The entire walk-through process was very helpful, and resulted in some significant changes to the way that we engaged people at that first visit. This program was located in an attractive old house on a quiet side street. The large bedrooms were a pleasant surprise to clients who had grown used to living in far less pleasant surroundings. As a result of the walk-through we decided to flip the intake process by conducting a tour of the house at the beginning, instead of our traditional approach of touring at the end. This resulted in more enthusiasm on the part of new clients, and made it much easier for them to manage the challenging paperwork of the admissions process.

But perhaps the most important part of the walk-through, was how it almost never happened…

When I arrived at the house, a house I had visited dozens of times as an administrator, I worked to stay in my role as a new client for the walk-through. And so, I walked to the front door of the house. This door was locked, with no sign. I knocked and there was no response. After a brief wait, and some concern, I proceeded to the side door that I had noticed when I had pulled into the driveway. This door was also locked, with two buzzers, a speaker, and no signs. After trying the door, I began pushing the buzzers. I felt anxious that I might now be late for the appointment, or that no one would answer, or that I was doing the wrong thing by pressing the buttons. Finally, a crackly voice came out of the intercom speaker advising me that the door had been opened and that I could try it again. I was relieved, but annoyed. Why couldn’t somebody just come to the door, greet me, and let me in? I felt like they were trying to keep me out.

While the locks needed to stay in place for safety, this walk-through experience resulted in some simple signs to help people to navigate the entrance to the program. This experience also helped me to understand the power of the walk-through, and the importance of seeing programs through the eyes of those we serve. I had entered that building dozens of times, but have never noticed how difficult it would be for an anxious first-time client trying to find the way inside.

About our Guest Blogger
Mat Roosa was a founding member of NIATx and has been a NIATx coach for a wide range of projects. He works as a consultant in the areas of quality improvement, organizational development and planning, evidence-based practice implementation, and also serves as a local government planner in behavioral health in New York State. His experience includes direct clinical practice in mental health and substance use services, teaching at the undergraduate and graduate levels, and human service agency administration. You can reach Mat at:

Learn more about process improvement and the NIATx model Mat Roosa's podcast:
Great Lakes ATTC Implementation Science Podcast Series 

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