Changing Practice Through Collaboration, Art, and Science

Respectfully submitted by Holly R. Ireland, LCSW-C

The Central East ATTC serving Health and Human Reserves Region 3 has been managed by the Danya Institute for nearly 20 years. Danya’s tagline is “Changing Communities Through Changing Practice” and collaboration has always been a central core value to our work. Workforce development and capacity building changes in practice could not be successfully sustained without collaboration. The mutual exchange of perspectives, ideas, and investment leads to richer and more lasting changes for systems, organizations, professionals and most importantly the individuals and families receiving behavioral healthcare. From it emerges the necessary innovation to keep pace with rapidly evolving trends, leading to a responsive and adaptive system of care.

In recent years there has been an emerging "science of collaboration."[1] This involves intentional efforts to measure the process of learning what works and what doesn't, then use data-informed decision making to improve how leaders design, manage, and evaluate collaboration projects. The process helps to educate and train future leaders with the necessary organizational and managerial skills in collaboration. Literature about the science of collaboration emerged historically in the science sector but is increasingly found in the health and behavioral health sectors.

Given Danya’s core value and the SAMHSA imperative to accelerate the adoption of evidence-based practices in behavioral health through intensive technical assistance (TA) to organizations, localities, and systems; the Central East ATTC has implemented several intensive TA capacity building collaborative projects in organizations, municipalities, counties, and statewide and regional systems of care. Stakeholder collaborations involving three or more entities or organizations have been central to implement capacity building projects in the adoption of evidence-based practices in Motivational Interviewing (MI) and Screening, Brief Intervention, and Referral to Treatment (SBIRT).

In Year 1, the Mount Rogers Community Services Board (MRCS)[2] in Wytheville, VA, collaborated with the Central East ATTC to increase Motivational Interviewing (MI) capacity. MRCS offers “a wide array of community services for individuals with mental health, intellectual and developmental disabilities, and substance use disorders. All services include the use of person-centered planning and embrace concepts of self-determination, empowerment, and recovery as core principles in supporting individuals to achieve their highest possible level of participation in work, relationships, and all aspects of community life.”[3] Candace Coffin, Director of Specialty Services –
Administration/Training, was the champion and internal facilitator of this project. The Central East ATTC engaged Christine Higgins, MINT Trainer, subject matter expert and external facilitator, to plan and implement this project. As part of the planning process, 20 staff members, mostly clinical supervisors, were identified and engaged as key collaborators and future MI trainers.

In Year 2, the project was launched in November 2018 and concluded in September 2019. It began with an MRCS Senior Leadership dinner meeting, which provided an overview of the 6-9 month project; and included two (2) back-to-back, one-day MI Basic training events on November 1 and 2, training 72 staff members. Christine returned to Wytheville in December 2019 to provide MI intermediate training to 24 staff members and clinical supervision of MI training to 22 supervisors.

From December through March, there were several virtual TA sessions with Chrisitine and the 22 supervisors, both group and individually, that involved video recording, coding and feedback, as well as coaching in the supervision of MI. To enhance relationship building, engagement and collaboration for the in-person and virtual sessions between Christine and the trainees, Candace created name placards with photos.

In March 2019, Christine provided MI Advanced to 14 of the supervisors, and 20 of them participated in an MI Training of Trainers in April 2019.

From April through September 2019, Christine provided an additional 20 hours of virtual TA to support the training plan development and implementation, as well as additional coaching in clinical supervision.

The MRCS MI Spirit Committee was formed to ensure full integration of MI in the onboarding of new staff, training of the existing 700+ staff members, and maintenance of a robust commitment to the spirit of MI throughout the work of the organization.

“We are so deeply grateful to the [Central East ATTC] for all the training – well worth it. Our trainers are ready and Christine has been a huge support.” - Candace Coffin.

MRCS continues to contract with Christine Higgins directly for the development of 15 minute video to show at new employee orientations to introduce Motivational Interviewing. They also have a monthly training calendar for two-day MI training sessions from March through December 2020. The MI Spirit is strong at MRCS and the change in practice will endure.




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