By: Kristina Spannbauer, Communications Specialist for the Great Lakes ATTC, MHTTC, & PTTC
of the greatest aspects of NIATx process improvement is the adaptability of this model. Over
the past several years, the Great Lakes ATTC, MHTTC, and PTTC have developed hybrid training series integrating NIATx
principles with other
in-demand technical assistance (TA) and intensive technical assistance (ITA) offered
by our centers. Some of the special focus topics featured in these series are
the National Culturally and Linguistically Appropriate
Services (CLAS) Standards,
suicide prevention, school-based mental health, recruitment and retention,
telehealth services, and supporting the COVID-19 workforce. Behavioral
healthcare and prevention professionals from our region who have participated
in these hybrid courses consistently report greater success in implementing and
applying the skills learned during training thanks to the inclusion of NIATx
In the spirit of embracing change, I sat down with Alfredo Cerrato, Scott Gatzke, and Mat Roosa–three of the Great Lakes ATTC, MHTTC, and PTTC's subject matter experts and most experienced trainers–to better understand their considerations, planning processes, and experiences when it comes to "infusing" our TA and ITA content with NIATx principles and the Change Leader Academy (CLA) curriculum.
What considerations and adaptations were required when integrating the NIATx model for process improvement with other technical assistance and training courses?
Since NIATx has a process focus, it naturally pairs with a wide array of
content to help people improve how they do what they do. As we've
worked to include NIATx with our other trainings, we've found that it's easier
to market content than it is to market process. For instance, people tend to be
more interested in learning evidence-based practices than they are in learning
process improvement strategies, but we've also discovered that the combination
of content and process draws people in. Folks are eager to learn process tools
that help them implement evidence-based practices at both an individual and
I agree. As we've continued to develop and host hybrid courses, it's become
apparent that participants are quicker to engage with the content when they are
learning process improvement strategies in relation to applicable, real-life practices
they will use in their work.
I approached the process from a cultural perspective. As we've worked to integrate
NIATx with our other technical assistance offerings, it's extremely important
that we always prioritize culture and culturally appropriate service delivery.
When developing the CLAS Standards Change Leader Academy, we were
dedicated to maintaining the integrity of the original CLAS Matters! training,
as well as to making abstract concepts more concrete through the application of
scientific methods and academic vocabulary.
What benefits and/or challenges did you experience when integrating NIATx with other trainings?
Mat: We found that conducting hybrid courses with two trainers–one who
focuses on the "content" and one who focuses on the "process"–has
been really beneficial. For example, Alfredo knows NIATx and he's also our
expert trainer for CLAS Standards. He and I function as co-trainers in the CLAS
Standards Change Leader Academy with Alfredo taking the lead on CLAS
content while I primarily teach the process improvement aspects of the series.
Alfredo: We've learned a lot while developing and facilitating the CLAS
CLA. One of my main
takeaways is that for this specific co-training approach to be effective,
subject matter experts (SMEs) in any field must also understand the NIATx
principles and be able to apply process improvement tools in their particular
field(s). Likewise, the NIATx trainer must be able to speak the language of the
SMEs when explaining concepts or providing examples.
As a trainer, what has been your most
memorable experience(s) when facilitating these trainings?
the stories of how the NIATx tools (i.e., walk-through, flowcharting,
nominal group technique, and PDSA cycles) empower the change leaders attending
the training to better understand their customers, connect with leadership and
staff in their organization, and make an actual improvement to their processes is
In the CLAS Standards Change Leader Academy, I am particularly impacted
by how people connect the historical dots and open up to the possibility of
change. I also notice that they become more aware of how current culture is
changing their worldview and how past worldviews have shaped their culture.
I always love it when people are willing to be open and acknowledge that they
are struggling to implement... they understand that knowing the material is not
enough to get the job done. I also love seeing people who typically may not
have much power in their system or organization become empowered with the
NIATx process. It's inspiring to watch them gain confidence and respect from
their peers and create a significant impact on the quality of services being
offered. Those are typically my favorite moments.
What advice would you give to those interested in learning more about NIATx or how to apply NIATx to their work?
Culture is intrinsic and vital to every person.
In that sense, cultural considerations trump those of process improvement, but it's
important to remember that every process can be bettered or refined by first
considering culture. If not considered, the process improvement effort will
likely fail. However, we must also acknowledge that process is needed to
understand and affect cultural change. Without an understanding of
process and process improvement, negative culture will be organically
perpetuated. Both concepts need one another to facilitate better outcomes.
Scott: When you really need to improve something, help your change team
stay laser focused on the narrow, specific aim you have identified for your
change project. Everyone’s world is full of competing needs and urgent issues, which
often leads to “scope creep” for many change projects (e.g., adding multiple
deliverables or goals for the project). As soon as the aim of the project
becomes unclear for the team, the change project will, at best, flounder or it will
become completely disbanded. As a change leader, keep the aim of your project
front-and-center for your executive sponsor and change team. Only work on the activities
which move toward achieving the change project aim.
Mat: My advice is quite simple: 1) attend a NIATx Change Leader
Academy; 2) use the NIATx tools; 3) practice them over and over; 4) work as a
team; and 5) find ways to understand that EVERYTHING is a process, and every
process can be improved.
About Our Subject Matter Experts:
Alfredo Cerrato is
the Senior Cultural and Workforce Development Officer for the Great Lakes ATTC,
MHTTC, and PTTC. He is also a nationally certified trainer on Culture: An
Integral Part of Mental Health Services for Hispanic and Latino Populations
by the National Hispanic and Latino Mental Health Technology Transfer Center in
Puerto Rico and a national trainer on cultural topics for the National
Association for Alcoholism and Drug Abuse Counselors (NAADAC). Mr. Cerrato has
25 years of international relations experience and specializes in
cross-cultural communications, conflict resolution, and process improvement.
Scott Gatzke is
Director of Dissemination for the Great Lakes ATTC, MHTTC, and PTTC. He is a
NIATx trainer and coach with over 25 years of experience in process design and
quality improvement in manufacturing, healthcare, and non-profit organizations.
Mat Roosa is a
founding member of NIATx and has been a NIATx coach for a wide range of
projects. He works as a consultant and trainer in the areas of quality
improvement, organizational development, and planning, evidence-based practice
implementation. Mat’s experience also includes direct clinical practice in
mental health and substance use services, teaching at the undergraduate and
graduate levels, and human services agency administration.