Evidence-Based Services in Pima County

The PCJCC Model Court's Evidenced-Based (EB) Services subcommittee has been tasked with researching currently available evidenced-based or evidenced-informed services in our local area. The goal of the EB Services subcommittee is to identify, initiate, and expand evidence-based services, including parenting program, substance use disorder treatment, and trauma-specific treatment options for families in dependency cases in Pima County.
The services included on our EB lists may be narrower in scope than what is currently offered by the local behavioral health community. The rationale was based on the subcommittee's decision to only use EB criteria found in the top U.S. clearinghouses for EB programs, including:  

• California Evidenced-Based Clearinghouse (CEBC) for Child Welfare
• American Psychological Association (APA) Clinical Practice Guidelines
• U.S. Department of Veterans Affairs/Department of Defense (VA/DoD) Clinical Practice Guidelines
• SAMHSA's Evidence-Based Practices (EBP) Resource Center (formerly NREPP)
• Title IV-E Prevention Services Clearinghouse (still in its nascent stages)


Children and their families involved in the child welfare system need access to quality services so they can optimize their ability to resolve the issues that resulted in the initial removal of children, and to avoid future involvement in child welfare. Likewise, professionals working with these children and their families need to be able to quickly identify the most effective program and treatment to address the needs of their clients.
For a program or treatment to be considered evidence-based, it must be implemented with fidelity. Monitoring fidelity of a program or treatment is beyond the purview of the EB Services subcommittee. However, we encourage providers of EB services to self-monitor. To support this effort, we have provided a Recommended Fidelity Checklist. (CLICK HERE for the fidelity checklist)

 

Definitions for Evidence-Based Treatment

The EB subcommittee used the following definitions to guide us in selecting EB programs.

Evidenced-Based Treatment: Programs for which multiple, high-quality, randomized controlled trials (studies) have been conducted with the targeted population that resulted in consistent positive findings. These programs are highly rated in the research and should be selected whenever possible.

Evidence-Informed Treatment: Programs for which multiple, lower-quality studies were conducted, including quasi-experimental research with the targeted population, which resulted in mainly consistent positive findings. These programs indicate a good foundational base of research and should only be selected when EB programs are not available in the local area.

Promising Treatment: Programs for which a single high-quality, randomized controlled study was conducted, using the targeted population, which resulted in positive results – or programs for which multiple studies were conducted with the targeted population that had inconsistent findings. These programs need more research to indicate efficacy. They should only be selected when EB or evidence-informed treatment programs are not available in the local area.

Program fidelity: In order to for EB programs to be effective, facilitators need to present the program according to the actual curriculum and program protocols. Program "drift" (i.e., adding material or eliminating material from the curriculum and protocols) may result in less positive outcomes, and perhaps even worse outcomes than if no program was offered at all. It is recommended that professionals who make referrals to programs listed as EB ask each agency how they ensure fidelity.

EB Parenting Classes List
The EB Services subcommittee decided to first focus on parenting classes because this is the most common service recommended to families in the child welfare system. To identify effective classes, we reviewed two clearinghouses for EB programs, including the California Evidenced- Based Clearing House for Child Welfare and SAMHSA's National Registry of Evidence-Based Programs and Practices. We identified EB classes that showed improved outcomes with a child-welfare population. We then developed a list of the available EB parenting classes organized by age range, number of
sessions, session length, language, and capacity. This list has been distributed to professionals working in child welfare, posted on the Court's website, and updated regularly. (CLICK HERE for the parenting list)

Substance Use Disorder (SUD) Treatment List
The second focus of the EB Services subcommittee was on SUD treatment because it is the most common parental issue that brings children into the child welfare system. To identify effective programs, we first consulted with the Program Specialist of SUDs at the former Regional Behavioral Health Authority (RHBA) Cenpatico, who provided the subcommittee with their
current list of EB SUD treatment providers in Pima County. We then compared this list with the two main clearinghouses.
We identified EB SUD treatment and treatment components that showed improved outcomes with adult and adolescent populations. We then developed a list of available EB SUD treatment organized by level of care and target population. This list will be distributed to professionals working in child welfare, posted on the Court's website, and updated regularly. (CLICK HERE for the SUD treatment list)

Trauma-Specific Treatment List
The third focus of the EB Services subcommittee was on trauma-specific treatment, because 100% of children, and many adults, in child welfare have exposure to abuse, neglect, and/or abandonment, all of which could potentially be considered traumatic in a child's life. To identify effective treatment, we first listed our assumptions behind how we determined whether traumaspecific
treatment was evidence-based. (CLICK HERE to see the assumptions)

Next, we identified trauma-specific treatment that showed improved outcomes with child welfare, adolescent, and adult populations as listed on several relevant clearinghouses. We wrote descriptions of the treatment and its ratings on relevant clearinghouses. (CLICK HERE to see the descriptions of trauma-specific treatments)

Then, we used the clearinghouses' education and training guidelines to make recommendations to Pima County practitioners for trauma treatment, training, and certification. (CLICK HERE to see the recommendations)

Finally, we developed a list of available EB trauma-specific treatment in Pima County that meets the committee's recommendations, organized by age group and level of care. This list will be distributed to professionals working in child welfare, posted on the Court's website, and updated regularly. (CLICK HERE for the list of trauma-specific treatment by age group)

Resources for Evidenced-Based Programming:
• CEBC: http://www.cebc4cw.org/
• APA: https://www.apa.org/about/offices/directorates/guidelines/clinical-practice
• VA/DoD: https://www.healthquality.va.gov/
• SAMHSA's EBP Resource Center: https://www.samhsa.gov/ebp-resource-center
• Title IV-E Prevention Services: https://preventionservices.abtsites.com

If Your Agency Offers a Program Not on our List
If your agency provides programs or treatment not listed on our EB program or treatment lists,
we invite you to do the following:

  1. Refer to the Resources for EB Programming above websites above to determine if your
    program is evidence-based.
  2. If your program or treatment is evidence-based, send an email to Michaela Luna at
    FamilyNavigator@sc.pima.gov with the relevant information.