During an afternoon session Monday at the 2012 National Council Conference, Suzanne Button, PhD, assistant executive director at Astor Services for Children and Families, described how her agency employed evidence-based practices (EBPs) to improve outcomes and change the culture.
In 2003, Astor Services asked the staff if there was a child with whom they had “gotten stuck” on treatment approach. Nine years later, the organization has shifted from a “largely psychodynamic treatment approach” to one that uses EBPs to target both specific diagnoses and also to design treatment in milieu settings.
Now, practices such as parental interaction therapy, structural family therapy, and trauma-focused cognitive behavioral therapy have been fully integrated, using outcome measures to evaluate the effectiveness of each treatment.
While Button talked about using culture change techniques and collaborative leadership to get a big organization to shift the way that it looks at its practices.
“We’re using evidence-based practice as a specific example,” Button explained, “but this is really about how to ‘turn a big boat’ in organizational culture in mental health.”
All of Astor’s clinical sites are now using practices that have evidence of success in scientific literature behind them. They have seen improvement in aggregate clinical outcomes, as well as a significant reduction in the use of restraint.
They also have seen an increase in employee satisfaction, according to Button. She said that’s due to a much more tangible feeling that “their work is working,” as practices have permeated the culture.
“We have used that to build a very collaborative, multi-level approach in our agency on transforming the organization,” she said. “Innovation has to be preceded by a culture change initiative.”
The result of that change is that along with strengthening its university partnerships, Button explained that Astor Services is also “much more infused with research” than ever before.
“People now ask for research, they ask for outcomes, they ask for a practice that works,” Button said.