Treatment Efficacy of Integrative Family and Systems Treatment (I-FAST) With and Without Consultation: The Role of Model Training in the Sustainability of Evidence-Based Family Treatments.

This study examined the efficacy of the Integrative Family and Systems Treatment (I-FAST) training model that seeks to support development of model expertise within the agency in the context of facilitating the sustainability of evidence-based family treatment within community mental health settings. A quasi-experimental design was used to examine treatment outcomes of I-FAST among agencies that received ongoing Consultation and agencies that received No Consultation upon completion of I-FAST training. χ (2) analyses and independent samples t test analyses showed that there were no significant differences between the two groups on clients who had achieved reliable change on Problem Severity and Functioning based on parents' assessments. Significance of this study is discussed in the context of the role of evidence-based family therapy (EBFT) training in facilitating its sustainability in community mental health settings.

Integrative Families and Systems Treatment: a middle path toward integrating common and specific factors in evidence-based family therapy.

A moderate common factors approach is proposed as a synthesis or middle path to integrate common and specific factors in evidence-based approaches to high-risk youth and families. The debate in family therapy between common and specific factors camps is reviewed and followed by suggestions from the literature for synthesis and creative flexibility in manual development. A preliminary integrative model termed Integrative Family and Systems Treatment is offered as one option in developing and testing a moderate common factors approach. Such a model might then be studied in eventual clinical trials with other well-developed evidence-based protocols to further address the common versus specific factor debate. Implications for further research and practice are offered.

Key processes, ingredients and components of successful systems collaboration: working with severely emotionally or behaviorally disturbed children and their families.

Systems collaboration has repeatedly been cited as a component of successful social service delivery. Through qualitative data, this study explored the process involved in inter-agency collaboration when providing Integrative Family and Systems Treatment (I-FAST) for families with severely emotionally or behaviorally disturbed children. Data were collected through a series of eight focus groups with 26 agency collaborators across 11 counties in Ohio. Data analysis revealed two emergent phenomena: the process of developing collaboration, consisting of making initial contact, a trial period and developing trust; and the key ingredients of collaboration, focusing on interpersonal and professional qualities. Implications of each theme are discussed.

Utilizing family strengths and resilience: integrative family and systems treatment with children and adolescents with severe emotional and behavioral problems.

Community mental health agencies are consistently challenged to provide realistic and effective home-based family-centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I-FAST) is developed based on existing evidence-based approaches for working with at-risk children, adolescents, and families and a strengths perspective. I-FAST identified 3 evidence-based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home-based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I-FAST for treating families with children at risk of out-of-home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I-FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre- to posttreatment with the families able to maintain these positive changes at 6-month follow-up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I-FAST.

Using benchmarking research to locate agency best practices for African American clients.

Using a collective case study design with benchmarking features, research reported here sought to locate differences in agency practices between public mental health agencies in which African American clients were doing comparatively better on specific proxy outcomes related to community tenure, and agencies with less success on those same variables. A panel of experts from the Ohio Department of Mental Health matched four agencies on per capita spending, percentage of African American clients, and urban-intensive setting. The panel also differentiated agencies on the basis of racial group comparisons for a number of proxy variables related to successful community tenure. Two agencies had a record of success with this client group (benchmark agencies); and two were less successful based on the selected criteria (comparison agencies). Findings indicated that when service elements explicitly related to culture were similar across study sites, the characteristics that did appear to make a difference were aspects of organizational culture. Implications for administration practice and further research are discussed.