Suzanne Kerns - Academia.edu (original) (raw)
Papers by Suzanne Kerns
Introduction to the Special Issue: Legislation Related to Children's Evidence-Based Practice
Administration and policy in mental health, Jan 16, 2015
Introduction to the Special Issue: Legislation Related to Children’s Evidence-Based Practice
Administration and Policy in Mental Health and Mental Health Services Research, 2015
Journal of Emotional and Behavioral Disorders, 2015
States and jurisdictions are under increased pressure to demonstrate the use of evidence-based tr... more States and jurisdictions are under increased pressure to demonstrate the use of evidence-based treatments (EBTs) for children's mental health, increasing the demand for a workforce trained in these practices. Universities are a critical pipeline for this workforce. This article describes the genesis and evolution of a university-based initiative for training in EBTs for children, youth, and families. Given both the need to make training in EBTs available to future providers in a range of disciplines and that mental health providers increasingly find themselves on interdisciplinary teams (despite universitybased training being relatively siloed along disciplinary lines), the initiative has had an interdisciplinary focus. Two tracks are described: (a) Practitioner Track, a course series in which students learn a specific EBT, and (b) Referral Track, a monthly lecture series designed to engage a wider university and community audience. Results of the program evaluation component of this initiative revealed that students can significantly increase their skills and self-efficacy in components of EBT delivery through participation in the active, skill-focused courses. Furthermore, the results of the lecture series evaluation appear to meet an important need for community-based providers and other supportive individuals in transferring useful knowledge about best practices. Implications and future directions are discussed.
Organizations adopting an evidence-based, research-based, or promising practice must systematical... more Organizations adopting an evidence-based, research-based, or promising practice must systematically support its implementation. When actively applied, three frameworks identified by the National Implementation Research Network (NIRN) support effective service delivery: intervention components, implementation drivers, and stages of implementation (Bertram, Blase, & Fixen, 2014; Fixsen, et al., 2005). In this paper, we briefly review these frameworks, and offer examples from three states that integrated and financed evidence based practices (EBPs).
Federal, state, and foundation funding sources increasingly mandate the use of evidence-based pra... more Federal, state, and foundation funding sources increasingly mandate the use of evidence-based practices (EBPs). However, confusion and uncertainty limit response to these mandates in systems of care. These two papers briefly present fundamental facts on the rationale for using EBPs within behavioral health service systems. The first paper clarifies definitions while addressing notable misconceptions about EBPs. The second addresses the critical importance of implementation factors that can positively or negatively affect EBP outcomes. Together, these papers offer examples, strategies, frameworks and tools for selecting, funding, implementing, improving, and sustaining evidence-based and promising practices within systems of care.
Administration and policy in mental health, Jan 3, 2015
Efforts to implement evidence based practices (EBP) are increasingly common in child-serving syst... more Efforts to implement evidence based practices (EBP) are increasingly common in child-serving systems. However, public systems undertaking comprehensive improvement efforts that aim to increase availability of multiple practices at the same time may struggle to build comprehensive and user-friendly strategies to develop the workforce and encourage adoption, faithful implementation, and sustainability of selected EBPs. Given that research shows model adherence predicts positive outcomes, one critical EBP implementation support is systematic quality, fidelity, and compliance monitoring. This paper describes the development and initial implementation of a quality assurance framework for a statewide EBP initiative within child welfare. This initiative aimed to improve provider practice and monitor provider competence and compliance across four different EBPs, and to inform funding and policy decisions. The paper presents preliminary data as an illustration of lessons learned during the q...
Research on Social Work Practice, 2014
This study examined the extent to which evidence-based practices (EBPs) are taught in North Ameri... more This study examined the extent to which evidence-based practices (EBPs) are taught in North American Masters of Social Work (MSW) curricula. A web-based survey distributed through the National Association of Deans and Directors and a similar Canadian listserv facilitated exploration of which EBPs are taught, what faculty positions teach them, in what size programs, geographic areas, and other factors, as well as the barriers and implications of doing so. Fifty-eight program deans and directors responded to the survey. While the majority of programs reported teaching at least one EBP and developing EBP skill sets, challenges to curriculum integration were noted. Ideological, definitional, and practical concerns emerge as constraints to teaching EBPs, with MSW program leaders identifying faculty-related barriers as a primary constraining factor. This article presents the study and its implications for academic and practice settings.
Child psychiatry and human development, 2003
Although the interconnection between delinquency and substance use in adolescence is well documen... more Although the interconnection between delinquency and substance use in adolescence is well documented, considerably less is known about substance-use initiation in childhood for juvenile delinquent populations. This descriptive study examined early substance initiation in childhood as reported by adolescents who were incarcerated for juvenile offenses (93 males, 96 females; 58% African American, 42% European American). Youth were individually interviewed using an adapted version of substance-related questions from the National Household Survey. Juvenile justice system records were reviewed to characterize offense histories. A majority of males and females reported using at least one substance (other than cigarettes) such as alcohol, marijuana, or inhalants by age 13. Alcohol use reportedly occurred by age 10 for 17% of the youth. For a substantial portion, early initiation turned into frequent early use. For example, 32% of the males and 39% of the females reported drinking alcoholic...
Clinical child and family psychology review, 2002
Violence prevention programs with varying degrees of scientific support have proliferated in the ... more Violence prevention programs with varying degrees of scientific support have proliferated in the United States and elsewhere. This paper previewed a broad range of programs involving youth, families, or systems that aimed to prevent or reduce violence-related behavior. The purpose of the review was to address critical issues concerning (1) target level of programming, (2) theory-driven versus problem-driven conceptualization, (3) cultural considerations, (4) developmental considerations, (5) intervention fidelity, and (6) outcome and impact assessment. Conclusions about these issues address tendencies and trends across programs.
Child maltreatment, 2015
Youth in the child welfare system (CWS) have substantially higher rates of mental health needs co... more Youth in the child welfare system (CWS) have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Caseworkers play the critically important role of "service broker" for CWS youth and families. This study examines preliminary caseworker-level outcomes of Project Focus Colorado (PF-C), a training and consultation program designed to improve access to EBPs for CWS youth. PF-C evaluation occurred in four child welfare offices (two intervention [n = 16 caseworkers] vs. two practice-as-usual, wait-list control [WLC; n = 12 caseworkers]). Receipt of PF-C was associated with significantly increased caseworker knowledge of (a) EBPs, (b) child mental health problems, (c) evidence-based treatment components targeting mental health problem areas, and (d) mental health screening instruments, compared to WLC. Dose of training and consultation was associated with greater ability to correct...
Children and Youth Services Review, 2014
Children and youths in the foster care system have high rates of emotional and behavioral health ... more Children and youths in the foster care system have high rates of emotional and behavioral health needs. While use of mental health services is higher than average for children and youths in care, gaps remain in efficiently linking children and youths in need of services with effective and responsive treatments. Two exploratory studies conducted through a state-academic partnership are considered with the aim of identifying priority strategies to improve collaboration among child welfare caseworkers and mental health service providers. A statewide sample of 127 child welfare caseworkers (study 1) and 148 mental health providers (study 2) participated. Results indicate that there are effective and innovative resources and infrastructure within both state systems. However, challenges exist. Caseworkers indicate limited training in identifying mental health needs, uncertainty about how to apply screening results to case planning, and concerns about the roles, relationships, and communication with mental health providers. They report variability in the extent of available evidence-based services. Mental health providers indicate multiple challenges in working with state dependent youth, including communicating and coordinating with child welfare caseworkers and families. They report shared and team meetings to be helpful in promoting collaboration. Providers want more training on the child welfare system and the unique needs of children and youths in foster care. Implications are discussed.
Academic Pediatrics, 2014
We evaluated the effect of Primary Care Positive Parenting Program (Triple P) training on pediatr... more We evaluated the effect of Primary Care Positive Parenting Program (Triple P) training on pediatric residents and the families they serve to test 2 hypotheses: first, training would significantly improve resident skill in identifying and addressing discrete parenting and child behavior problems; and second, parents would report an improvement in their sense of selfefficacy, use of positive discipline strategies, and their child's behavior.
Family Integrated Transitions: A Promising Program for Juvenile Offenders with Co-Occurring Disorders
Journal of Child & Adolescent Substance Abuse, 2011
... Walker a , Megan T. DeRobertis a & David G. Stewart a pages 421-436. ... Evidence-bas... more ... Walker a , Megan T. DeRobertis a & David G. Stewart a pages 421-436. ... Evidence-based treatment for justice-involved youth . In CL Kessler & LJ Kraus (Eds.), The mental health needs of young offenders: Forging paths toward reintegration and rehabilitation (pp. 340 367 ). ...
Journal of Adolescent Health, 2010
Purpose: The purpose of this study was twofold: (1) to examine the effects of School-Based Health... more Purpose: The purpose of this study was twofold: (1) to examine the effects of School-Based Health Center (SBHC) use on academic outcomes for high school students, using a well-controlled, longitudinal model, and (2) to examine whether SBHC medical and mental health service use differentially impacts academic outcomes. Methods: Analyses used a latent variable growth curve modeling approach to examine longitudinal outcomes over five school semesters for ninth grade SBHC users and nonusers from Fall 2005 to Fall 2007 (n ¼ 2,306). Propensity score analysis was used to control for self-selection factors in the SBHC user and nonuser groups. Results: Results indicated a significant increase in attendance for SBHC medical users compared to nonusers. Grade point average increases over time were observed for mental health users compared to nonusers. Discipline incidents were not found to be associated with SBHC use. Conclusions: SBHC use was associated with academic improvements over time for a high-risk group of users. The moderating effect of type of use (medical and mental health) reinforces the importance of looking at subgroups when determining the impact of SBHC use on outcomes. Ó
Implementation Science, 2013
Background: Evidence-based treatments for child mental health problems are not consistently avail... more Background: Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes 'gold standard' supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. Methods/Design: The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within-and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment.
Child Maltreatment, 2012
Youth in the foster care system have substantially higher rates of mental health needs compared t... more Youth in the foster care system have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Increasingly emerging in the literature on mental health services is the importance of ''brokers'' or ''gateway providers'' of services. For youth in foster care, child welfare caseworkers often play this role. This study examines caseworker-level outcomes of Project Focus, a caseworker training and consultation model designed to improve emotional and behavioral outcomes for youth in foster care through increased linkages with EBPs. Project Focus was tested through a small, randomized trial involving four child welfare offices. Caseworkers in the Project Focus intervention group demonstrated an increased awareness of EBPs and a trend toward increased ability to identify appropriate EBP referrals for particular mental health problems but did not have significantly different rates of actual referral to EBPs. Dose of consultation was associated with general awareness of EBPs. Implications for practice and outcomes for youth are discussed.
Archives of Pediatrics & Adolescent Medicine, 2011
To determine the association between use of school-based health centers (SBHCs) and school dropout.
Archives of Pediatrics & Adolescent Medicine, 2012
Introduction to the Special Issue: Legislation Related to Children's Evidence-Based Practice
Administration and policy in mental health, Jan 16, 2015
Introduction to the Special Issue: Legislation Related to Children’s Evidence-Based Practice
Administration and Policy in Mental Health and Mental Health Services Research, 2015
Journal of Emotional and Behavioral Disorders, 2015
States and jurisdictions are under increased pressure to demonstrate the use of evidence-based tr... more States and jurisdictions are under increased pressure to demonstrate the use of evidence-based treatments (EBTs) for children's mental health, increasing the demand for a workforce trained in these practices. Universities are a critical pipeline for this workforce. This article describes the genesis and evolution of a university-based initiative for training in EBTs for children, youth, and families. Given both the need to make training in EBTs available to future providers in a range of disciplines and that mental health providers increasingly find themselves on interdisciplinary teams (despite universitybased training being relatively siloed along disciplinary lines), the initiative has had an interdisciplinary focus. Two tracks are described: (a) Practitioner Track, a course series in which students learn a specific EBT, and (b) Referral Track, a monthly lecture series designed to engage a wider university and community audience. Results of the program evaluation component of this initiative revealed that students can significantly increase their skills and self-efficacy in components of EBT delivery through participation in the active, skill-focused courses. Furthermore, the results of the lecture series evaluation appear to meet an important need for community-based providers and other supportive individuals in transferring useful knowledge about best practices. Implications and future directions are discussed.
Organizations adopting an evidence-based, research-based, or promising practice must systematical... more Organizations adopting an evidence-based, research-based, or promising practice must systematically support its implementation. When actively applied, three frameworks identified by the National Implementation Research Network (NIRN) support effective service delivery: intervention components, implementation drivers, and stages of implementation (Bertram, Blase, & Fixen, 2014; Fixsen, et al., 2005). In this paper, we briefly review these frameworks, and offer examples from three states that integrated and financed evidence based practices (EBPs).
Federal, state, and foundation funding sources increasingly mandate the use of evidence-based pra... more Federal, state, and foundation funding sources increasingly mandate the use of evidence-based practices (EBPs). However, confusion and uncertainty limit response to these mandates in systems of care. These two papers briefly present fundamental facts on the rationale for using EBPs within behavioral health service systems. The first paper clarifies definitions while addressing notable misconceptions about EBPs. The second addresses the critical importance of implementation factors that can positively or negatively affect EBP outcomes. Together, these papers offer examples, strategies, frameworks and tools for selecting, funding, implementing, improving, and sustaining evidence-based and promising practices within systems of care.
Administration and policy in mental health, Jan 3, 2015
Efforts to implement evidence based practices (EBP) are increasingly common in child-serving syst... more Efforts to implement evidence based practices (EBP) are increasingly common in child-serving systems. However, public systems undertaking comprehensive improvement efforts that aim to increase availability of multiple practices at the same time may struggle to build comprehensive and user-friendly strategies to develop the workforce and encourage adoption, faithful implementation, and sustainability of selected EBPs. Given that research shows model adherence predicts positive outcomes, one critical EBP implementation support is systematic quality, fidelity, and compliance monitoring. This paper describes the development and initial implementation of a quality assurance framework for a statewide EBP initiative within child welfare. This initiative aimed to improve provider practice and monitor provider competence and compliance across four different EBPs, and to inform funding and policy decisions. The paper presents preliminary data as an illustration of lessons learned during the q...
Research on Social Work Practice, 2014
This study examined the extent to which evidence-based practices (EBPs) are taught in North Ameri... more This study examined the extent to which evidence-based practices (EBPs) are taught in North American Masters of Social Work (MSW) curricula. A web-based survey distributed through the National Association of Deans and Directors and a similar Canadian listserv facilitated exploration of which EBPs are taught, what faculty positions teach them, in what size programs, geographic areas, and other factors, as well as the barriers and implications of doing so. Fifty-eight program deans and directors responded to the survey. While the majority of programs reported teaching at least one EBP and developing EBP skill sets, challenges to curriculum integration were noted. Ideological, definitional, and practical concerns emerge as constraints to teaching EBPs, with MSW program leaders identifying faculty-related barriers as a primary constraining factor. This article presents the study and its implications for academic and practice settings.
Child psychiatry and human development, 2003
Although the interconnection between delinquency and substance use in adolescence is well documen... more Although the interconnection between delinquency and substance use in adolescence is well documented, considerably less is known about substance-use initiation in childhood for juvenile delinquent populations. This descriptive study examined early substance initiation in childhood as reported by adolescents who were incarcerated for juvenile offenses (93 males, 96 females; 58% African American, 42% European American). Youth were individually interviewed using an adapted version of substance-related questions from the National Household Survey. Juvenile justice system records were reviewed to characterize offense histories. A majority of males and females reported using at least one substance (other than cigarettes) such as alcohol, marijuana, or inhalants by age 13. Alcohol use reportedly occurred by age 10 for 17% of the youth. For a substantial portion, early initiation turned into frequent early use. For example, 32% of the males and 39% of the females reported drinking alcoholic...
Clinical child and family psychology review, 2002
Violence prevention programs with varying degrees of scientific support have proliferated in the ... more Violence prevention programs with varying degrees of scientific support have proliferated in the United States and elsewhere. This paper previewed a broad range of programs involving youth, families, or systems that aimed to prevent or reduce violence-related behavior. The purpose of the review was to address critical issues concerning (1) target level of programming, (2) theory-driven versus problem-driven conceptualization, (3) cultural considerations, (4) developmental considerations, (5) intervention fidelity, and (6) outcome and impact assessment. Conclusions about these issues address tendencies and trends across programs.
Child maltreatment, 2015
Youth in the child welfare system (CWS) have substantially higher rates of mental health needs co... more Youth in the child welfare system (CWS) have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Caseworkers play the critically important role of "service broker" for CWS youth and families. This study examines preliminary caseworker-level outcomes of Project Focus Colorado (PF-C), a training and consultation program designed to improve access to EBPs for CWS youth. PF-C evaluation occurred in four child welfare offices (two intervention [n = 16 caseworkers] vs. two practice-as-usual, wait-list control [WLC; n = 12 caseworkers]). Receipt of PF-C was associated with significantly increased caseworker knowledge of (a) EBPs, (b) child mental health problems, (c) evidence-based treatment components targeting mental health problem areas, and (d) mental health screening instruments, compared to WLC. Dose of training and consultation was associated with greater ability to correct...
Children and Youth Services Review, 2014
Children and youths in the foster care system have high rates of emotional and behavioral health ... more Children and youths in the foster care system have high rates of emotional and behavioral health needs. While use of mental health services is higher than average for children and youths in care, gaps remain in efficiently linking children and youths in need of services with effective and responsive treatments. Two exploratory studies conducted through a state-academic partnership are considered with the aim of identifying priority strategies to improve collaboration among child welfare caseworkers and mental health service providers. A statewide sample of 127 child welfare caseworkers (study 1) and 148 mental health providers (study 2) participated. Results indicate that there are effective and innovative resources and infrastructure within both state systems. However, challenges exist. Caseworkers indicate limited training in identifying mental health needs, uncertainty about how to apply screening results to case planning, and concerns about the roles, relationships, and communication with mental health providers. They report variability in the extent of available evidence-based services. Mental health providers indicate multiple challenges in working with state dependent youth, including communicating and coordinating with child welfare caseworkers and families. They report shared and team meetings to be helpful in promoting collaboration. Providers want more training on the child welfare system and the unique needs of children and youths in foster care. Implications are discussed.
Academic Pediatrics, 2014
We evaluated the effect of Primary Care Positive Parenting Program (Triple P) training on pediatr... more We evaluated the effect of Primary Care Positive Parenting Program (Triple P) training on pediatric residents and the families they serve to test 2 hypotheses: first, training would significantly improve resident skill in identifying and addressing discrete parenting and child behavior problems; and second, parents would report an improvement in their sense of selfefficacy, use of positive discipline strategies, and their child's behavior.
Family Integrated Transitions: A Promising Program for Juvenile Offenders with Co-Occurring Disorders
Journal of Child & Adolescent Substance Abuse, 2011
... Walker a , Megan T. DeRobertis a & David G. Stewart a pages 421-436. ... Evidence-bas... more ... Walker a , Megan T. DeRobertis a & David G. Stewart a pages 421-436. ... Evidence-based treatment for justice-involved youth . In CL Kessler & LJ Kraus (Eds.), The mental health needs of young offenders: Forging paths toward reintegration and rehabilitation (pp. 340 367 ). ...
Journal of Adolescent Health, 2010
Purpose: The purpose of this study was twofold: (1) to examine the effects of School-Based Health... more Purpose: The purpose of this study was twofold: (1) to examine the effects of School-Based Health Center (SBHC) use on academic outcomes for high school students, using a well-controlled, longitudinal model, and (2) to examine whether SBHC medical and mental health service use differentially impacts academic outcomes. Methods: Analyses used a latent variable growth curve modeling approach to examine longitudinal outcomes over five school semesters for ninth grade SBHC users and nonusers from Fall 2005 to Fall 2007 (n ¼ 2,306). Propensity score analysis was used to control for self-selection factors in the SBHC user and nonuser groups. Results: Results indicated a significant increase in attendance for SBHC medical users compared to nonusers. Grade point average increases over time were observed for mental health users compared to nonusers. Discipline incidents were not found to be associated with SBHC use. Conclusions: SBHC use was associated with academic improvements over time for a high-risk group of users. The moderating effect of type of use (medical and mental health) reinforces the importance of looking at subgroups when determining the impact of SBHC use on outcomes. Ó
Implementation Science, 2013
Background: Evidence-based treatments for child mental health problems are not consistently avail... more Background: Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes 'gold standard' supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. Methods/Design: The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within-and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment.
Child Maltreatment, 2012
Youth in the foster care system have substantially higher rates of mental health needs compared t... more Youth in the foster care system have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Increasingly emerging in the literature on mental health services is the importance of ''brokers'' or ''gateway providers'' of services. For youth in foster care, child welfare caseworkers often play this role. This study examines caseworker-level outcomes of Project Focus, a caseworker training and consultation model designed to improve emotional and behavioral outcomes for youth in foster care through increased linkages with EBPs. Project Focus was tested through a small, randomized trial involving four child welfare offices. Caseworkers in the Project Focus intervention group demonstrated an increased awareness of EBPs and a trend toward increased ability to identify appropriate EBP referrals for particular mental health problems but did not have significantly different rates of actual referral to EBPs. Dose of consultation was associated with general awareness of EBPs. Implications for practice and outcomes for youth are discussed.
Archives of Pediatrics & Adolescent Medicine, 2011
To determine the association between use of school-based health centers (SBHCs) and school dropout.
Archives of Pediatrics & Adolescent Medicine, 2012