Community Development Teams to Scale-Up MTFC in California
(PI: Chamberlain)
National Institute of Mental Health

A number of rigorous randomized trials have shown that interventions can produce positive outcomes for children and adolescents with mental health and behavioral problems. Pressure is building from federal scientific and practice institutes, state legislatures, policy groups, and public interest legal challenges to incorporate evidence-based practices into publicly funded child welfare, mental health, and juvenile justice systems. Despite the increasing availability and demand for validated interventions, it is estimated that 90% of such public systems do not deliver evidence-based treatments or services. This project speaks directly to this large gap.

Given that roughly 10% of child-serving public agencies are early adopters of evidence-based programs, are there contexts and circumstances in the remaining majority of systems that could be improved to increase their willingness and ability to adopt and implement such models? This randomized trial evaluates a theory-driven intervention designed to engage and support evidence-based programming for non–early adopters against a more traditional model of transport. The design is aimed at increasing our understanding of how to engage and support non–early adopters and to examine how static and dynamic contextual factors influence uptake, implementation, and sustainability.

The effects of using community development teams (CDTs) are being tested for increasing the number of counties that successfully adopt, implement, and sustain Multidimensional Treatment Foster Care (MTFC), an evidence-based intervention designed to reduce placement in group and residential care, juvenile arrest rates, substance abuse, youth violence, and child behavioral and mental health problems. CDTs are designed to impact the implementation process at county/system, organizational, practitioner, and consumer levels through well-specified mechanisms including multicounty team meetings, expert consultation, peer-to-peer exchange, and individualized consultation. CDTs target changing organizational culture, climate, and attitudes.

Forty California counties that have not used MTFC will be randomly assigned to the CDT condition or to a standard implementation condition. Both conditions will receive funding for 1 year of MTFC implementation. Enrollment of counties will occur in three cohorts (12–14 counties each).