EMPIRICALLY SUPPORTED PRACTICES

My family and I emigrated to New Zealand from Scotland in 2002. As anyone who has emigrated to another country will know, there’s a huge and exciting learning curve that can sometimes also be stressful. New people, places, terminology, expectations, opportunities, attitudes and ways of doing things. But many familiar things too. 

There were some surprises. I remember the first Saturday living in Wellington and the kids wanted us all to go and see the shops only to find that when we all walked down to the main  street Lambton Quay everything to their horror was shut (like Canberra and Ottawa Wellington is a public sector city and that end of the street mainly serves government workers Monday to Friday). 

There were also some early challenges with the schooling system in particular (I am not sure why we imagined that this would be straightforward as it wasn’t until our third child that I felt that we remotely understood the Scottish system). As we arrived in Wellington near the end of the school year, we elected to have them start school at the beginning of the new year. Although I was job-hunting, Rachael had secured a job with the Ministry of Education before we’d left Scotland and so home schooling was solely down to me. It took me a whole day to realise that my talents in relation to home-schooling were – limited! 

With some similarities to a child in OOHC who has missed crucial schooling there’s always a lingering worry that there are things that you just don’t know, for example even today I couldn’t tell you with any confidence what the telephone number for emergency services is in New Zealand. So it’s always a work in progress.  However, while we adjusted quickly and well, we noticed that some other’s from the UK did not, and some even went back. For us emigrating felt a bit like transplanting a plant that has been grown in one place with one soil type, growing conditions and climate, to another garden altogether. Even where the two environments look similar and great care is taken, the plant may not thrive or even survive!

I feel a bit the same about evidenced-based programs from the US. There are a number of these for residential care, foster care, and now transitioning from care too. Don’t get me wrong. I love a quality evidence-based program, aka Manualised Evidence-supported Treatments (MEST), and with some I am in awe of the quality of the design thinking, the translation of this into clear systems and processes, and the centrality of research, monitoring and quality assurance.

However, as with transplanting plants, replicating a program in a country that it was not designed for, let alone one that has not already been sufficiently scaled up or independently evaluated, can all too often lead to disappointing results. Organisations, worker training and experience, child and family problems, culture, concepts, terminology, systems, values, statutory requirements, structures and related provision will all be different. Yet meaningful national, state/province/territory or local program adaptations can be tricky to negotiate as for the developer they threaten program fidelity and integrity. Meanwhile adopting such a program usually also involves a significant ongoing investment, much of which goes to the developer, for organisational accreditation/licensing, infrastructure, systems set up, training, monitoring and quality assurance. 

In some circumstances this may still be exactly the right thing to do. However, alongside of course going to the expense of designing your own bespoke evidence-based program or MEST, there is an alternative for consideration that is growing in popularity – incorporating Empirically Supported Practices (ESPs), aka Evidence-Based Practices, Common Elements, Common Factors or Kernels approach. 

In the book From Evidence to Outcomes and Child Welfare, Robyn Mildon, Nancy Dickenson and Aron Shlonsky define ESPs as “effective skills, techniques, and strategies that can be used by an individual practitioner. Such practices describe core intervention components that have been shown to reliably produce desirable effects and can be used individually or in combination to form more complex procedures or programs”.

The PracticeWise Evidence Based Services Database (PWEBS) includes the following examples of ‘evidence-based practices’ through their subscription-based website: Activity selection; Anger management; Assertiveness training; Behavioural contracting; Caregiver engagement; Case management; Communication skills, advanced; Crisis management; Cultural training; Education support; Empathy; Family engagement; Goal setting; Mentoring Modelling; Personal safety skills; Problem solving; Relationship/rapport building; Relaxation; Social skills training; Support networking; Supportive listening; Talent or skill building; Tangible rewards; and Warmth, positive regard.

With a focus on practitioners, individually or working in teams, select empirically supported practices can be adopted and incorporated by organisations to strengthen the robustness of existing programs or services or to develop new ones. For use with qualified and unqualified workers alike, ESPs can be integrated as part of professional development plans, and through induction and team training events, individual online learning opportunities, team meetings, modelling, and supervision, as well as contribute towards the development of new systems, processes and leadership thinking. 

This way, and depending on your needs, you may be able select ‘plants’ that are more likely to survive and thrive, and be more adaptable to your particular conditions. And that flower in less time and at less cost too.

I’d love to hear your thoughts! You can email me at: iain@betteroutcomes.co.nz

Kia kaha (Stay Strong).

Iain