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by Stacey Burling, STAFF WRITER
Amy Herschell and Kristen Schaffner, experts at taming particularly difficult children, described the kind of kid who gets referred to the treatment model they espouse, one that harnesses the power of parental attention:
He’s 5 and in danger of being thrown out of day care. He’s mean to other kids in his class and his siblings. He refuses to do what adults tell him to do. He throws things or spits or bites or swears. He has tantrums. His problems are so consuming, his parents’ jobs are at risk. No one wants to be his babysitter. No one wants to be his friend.
It’s the kind of behavior that puts a kid on a bad path that some never get off. Herschell and Schaffner say a program that coaches parents to reward good behavior and ignore bad, to discipline consistently and effectively, can quickly transform even that hypothetical child into one whose behavior is better than average.
The duo, who both work at the University of Pittsburgh and West Virginia University, along with Sarah Taber-Thomas, clinical assistant professor at the University of Buffalo, spent three days in Philadelphia this month teaching therapists and managers at Community Behavioral Health about Parent-Child Interaction Therapy (PCIT). Though the program was developed in the 1970s, it has only recently begun spreading from universities to community treatment centers. The approach has been shown to improve children’s behavior both at home and at school and to reduce parental depression and stress. Studies found that the results persisted for years.
CBH offered the training to seven agencies that provide services to its Medicaid clients (there were also a few trainees from Chester County) as part of its effort to expand access to treatments that are proven to work, said Ronnie Rubin, director of CBH’s Evidence-Based Practices and Innovation Center. While translational medicine — the effort to move cutting-edge science more quickly from bench to bedside — has been trendy in the medical world for several years, Rubin said it has been slower to take off in mental health care.
Herschell said there has been widespread interest in PCIT in Pennsylvania. About 100 agencies have some workers who have had training. Philadelphia, she said, has given an unusual amount of support at the county level.
PCIT consists of two parts delivered over 10 to 20 sessions that last an hour or so. In the first, a therapist helps a parent create a stronger, warmer bond with the child.
They focus on discipline in the second. Most of the work is between the parent and child. They play — the child decides how — while a therapist watches behind a one-way mirror, coaching the parent, who wears a “bug” in the ear.
The goal is to praise the child for behaving well. Maybe he sat still for a while or drew something creative. If he has a tantrum, Mom can focus on drawing her own picture until he’s ready to interact nicely again. The coach may suggest what to say and do with the child but also praises the parent. “Great labeled praise,” the coach might say, or “I like the way you’re following his lead.” The coach, Schaffner said, is “working on shaping the parent behavior just like they’re trying to shape the child behavior.”
That voice in the ear is a key difference between PCIT and other efforts to help parents manage difficult children.
“Coaching is where the magic happens,” Schaffner said. “It’s amazing how powerful it is.”
Herschell said that children in PCIT programs typically start out doing what their parents ask only about 30 percent of the time. Average kids have compliance rates of 60 to 70 percent. By the time the program ends, PCIT graduates are doing what they’re asked 80 to 90 percent of the time, she said.
Some of this sounds like advice you’d get in any parenting program, but the experts said children who need PCIT really are more challenging than other kids.
Rubin said that in PCIT, parents are taught the sorts of things therapists learn in advanced classes. “It’s like good parenting on steroids,” she said.
Some children truly are harder to parent, and a mismatch between parenting style and the child’s temperament can bring out the worst in both of them.
“Negative behaviors pull for negative attention,” Taber-Thomas said. “Over time, that spirals.”
Parents sometimes have trouble seeing the good in a child who misbehaves a lot, Rubin said. The program helps parents reconnect with all the good things their child is doing and to appreciate them. That helps the child relax and feel closer to the parent.
“We’re making the parent’s attention more powerful and more strategic,” Herschell said.
The beauty of PCIT, the trainers said, is that it “empowers” parents to change their children’s lives and, as a consequence, their own.
“The difference is those therapeutic skills are being given to the parents as an agent of change,” Rubin said.
The PCIT trainers will be back early next year to teach workers about the discipline phase, but Rubin hopes agencies will begin offering the program immediately to 2.5- to 7-year-olds and their parents. People who are interested in participating in the program or referring patients to it can call 888-545-2600. A brochure on PCIT can be found here. And a link to a map of Philadelphia PCIT providers and their contact information is here.
The 2016 EPIC Seminar Series is focused on the theme of implementing evidence-based practices (EBPs) in community behavioral health settings. These presentations are geared toward behavioral health administrators and clinicians who are interested in an exploration of the latest topics in the field of evidence-based practice and implementation science. Seminars will cover a range of issues that cut across EBPs, including organizational, cultural and practice change factors related to successful implementation of EBPs.
Torrey Creed, Ph.D. will join us to share concrete ideas about what it takes to keep your EBP or innovative practice going. Dr. Creed will share key insights into what sustainability is, why it doesn’t happen automatically, and how to make it more successful.
About our Presenter:
Torrey A. Creed, PhD. is an Assistant Professor in Psychiatry at the University of Pennsylvania’s Aaron T. Beck Psychopathology Research Center. As the director of The Beck Community Initiative at Penn, she leads a large-scale implementation program to increase community access to evidence-based cognitive behavioral therapy (CBT). This program implements CBT in community services with diverse populations, presenting problems, and levels of care. Dr. Creed has traveled nationally and internationally to deliver tailored training in CBT. Her co-authored book, Cognitive Therapy for Adolescents in School Settings, is used as a guide for mental health services in Philadelphia and other public schools. Dr. Creed’s primary research interests are the adaptation, implementation, and sustainment of CBT for community mental health settings, and the role of recovery and resilience in behavioral health.
Join Carrie Epstein, national expert in child trauma treatment, to discuss the ways in which evidence-based practices (EBPs) support clinical practice. Topics include,include common misconceptions and facts about delivering EBPs, what client centered practice looks like within EBP implementation, and how to follow a clinical roadmap with flexibility.
We would like to call your attention to recent research on the impact of staffing models on the delivery of behavioral health services. The study, conducted by partners at the University of Pennsylvania, Center for Mental Health Policy and Services Research, is one of the first to investigate the relation between independent contractor employment status and service quality, specifically attitudes and knowledge of Evidence-based Practices (EBPs). They found that independent contractors had less knowledge and more negative attitudes about the use of EBPs. In qualitative interviews, agency leadership indicated that there is less investment in training and professional development for contract employees due to concerns about turnover and contract employees’ reluctance to engage in non-billable activities.
While the research stops short of finding that the use of independent contractors results in lower quality of care, this is an area of significant concern for our system. We understand that providers are turning to this staffing model to address financial challenges; however, there are important clinical implications of this staffing model. Independent contractors, including non-licensed clinicians, are not afforded professional development, training, supervision and support to ensure the delivery of quality services.
This staffing model also impacts workforce turnover, stability and continuity of care for service recipients. As a system, our priority is effective and efficient service delivery, which includes incorporating evidence-based practices.
As you know, we have been discussing staffing models for quite some time and this study serves to reinforce this important point. We need to identify strategies to support the development of a highly skilled workforce and address this staffing trend. To that end, we will be taking a number of steps to address this issue, such as:
To learn more about the study, please take a look at a recent media article in the Philly Voice. Additionally, we encourage you to learn more about DBHIDS’ Evidence-based Practice and Innovation Center to better understand how we aim to work with you to further promote the delivery of behavioral health evidence-based practices throughout Philadelphia.
Please click through the questions below for answers to frequently asked questions. If you have a question that doesn’t appear below, please feel free to share at epic_dbhids@phila.gov.
You can learn more simply by clicking on each FAQ.
What is an evidence-based practice?
An evidence-based practice (EBP) is a specific treatment technique, model, or program that has been shown, through research, to improve outcomes.
The term, evidence-based practice, also refers to the process of integrating:
A free downloadable handout is available providing more information on understanding EBPs.
(Definition from the American Psychological Association, 2006.)
What are the advantages to using EBPs?
There are many advantages to using EBPs. We have highlighted four key examples below.
EBPs are tools that should be offered in the context of recovery frameworks and individualized treatment. Learn more about this perspective by checking out the DBHIDS Practice Guidelines.
What is the “evidence”?
The “evidence” that a particular practice is effective is collected through research studies that measure the outcomes of the practice. The most rigorous research studies are called Randomized Control Trials. When there is an accumulation of research evidence from several research studies showing that a specific practice helps people get better, it can be considered an evidence-based practice.
Are there different levels of evidence?
Yes, some practices have not been evaluated through multiple rigorous research studies, but have shown some success in helping people improve through other types of evaluations. As the research evidence for different practices is still being developed, DBHIDS recognizes that there is a continuum of research evidence.
Evidence-Based Practice:
A practice that has been demonstrated to be effective through an accumulated body of well-designed research studies conducted by more than one research team in diverse settings and populations.
Evidence-Supported Practice:
A practice that has demonstrated positive outcomes in a limited number of research studies or in studies that use quasi-experimental designs. This could also include a practice that has a strong body of research support but is being delivered to different population or in a different setting.
Promising Practice:
A practice that has demonstrated some positive outcomes through evaluation or research but those studies are limited in their research methodology and the practice has not yet been evaluated through more rigorous or generalizable methods.
How do providers ensure that EBPs are delivered with quality?
While there are many factors to consider when thinking about the quality delivery of an EBP we have detailed three frequently used terms below.
An important feature of EBPs is that the elements of the practice are clearly articulated so that they can be delivered consistently. This is often done through specific training expectations and the use of a manual or protocol to guide treatment delivery. This is important because it allows a researcher to be sure that the outcomes achieved are due to the specific practice. It also provides a roadmap for how a treatment provider should deliver the practice in order to achieve similar outcomes. In other words, an EBP is delivered with “fidelity” when care is taken to ensure that it is delivered as it was designed in the research studies.
The success and sustainability of an EBP starts with selecting a practice or program that fits with your organization, population, or community. Fit impacts things like how well the innovation is adopted at an agency, and how effective it is for the intended population. Below are a few examples of the kinds of fit questions you may want to think about.
How does this program fit with:
To read more about fit you can check out this ASPE Brief on contextual fit, this infographic that highlights fit and offers additional useful resources, or this hexagon tool created by the National Implementation Research Network (NIRN).
Adaptation is the process of making changes to an evidence-based practice or program in order to make it more suitable for a particular population, setting or structure without compromising or removing its core components. Adaptations to EBPs need to be done systematically and thoughtfully to ensure that the treatment isn’t compromised. Fortunately, some minor adaptations can be done without changing core elements.
Examples:
You can read more about making thoughtful adaptations by using this guide for adapting evidence-based programs or this tip sheet.
Are EBPs being developed in diverse communities such as ours?
Yes, in fact in recent decades research funders have begun to expect more culturally diverse samples. They have also begun to require that research be conducted in “real world” communities to ensure that the treatment and trainings developed are relevant and feasible. Here in Philadelphia we’ve seen more researchers interested in doing research in our community settings.
You can also learn more by visiting the general registries section on the EPIC Resources page. Many EBP registries provide descriptive information about where and with whom the practice or intervention has been researched. These categories include things like: age, race/ethnicity, geographic location, settings, gender, and many more.
What is implementation science? How does that relate to EBPs?
The definition of implementation is: “a specified set of activities designed to put into practice an activity or program of known dimensions.” Implementation Science is a field of research that aims to identify concrete strategies for how to implement and sustain a practice; these may include supports such as training, coaching, or infrastructure.
Implementation Science is important when talking about EBPs because evidence-based programs aren’t much help unless we can put them into everyday practice and produce the same positive results that they produced during the research process. Implementation Science helps us understand HOW to make use of the interventions and programs that have been identified as effective. Read more about implementation science, or watch this quick implementation overview for more information.
(Definition from the National Implementation Research Network, 2016.)
How does clinician expertise factor into the delivery of EBPs?
Clinician expertise isn’t just a factor in the delivery of EBPs – it’s an imperative. EBPs sometimes get unfairly judged as “cookbooks” because they provide written structures, but within those structures practitioner success depends on their own experience, judgment, and skills.
A clinician using an EBP is analogous to an architect building a house. The architect needs to follow formulas and plans regarding important structures like the foundation and weight bearing walls, but what the house looks like in the end is determined by the creativity and skill set of the architect.
Practitioner experience, knowledge and skill form the basis for: client engagement, assessment of contributing factors to behaviors of concern, delivery of intervention, and so forth. Clinician expertise is the foundation by which the successful delivery of EBPs is built.
I am seeking services for myself / my family, what do I need to know about seeking evidence-based practices?
You can find lots of useful resources under the family section of our resource section, but here are two resources that we find particularly useful.
You can also find a listing of the available Evidence-based Practices in Philadelphia by visiting the EBPs in Philadelphia section of our website.
I’d like to learn more about EBP research, where can I find research articles?
This blog post from the Canadian Centre for Addiction and Mental Health offers some free resources and search tips for finding research articles.
In addition, the American Psychological Association has a nice resource that highlights the kinds of things to look for when reading research articles.
How does my organization take part in a DBHIDS-EBP training initiative?
All EBP training opportunities go through a formal procurement process. You can monitor the CBH website for new contracting opportunities, or sign up for CBH News to get email updates on things like upcoming procurement opportunities.
To learn more about the current department funded initiatives visit the Department Funded Initiatives section of our website.
Please note that the EPIC EBP Program Designation has launched. Providers delivering EBPs are encouraged to submit an application. For additional information, please visit the EPIC EBP Program Designation page.
Below is a listing of the behavioral health evidence-based practices (EBPs) in Philadelphia. For each of the following EBPs you will find a brief case example, an in-depth overview of the treatment, and contact information for providers who currently deliver each EBP. You can learn more about each practice by clicking on the practice title.
Please note: This website currently features EBPs that were implemented through DBHIDS-sponsored training initiatives or EBPs that require training or monitoring from treatment developers. This is not an exhaustive list of the evidence-based practices, programs, or innovations in the Philadelphia behavioral health provider network. This website will be periodically updated with additional EBPs in Philadelphia.
Applied Behavior Analysis (ABA): 0-5 years
Applied Behavior Analysis helps individuals with Autism Spectrum Disorder (ASD) and learners with other special needs increase skills and behaviors that are not yet developed, decrease problematic behaviors that interfere with learning, and teach caregivers how to successfully manage challenging behaviors.
ABA Case Example: A 3-year-old is demonstrating challenging behaviors commonly associated with ASD. She is not communicating using spoken language. Rather, she will scream and make unintelligible sounds. She engages in destructive tantrums, including banging her head repeatedly against the floor or wall when upset. She has been suspended from her daycare until supportive services are approved due to her unsafe tantrums. Her parents also want help at home to get her to use more words and to be safe when upset.
Child Parent Psychotherapy (CPP): 0-5 years
Child Parent Psychotherapy (CPP) helps caregivers of young children who have experienced trauma develop a strong, nurturing relationship with their child to restore the child’s sense of safety and to support positive development.
CPP Case Example: A young child is displaying a lot of acting out behaviors, such as fighting, defiance, hyperactivity, and disregulation. Both child and caregiver have histories that include trauma. Caregivers’ history from their own childhood experiences may be influencing the current relationship. In joint sessions the caregiver will learn new ways to interact and provide support to their child.
Get more in-depth information about the CPP treatment option.
Find providers in Philadelphia who offer the CPP treatment option.
The Incredible Years (IY)
The Incredible Years (IY) is a group of interlocking evidence-based programs which address the skills needed for caregivers, teachers, and children to increase the chances of academic success, strong interpersonal relationships, and healthy development in the child.
IY Case Example 1: A child frequently has been getting in trouble at school related to interpersonal issues with other children as well as the teacher. The child’s caregiver would like to increase both their own and their child’s ability to communicate effectively with others to decrease interpersonal issues.
IY Case Example 2: A teacher has noticed that most of the children in class are experiencing difficulty with working together during activities and become angry with one another easily. The teacher is interested in improvement classroom management skills to promote prosocial behavior and emotional regulation in the children in this class.
Get more in-depth information about the IY treatment option.
Find providers in Philadelphia who offer the IY treatment option.
Parent Child Interaction Therapy (PCIT): 2-7 years
Parent Child Interaction Therapy (PCIT) is a treatment for young children and their caregivers that uses a coaching model to strengthen the parent-child relationship and build skills for behavior management.
PCIT Case Example: A young child doesn’t listen to instructions, is aggressive at home or at school and is having frequent, intense tantrums. The caregiver is feeling frustrated and overwhelmed as they struggle to manage behaviors. This family could benefit from both relationship building and additional behavior management skills.
Get more in-depth information about the PCIT treatment option.
Find providers in Philadelphia who offer the PCIT treatment option.
Parent Child Interaction Therapy (PCIT) Brochure
Primary Child-Adult Relationship Enhancement (PriCARE): 2-7 years
Primary Child-Adult Relationship Enhancement (PriCARE) assists caregivers of children with disruptive behaviors or traumatic experiences in developing positive parenting skills and helps improve parent-child relationships.
Get more in-depth information about the PriCARE treatment option.
Find providers in Philadelphia who offer the PriCARE treatment option.
Applied Behavior Analysis (ABA): 5-18 years
Applied Behavior Analysis helps individuals with Autism Spectrum Disorder (ASD) and learners with other special needs increase skills and behaviors that are not yet developed, decrease problematic behaviors that interfere with learning, and teach caregivers how to successfully manage challenging behaviors.
ABA Case Example: A young teenager is exhibiting challenging behaviors commonly associated with ASD. The child is not communicating using functional language but will echo almost anything that is said to her. She is struggling with managing self-care associated with puberty and still has toileting accidents if doing a preferred activity. She will also hit herself and her family when really frustrated. When not closely supervised, she will run out of her house and go to a local store, where she likes to look at anything sparkly or shiny. These challenging behaviors are exhibited mostly in the home, and community settings. These challenging behaviors are affecting family dynamics and putting her safety at risk.
Trauma Focused Cognitive Behavioral Therapy (TF-CBT): 3-18 years
Trauma Focused Cognitive Behavioral Therapy (TF-CBT) helps children and their caregivers overcome the impact of traumatic events through psychoeducation, creating a safe space to process the event, and developing new coping strategies.
TF-CBT Case Example: A child or adolescent is exhibiting significant emotional or behavioral difficulties after a traumatic event. Her caregiver is struggling to manage these new challenging behaviors. The child and parent would benefit from gaining a better understanding of how trauma has impacted their family and learning new strategies for coping with this experience.
Get more in-depth information about the TF-CBT treatment option.
Find providers in Philadelphia who offter the TFCBT treatment option.
Cognitive Behavior Therapy (CBT): 5-18 years
Cognitive Behavior Therapy (CBT) is a solution-focused treatment that helps a person learn skills and solve problems by identifying unhelpful thinking patterns, changing inaccurate beliefs, engaging in new behaviors, and relating to others in more positive ways that support meeting their personal goals and recovery.
*Through the Beck Community Initiative, providers have been trained in transdiagnostic Cognitive Behavior Therapy (CBT) for a broad range of presenting concerns, or in a model of CBT for adults with schizophrenia and serious mental illness (Recovery Oriented Cognitive Therapy – CT-R).
CBT Case Example: An adult or child’s feelings of depression and anxiety are getting in the way of their engagement in activities. They want to develop new skills and strategies for managing their thoughts, feelings, and behaviors so they can achieve their goals.
Get more in-depth information about the CBT treatment option.
Find providers in Philadelphia who offer the CBT treatment option.
Ecosystemic Structural Family Therapy (ESFT): 5-18 years
Ecosystemic Structural Family Therapy (ESFT) helps families build new patterns of interacting in order to reduce conflict and improve behavior and relationships among family members.
ESFT Case Example: A child is defiant toward his caregivers, frequently engaging in verbally and physically aggressive behavior. His caregivers are frustrated and feel they don’t know how to get their child’s behavior under control. There is a lot of tension among family members. They want to find new ways of interacting and relating to one another so they can address these behaviors and begin to reconnect.
Get more in-depth information about the ESFT treatment option.
Find providers in Philadelphia who offer the ESFT treatment option.
Child and Family Traumatic Stress Intervention (CFTSI): 7-18 years
Child and Family Traumatic Stress Intervention (CFTSI) is a brief intervention for children who have experienced a potentially traumatic event. This intervention is aimed at preventing post-traumatic stress disorder symptoms by strengthening the family’s ability to communicate and offer the child support.
CFTSI Case Example: A child or adolescent has recently been involved in a traumatic experience and is exhibiting symptoms such as sleep difficulty, intrusive thoughts, depressive withdrawal, anxiety, tantrums, and aggression. The child’s caregivers want to better understand their child’s response to the event and learn strategies to support the child through this difficult time.
Get more in-depth information about the CFTSI treatment option.
Find providers in Philadelphia who offer the CFTSI treatment option.
Joint Planning Team (JPT): 10-17 years
Joint Planning Team (JPT) is a support and planning process that brings people from different parts of the family’s life together to help them identify resources and develop skills to sustain youth in the home.
JPT Case Example: A family is involved with multiple systems (e.g. school, behavioral health, juvenile justice, and/or child welfare) and needs help with complex service coordination. This family could use support in learning how to navigate the system, community supports, and treatments that will help them get back on track.
Get more in-depth information about the JPT treatment option.
Find providers in Philadelphia who offer the JPT treatment option.
Multisystemic Therapy for Problem Sexual Behaviors (MST-PSB): 11-17 years
Multisystemic Therapy for Problem Sexual Behaviors (MST-PSB) is a treatment for youth who have exhibited problematic sexual behavior. MST-PSB works with the whole family to address the behavior and develop skills and supports while keeping the youth in their community and maintaining the safety of others around them.
MST-PSB Case Example: A young person has engaged in problem sexual behavior. The family knows that the safety of the victim, community, and their child is a top priority and wants to engage in intensive treatment that addresses the behavior while allowing their child to remain safely at home.
Get more in-depth information about the MST-PSB treatment option.
Find providers in Philadelphia who offer the MST-PSB treatment option.
Functional Family Therapy (FFT): 11-18 years
Functional Family Therapy (FFT) is a family-based intervention aimed at changing the patterns of how families members communicate, problem solve, and support one another.
FFT Case Example: A teenager is acting out, getting in trouble at home, school, and with the juvenile justice system (e.g. truancy, violent acting out, delinquent and disruptive behavior). The family is in crisis and the teen is at risk for more serious problems down the road. They would benefit from intensive, family services in their home and community to address these challenges.
Get more in-depth information about the FFT treatment option.
Find providers in Philadelphia who offer the FFT treatment option.
Dialectical Behavioral Therapy (DBT): 14-18 years
Dialectical Behavior Therapy (DBT) helps individuals who have struggled with suicidal thoughts, self-harm, and emotion disregulation to develop coping strategies and skills for committing to “a life worth living.”
DBT Case Example: An adult was recently admitted to the hospital because of suicidal feelings. He/she has significant challenges regulating emotions, managing interpersonal relationships and has a history of self-harm behaviors such as cutting and/or suicidal thoughts. He/she could benefit from learning new ways of coping with personal and relationship challenges, as well as coaching to use those skills during times of crisis.
Get more in-depth information about the DBT treatment option.
Find providers in Philadelphia who offer the DBT treatment option.
Applied Behavior Analysis (ABA): 18+ years
Applied Behavior Analysis helps individuals with Autism Spectrum Disorder (ASD) and learners with other special needs increase skills and behaviors that are not yet developed, decrease problematic behaviors that interfere with learning, and teach caregivers how to successfully manage challenging behaviors.
ABA Case Example: A young man has an ASD diagnosis and learning difficulties. In some areas he has age-appropriate functioning, but in others, such as adaptive skills and social-emotional development, he is significantly behind his peers. He must continue to live with his parents and relies on them to take care of most of his needs. He can speak in full sentences; however, he struggles with social interactions and initiating conversation. He is described as isolated and has no friends or romantic interests. He also does not express emotions in an age-appropriate manner. If he feels sad or angry, he will burst into tears, scream, and/or walk away from the situation.
Eye-Movement Desensitization and Reprocessing (EMDR)
Eye-Movement Desensitization and Reprocessing (EMDR) therapy helps individuals who have experienced traumatic events process and address symptoms related to traumatic memories.
EMDR Case Example 1: A 35-year-old woman was physically attacked on her way home from work. As a result, she has extreme difficulty trusting others, has become fearful of going outside on her own, and has panic attacks whenever she is reminded of this traumatic event. These difficulties are impacting her ability to travel to work, and she often feels unsafe. She is interested in a therapeutic intervention to help address symptoms related to the trauma.
EMDR Case Example 2: A 17-year-old experienced a traumatic event when he witnessed the death of a close friend. Since this event, he has had flashbacks related to the death, avoids anything that reminds him of the traumatic event, and has trouble sleeping due to recurring nightmares. He has expressed interest in identifying and processing these emotional and behavioral difficulties to improve their overall well-being.
Get more in-depth information about the EMDR treatment option.
Find providers in Philadelphia who offer the EMDR treatment option.
Assertive Community Treatment (ACT)
Assertive Community Treatment (ACT) teams provide case management, psychiatric services, employment and housing assistance, family support, substance abuse treatment, and other services and supports critical to an individual’s ability to live successfully in the community.
ACT Case Example: An adult is struggling with a serious mental illness, and is having difficulty functioning in areas such as work, relationships, housing, money management, physical health, and wellness. Coordinated, comprehensive services will help them manage these complex needs and engage in community activities and supports.
Get more in-depth information about the ACT treatment option.
Find providers in Philadelphia who offer the ACT treatment option.
Cognitive Behavior Therapy (CBT)
Cognitive Behavior Therapy (CBT) is a solution-focused treatment that helps a person learn skills and solve problems by identifying unhelpful thinking patterns, changing inaccurate beliefs, engaging in new behaviors, and relating to others in more positive ways that support meeting their personal goals and recovery.
*Through the Beck Community Initiative, providers have been trained in transdiagnostic Cognitive Behavior Therapy (CBT) for a broad range of presenting concerns, or in a model of CBT for adults with schizophrenia and serious mental illness (Recovery Oriented Cognitive Therapy – CT-R).
CBT Case Example: An adult’s feelings of depression and anxiety are getting in the way of their engagement in activities. They want to develop new skills and strategies for managing their thoughts, feelings, and behaviors so they can achieve their goals.
CBT for Schizophrenia and Serious Mental Illness (CT-R) Case Example: An individual experiences auditory hallucinations and, at times, is aggressive and disruptive in their treatment setting. The CT-R model uses strategies to engage the individual in meaningful, interactive activities that are connected to their recovery goals.
Get more in-depth information about the CBT treatment option.
Find providers in Philadelphia who offer the CBT treatment option.
Find providers in Philadelphia who offer the CBT for schizophrenia and serious mental illness (CT-R) treatment option.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavior Therapy (DBT) helps individuals who have struggled with suicidal thoughts, self-harm, and emotion disregulation to develop coping strategies and skills for committing to “a life worth living.”
DBT Case Example: An adult was recently admitted to the hospital because of suicidal feelings. He/she has significant challenges regulating emotions, managing interpersonal relationships and has a history of self-harm behaviors such as cutting and/or suicidal thoughts. He/she could benefit from learning new ways of coping with personal and relationship challenges, as well as coaching to use those skills during times of crisis.
Get more in-depth information about the DBT treatment option.
Find providers in Philadelphia who offer the DBT treatment option.
Prolonged Exposure (PE)
Prolonged Exposure (PE) aims to reduce post-traumatic stress disorder (PTSD) symptoms by helping individuals approach trauma-related thoughts, feelings, and situations that had previously been avoided.
PE Case Example: After experiencing a traumatic event, an adult is displaying PTSD symptoms such as reliving the event, avoiding situations that remind them of the event, remaining jittery or on alert, and changing the way they think about themselves or others. These symptoms are impacting their ability to engage in activities and relationships. They are looking for a treatment that will reduce these symptoms and help them move forward in life.
Get more in-depth information about the PE treatment option.
Find providers in Philadelphia who offer the PE treatment option.
This website is a resource for information about EBPs in Philadelphia. It does not include the full continuum of behavioral health services available and is not a substitute for a comprehensive evaluation to identify the most appropriate course of treatment for an individual or family. Learn more about the full continuum of behavioral health services available in the DBHIDS network.
For additional information about accessing services please contact CBH Member Services at 888-545-2600 or visit DBHIDS’s Resources Page.
Sponsored by the DBHIDS’ Evidence-Based Practice and Innovation Center (EPIC). We are excited to announce an event this summer for providers, families and recipients of services to learn about the Evidence-based Practices in Philadelphia and to celebrate how they support resilience and recovery. Please plan to join us for this event. More information to follow about how to participate and register.
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