Clinician's Corner
Technology as an Accelerator of Evidence Based Practices: Does SeginusABC aid to Increase and/or Sustain MST Adherence Scores?
By Dan Ensor, MST Expert / System Supervisor
Community Solutions, Inc.
November 13, 2009
Adherence and fidelity are cornerstones of Multisystemic Therapy and other evidence based practices. SeginusABC was specifically designed to facilitate the MST Analytic Process by incorporating feedback and ideas from Community Solutions, Inc and MST Services staff. The goal has been to incorporate tools and methods to help increase Adherence to the model. The Transportability study indicates that the higher the Adherence scores are, the better the outcomes are for families. Therefore, there is interest in proving how SeginusABC contributes. While this data is very preliminary and additional data collection and analysis is required, the initial findings are optimistic.
The use of technology as a tool is not new. But Technology as an accelerator of evidence based practices for therapists could become more meaningful as funding sources continue to move toward evidence based practices, and funding become more dependent on outcomes.
The purpose of this review is to provide an initial assessment of Adherence scores across six Community Solutions, Inc programs where the SeginusABC: MST Edition software was implemented. Data for two teams, one using SeginusABC and the other not are analyzed for comparison. These teams are in the same geographical area and share a referral source and client pool. They are also served by the same MST expert.
The questions explored in this review are:
- Does SeginusABC help maintain or sustain high level of Adherence?
- Does SeginusABC help improve Adherence to the model?
- Does SeginusABC accelerate the team readiness when a new program or a new team is launched?
According to the 2008 MST Data report on the MSTI Website, the National Average for Overall Adherence is 0.634. A review of the data indicates that all 20 teams in the study have been able to surpass the national average in each period since the inception of the Seginus program, with the exception on only 2 teams in one reporting period each.
The National Average for the Percent of Youth Reporting Adherence is 58.9%. A review of the data indicates that 15 out of the 20 teams have been able to outperform the National Average in each period for the Percent of Youth Reporting Adherence. There were 5 teams that did not surpass the National Average during their first period of the team's start up. However, 3 of those teams since start up have been able to surpass the national average in their remaining reporting periods. Only 2 teams out of 20 have had one period each of not surpassing the National Average after their start up period.
There are different data starting points for each program due to varying SeginusABC implementation dates and the start of new teams. In addition, the software has evolved significantly from its pilot start. The Weekly Summary format within the system was modified several times as user feedback was taken into consideration. Another concern is inconsistent use of SeginusABC even after formal implementation. In cases such as these, re-trainings had to be done. Various administrative challenges including staff turnover may also impact adherence.
The next phase of investigation will explore to what extent SeginusABC helps to sustain high levels of Overall Adherence and Youth Reporting Adherence when challenges related to staff turnover or supervisory changes occur. In addition, given there is evidence to support a positive relationship between the SeginusABC program and Therapist Adherence (TAM-Rs), we will begin to examine if there is a positive impact on Supervisor Adherence as well.
For access to the data tables mentioned in this article, please contact:
Dan Ensor
MST Expert / System Supervisor
Community Solutions, Inc.
Windsor, CT
For more about SeginusABC support for Multisystemic Therapy, visit http://www.seginusabc.com/seginusabc_mst_edition.htm
