Transforming mental health practice in child-serving systems: A statewide model for disseminating, implementing, and sustaining a trauma-informed, evidence-based practice

Policymakers are increasingly charging public-sector child-serving systems (e.g., mental health, child welfare, juvenile justice) to implement evidence-based practices. Recent reviews reveal a relative lack of data regarding the effectiveness of specific dissemination and implementation strategies, but have identified a number of factors such as government funding and ideological support, organizational openness to change, active learning models and ongoing consultation/supervision that may be associated with effectiveness. Various conceptual models have emerged that incorporate some or all of these factors. The current chapter will begin with a review of the dissemination and implementation science literature. This review will be followed by a description of the Tennessee Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Learning Collaborative, a statewide dissemination and implementation project led by the five Centers of Excellence for Children in State Custody in the state of Tennessee in collaboration with experts from the National Child Traumatic Stress Network and community partners. Since 2008, the Tennessee TF-CBT Learning Collaborative has trained more than 700 clinicians in 50 community mental health agencies across the state using the National Center for Child Traumatic Stress Learning Collaborative model through four 9-month learning collaborative experiences. These intensive training opportunities were followed with six booster sessions for new staff within the agencies, six advanced topic trainings for supervisors and advanced clinicians, and ongoing consultation calls for clinicians, supervisors and agency senior leaders. This presentation of the efforts in Tennessee will be followed by a discussion of the lessons learned from the Tennessee experience that may help others overcome dissemination and implementation challenges in their jurisdictions.