Clinical Resources
October 2006
JCFS Evidence-Based Practices Project
The goal of the JCFS Evidence-Based Practices Project is to enable and support JCFS clinicians to use the principles and methods of evidence-based practice (EBP) to assist in clinical decision making and clinical program development.
What is EBP?
Evidence-Based Practice incorporates the best available research evidence with clinical experience, client interests and organization values to provide the best possible services to meet client needs. The description "evidence-based" emphasizes how research information (accessed through electronic search) clarifies and supports clinical experience.
The JCFS EBP Project
The JCFS Evidence-Based Practices core project team consists of Fred Steffen, Project Director, Elisabeth Hutchins, Project Coordinator, Steve Wildman, Administrative Assistant, and Stanley McCracken, Consultant. JCFS is delighted to have Stan as our Project Consultant. He is a Senior Lecturer at the University of Chicago School of Social Service Administration and the Director of Training at the Heartland Training Center for Human Service Excellence. Not only is he justifiably renowned as one of the country's leading experts in the application of EBP, he is an inspiring and enthusiastic teacher.
Program Based EBP Projects
Several are in the development stage; others are well underway.
- Foster Care - Verifying the evidence base for therapeutic parenting services aimed at reunification and developing a JCFS model for piloting
- SOC- Continuing participation in the CPP pilot (see page 4) and expanding use of the model into other programs
- Psychological Services-Ongoing scholarly inquiry and presentations, most recently including treatments for Anxiety Disorders with Children (Coping Cat Method) and a collaboration with Midwestern University to explore cultural differences on the WISC-IV observed in comparisons of Orthodox and non-Orthodox Jewish children
- Residential Services- Identifying milieu components with strong evidentiary support for possible incorporation into the existing practice model
- Therapeutic Day School - Identifying the most effective methods for managing challenging classroom behavior
- J-CERT - Clarifying the evidence base for the effectiveness of intervention techniques used to respond to disasters
October 2006
Child-Parent Psychotherapy Pilot in SOC
JCFS is participating in a pilot implementation of Child-Parent Psychotherapy (CPP). DCFS selected JCFS to pilot this evidence-based intervention designed to treat young children and families coping with trauma. The research component of the pilot, which is being conducted by John Lyons of Northwestern University, will focus on the process of embedding such a model in agency settings.
Child-Parent Psychotherapy
Alicia Lieberman and Patricia Van Horn at the University of California-San Francisco developed CPP, initially for work with children age birth to 5 who had been exposed to domestic violence. The model has been extended to other forms of trauma and to children up to the age of seven. In their model, the child-parent relationship itself is "the client". Treatment takes place in weekly joint child-parent sessions (usually home based) for approximately one year in which the clinician is a facilitator more than an instructor. The manual for the CPP model is available for order from Amazon.com: Lieberman, A.F. & Van Horn, P. Don't Hit My Mommy! Washington, DC: Zero To Three Press, 2005.
The Evidence Base
The Child-Parent Psychotherapy model was built on its developers' clinical experience and favored theories (attachment, developmental) and was manualized and tested for effectiveness. Here are summaries of some of the results:
- Children of depressed mothers who received CPP showed normal cognitive development in contrast to their untreated peers who showed IQ decline (Cicchetti, et al., 2000)
- Anxious parent-child pairs showed improved quality of attachment and negotiation of conflict (Lieberman, et al., 1991)
- Maltreated child-parent pairs showed decreased maladaptive maternal representations, decreased negative self-representations, and increased positive self-representations (Toth, et al., 2002)
- The National Child Traumatic Stress Network (www.NCTSN.org) classifies trauma treatments according to levels of empirical support and gives CPP its highest rating. Assuming high fidelity in applying the model, Child-Parent Psychotherapy results in improved child-parent interaction and supports healthy child development.
The Project To Date
Six JCFS clinicians are actively participating in the project. They are required to complete three full-day workshops conducted by Patricia Van Horn and two full-day booster workshops. They must treat one or more clients in the model, participate in weekly phone supervision with Van Horn utilizing clinicians' process notes, and participate in additional individual and group supervision conducted by JCFS Clinical Director Lili Gray.
In November, to achieve the goal to embed CPP throughout the agency, the EBP Project will begin another training cycle in the model for 25 additional JCFS clinicians.
On October 12, 2006, Alicia Lieberman gave an all-day presentation to 300 people, sponsored by the Illinois Association for Infant Mental Health, whose President, Susan Kaplan, is a former JCFS employee. A highlight was a live case consultation in which Beth Pettinelli, one of the JCFS clinicians participating in the Child-Parent Psychotherapy pilot, presented one of her cases. Beth, who has been a clinician in the agency for more than seven years and currently works in the Foster Care Therapeutic Parenting Program, made a superb presentation, which inspired an enthusiastic and interesting discussion about the complexity of applying the model to children and mothers in the child welfare system.
