Procurement and Contracting as an Implementation Strategy: Getting To Outcomes® Contracting

Saturday 4:00 – 5:15 Symposium IV

Presentor: Ronnie M. Rubin

Ronnie M. Rubin, Philadelphia Department of Behavioral Health and Intellectual disAbilities Services; Marilyn L. Ray, Finger Lakes Law and Social Policy Center; Abraham Wandersman, University of South Carolina; Andrea Lamont, University of South Carolina; Gordon Hannah, ; Kassandra A. Alia, University of South Carolina ; Matthew O. Hurford, Philadelphia Department of Behavioral Health and Intellectual disAbilities Services, Arthur C. Evans, Philadelphia Department of Behavioral Health and Intellectual disAbilities Services


Billions of dollars are spent each year on behavioral health services and there is a movement to require the use of evidence based practices (EBPs) in these services.  Financing, contracting and regulatory strategies are proposed in several implementation science frameworks and many funders are moving toward performance based contracting. However, there are few systematic evaluations of how these strategies are deployed to ensure quality implementation of EBPs. Utilizing the Getting To Outcomes (GTO®) framework (Chinman, Imm & Wandersman, 2004), the Philadelphia Department of Behavioral Health and Intellectual Disabilities Services (DBHIDS) is engaged in an initiative to integrate accountability for the delivery of EBPs and the achievement of recovery and resilience outcomes into the procurement and contracting functions of its public behavioral health managed care organization. We will present an overview of the Getting To Outcomes Contracting (GTOC) Initiative, including how GTO was used to develop an RFP for co-occurring disorders, the training technical assistance efforts and strategies for scaling up. Data will be presented on the evaluation of this initiative, including comparisons of pre- and post-GTOC Initiative RFPs. This effort provides an example of how a behavioral health system can leverage implementation science strategies to procure evidence based services.

Automated Feedback on Therapist Fidelity: Current Status and Future Directions

Saturday 4:00 – 5:15 Symposium IV

Presentor: David Atkins

David C. Atkins, University of Washington; Zac E. Imel, University of Utah; Dogan Can, University of Southern California; Bo Xiao, University of Southern California; Panayiotis Georgiou, University of Southern California; Shrikanth Narayanan, University of Southern California



Cognitive science on learning shows that specific, proximal feedback is critical to the development of expertise, and this is precisely what is lacking from training and quality monitoring with behavioral interventions such as psychotherapy.  Particularly with an eye toward implementation and dissemination, research-based tools such as behavioral coding will never scale up to every-day practice.  The current talk will present ongoing interdisciplinary research on developing tools for automated feedback to therapists learning and practicing motivational interviewing (MI).  In collaboration with engineers and computer scientists, we have recently shown that a processing pipeline of tools – including voice activity detection, speaker segmentation, automated speech recognition, and text-based machine learning – can take an audiorecording of MI and yield accurate ratings of therapist empathy.  Ongoing feasibility research will provide machine-generated feedback to therapists on their sessions, focusing on acceptability, perceived accuracy, and user-interface interpretability.  In addition, we will comment on the opportunities, as well as possible pitfalls, of increased human-computer interaction in behavioral interventions.  In our experiences, technology works best when it serves to support the human task, rather than trying to supplant it.  In closing, we will discuss future plans for technology-augmented therapist training and supervision.

Web-Based Feedback to Aid Successful Implementation: The Interactive Stages of Implementation Completion Tool

Saturday 4:00 – 5:15 Symposium IV

Presentor: Lisa Saldana

Lisa Saldana, Oregon Social Learning Center; Holle Schaper, Oregon Social Learning Center; Mark Campbell, Oregon Social Learning Center; Patricia Chamberlain, Oregon Social Learning Center



The Stages of Implementation Completion (SIC) is an 8-staged measure that was developed to evaluate the implementation of evidence-based practices (EBPs). Each of the stages maps onto three phases of implementation: pre-implementation, implementation, and sustainability. The SIC measures adopting sites’ implementation performance, as indicated by activity completion and duration. Early stage implementation performance has been shown to predict successful implementation outcomes and the measure has sound psychometrics. Subsequently, the Interactive SIC was developed to allow for real-time, web-based feedback to be delivered by purveyors to organizations. A purveyor can enter an organization’s data at the time of completion, and the prediction models for success are updated immediately to show the most up-to-date prediction for accomplishing key implementation milestones (e.g., successful program start-up, achievement of program competency/certification). This website functions on both Mac and PC platforms. The development of a tool that predicts outcomes by assessing implementation performance will help identify areas in need of intervention (e.g., through additional support/consultation) and strategies that best meet the needs of organizations. This project aims to provide efficient tools that will help increase the uptake of EBPs, thereby increasing the availability of services to vulnerable populations and decreasing wasted resources from failed implementation efforts