Podcast Transcript: Training Youth Workers to Use an Evidence-Based Practice

NCFY: Welcome to Voices from the Field, a podcast series from the Family and Youth Services Bureau. For the past year, Dr. Melanie Barwick has been studying four different youth serving programs as they implement an evidence-based practice called motivational interviewing, or MI. Barwick paired each program with an MI expert who could train them over time, and measured the effectiveness of the practice in improving clients’ mental health. 

BARWICK: We were really interested in trying to find out what is the best way to introduce something like motivational interviewing into a service provider setting. Ultimately, what we would like to do is be able to describe better, here’s what best practices look like for enabling clinicians to change their practice. 

NCFY: Wayne Skinner is one of the trainers that Dr. Barwick enlisted in her study. He says the implementation was so effective because the experts and the youth workers grew much closer than through a typical training.

SKINNER: We offered coaching and consultation to the front line workers. And in parallel, we offered that also to their supervisors. This was a design feature I think that Melanie put in to allow us to support the supervisors in kind of getting MI and understanding how congruent MI would be with their goals of client engagement and retention and potential completion of treatment. I mean, those are the big fish you’re trying to catch when you do this work. 

BARWICK: We tend to have this approach of, "Let some people into the two-day training and let them scramble if you will and see what they’re able to accomplish and transfer to the work environment." And so we were able to demonstrate that with coaching supports--and those coaching supports looked somewhat different across different types of studies--that you ended up with clinicians who had an improved level of ability to engage in motivational interviewing when they were with their client. And all of the clinicians have come back to say how extremely valuable the availability of the coaching supervision from the trainers have been in enabling them to increase their comfort and increased their skill in learning MI. 

NCFY: Barwick’s work illustrates just how much time it takes to implement an evidence-based practice, to say nothing of the financial investment of paying for trainings. 

BARWICK: It takes time and application and reflection and coaching for clinicians to be able to build their competency. You have to kind of stop and pause and pull away from service delivery in order to make changes. Maybe it will always take a group of people from the outside to facilitate implementation and to help with coaching the implementation. We have the coaches on the EBP itself and then people to help you plow your way through an actual implementation initiative. 

NCFY: But Skinner says the investment is worthwhile if it helps youth workers develop new methods for helping previously hard to reach clients. 

SKINNER: They have people who keep coming back to them for help, right? They have stories they can tell about particular people whose lives were transformed by what they did. Asking people to abandon that is asking them to stop believing in what their experience tells them. But from a research point of view, that’s not really the question. The question is, you help people, but other people doing similar work in different ways--do they have better or worse rates of helping? 

So my question actually is, what do we do for the people who aren’t being helped by your program? And certainly, you’re busy enough dealing with the people who say this is great, this is a lifeline, I’m hanging out with you guys until I get better. And that fills up your whole day.  But there’s a whole bunch of other people who didn’t have that experience. And so where do they go? You know, we need to have ways of trying to work with and engage folks I think, the whole population, especially the ones actually who we don’t engage effectively because they remain at the highest risk. 

NCFY: For more information on evidence based practices, visit the National Clearinghouse on Families and Youth, online at ncfy.acf.hhs.gov.

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