Competent delivery of interventions in child and youth social care is important, due to the direct effect on client outcomes. This is acknowledged in evidence-based interventions (EBI) when, post-training, continued support is available to ensure competent delivery of the intervention. In addition to EBI, practice-based interventions (PBI) are used in the Netherlands. The current paper discusses to what extent competent delivery of PBI can be influenced by introducing supervision for professionals. This study used a mixed-method design: (1) A small-n study consisting of six participants in a non-concurrent multiple baseline design (MBL). Professionals were asked to record conversations with clients during a baseline period (without supervision) and an intervention period (with supervision). Visual inspection, the non-overlap of all pairs (NAP), and the Combinatorial Inference Technique (CIT) scores were calculated. (2) Qualitative interviews with the six participants, two supervisors, and one lead supervisor focused on the feasibility of the supervision. Four of six professionals showed improvement in treatment fidelity or one of its sub-scales. Had all participants shown progress, this could have been interpreted as an indication that targeted support of professionals contributes to increasing treatment integrity. Interviews have shown that supervision increased the professionals’ enthusiasm, self-confidence, and awareness of working with the core components of the intervention. The study has shown that supervision can be created for PBI and that this stimulates professionals to work with the core components of the intervention. The heterogeneous findings on intervention fidelity can be the result of supervision being newly introduced.
Contribution of Pauline Goense to the 2nd Biennial Australian Implementation Conference on how policies, programs and practices can best be implemented so as to most effectively make a real, positive and enduring impact on people’s lives.
Evidence concerning psychosocial interventions for children and young people with externalizing behavior problems has amassed at an impressive pace in recent years. Interventions that have been proven effective are now considered vehicles through which the knowledge of “what works” can be applied in practice. Outcomes for children, young people, and their families, however, have not improved in line with these advances in knowledge. This difference between the knowledge of “what works” and the application of this knowledge in real-life practice has become known as the “implementation gap”. This dissertation explores questions considering the implementation gap, with a focus on whether professionals are delivering the interventions as intended (treatment integrity).The results of the research underlying this dissertation show that 1) although measuring treatment integrity is important, it is often missing or not examined under adequate circumstances in studies, 2) applying interventions with a high level of treatment integrity makes a real difference to the end-users of the services and 3) targeted and continued support to professionals with a focus on providing feedback on levels of treatment integrity is necessary to enable them to deliver interventions as intended. Organizing support around common factors of interventions can be a first step in integrating and providing feasible support for professionals that provide more than one intervention.
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