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Children and Youth Services Review

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Community-based social services -- United States, Youth mental health


Since about the turn of the century, a growing awareness of the poor outcomes resulting from “as usual” community mental health care has led to increasing efforts to implement programs and interventions with empirical evidence of effectiveness. However, these efforts have encountered numerous barriers, in particular the high cost of implementation, which has severely limited uptake and sustainment of empiricallysupported programs and interventions. Typically, the largest contributor to cost is the training and coaching required to ensure provider competence and fidelity to the intervention or program model. This paper describes a social innovation that aims to provide high-quality training and coaching that is affordable and sustainable in community mental health settings. The main strategy for this is the use of a completely “remote” process for training and coaching. This process relies on a web-based platform through which trainees access a library of real examples of good—and not-so-good—practice, and through which they also receive individualized coaching and feedback based on video recordings of their own practice with clients. Specifically, the paper describes a remote training intervention for practitioners working with young people aged 16-25 who experience serious mental health conditions. This approach is designed to train providers to work with young people in ways that increase their engagement and retention in services, as well as their alliance with treatment providers. Enhancing providers’ skills in these areas is urgently needed, given that young people in this age range have the highest rates of serious mental health conditions, and yet they are also the least likely to engage in or complete mental health treatment. Findings indicate that participants were highly satisfied with the training, and that their skills in key areas increased significantly, as measured both by their own subjective assessment and by expert ratings of their video-recorded practice.


© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license

This is the author’s version of a work that was accepted for publication in Children & Youth Services Review. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Children and Youth Services Review, Volume 100, 2019, Pages 119-128.



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