The Fort Bragg managed care experiment: What do the results mean for publicly funded systems of care?

Multisystemic Therapy: Monitoring Treatment Fidelity*

“…Fam Proc 39:83-103, 2000 T HE recent publication of sobering findings regarding the failure of service system initiatives to impact child outcomes differentially (Bickman, 1996;Bickman, Summerfelt, Firth, & Douglas, 1997) and mixed evidence regarding service effectiveness (Burns, Hoagwood, & Maultsby, 1998;Fraser, Nelson, & Rivard, 1997;Hoagwood & Erwin, 1997;Jensen, Hoagwood, & Petti, 1996) have drawn attention to the specific nature of clinical interventions deployed via innovative services and service system initiatives (Henggeler, Schoenwald, & Munger, 1996;Kingdon & Ichinose, 1996;Oswald & Singh, 1996;Rosenblatt, 1996;Weisz, Han, & Valeri, 1997). Relations between therapist adherence to MST principles and instrumental and ultimate outcome variables are examined, as are relations between clinical supervision and therapist adherence.…”

“…The modest associations between adherence measures and youth outcomes argue for further refinement and validation of the MST adherence measure, especially in light of the well-established effectiveness of MST with challenging clinical populations and the increasing dissemination of MST programs. Fam Proc 39:83-103, 2000 T HE recent publication of sobering findings regarding the failure of service system initiatives to impact child outcomes differentially (Bickman, 1996;Bickman, Summerfelt, Firth, & Douglas, 1997) and mixed evidence regarding service effectiveness (Burns, Hoagwood, & Maultsby, 1998;Fraser, Nelson, & Rivard, 1997;Hoagwood & Erwin, 1997;Jensen, Hoagwood, & Petti, 1996) have drawn attention to the specific nature of clinical interventions deployed via innovative services and service system initiatives (Henggeler, Schoenwald, & Munger, 1996;Kingdon & Ichinose, 1996;Oswald & Singh, 1996;Rosenblatt, 1996;Weisz, Han, & Valeri, 1997). Such attention is warranted because psychotherapy of some type continues to bear the burden of producing change in the referral problems irrespective of the service system (mental health, juvenile justice) or setting (clinic, family home, school, group home) in which youth with complex problems receive treatment (Kazdin, 1994).…”

Program Strength and Fidelity in Evaluation

“…A number of publications have been written that seek to interpret the results of the study from various perspectives (Behar, 1996;Behar, 1997;Bickman, 1996bBickman, , 1996cBickman, , 1997Bickman et al, 1998;Burchard, 1996;DeLeon & Williams, 1997;Evans & Banks, 1996;Feldman, 1997;Friedman, 1996;Friedman & Burns, 1996;Hoagwood, 1997;Kingdon & Ichinose, 1996;Lane, 1996;Mordock, 1997Mordock, , 1998Paris, 1996;Saxe & Cross, 1997;Sechrest & Walsh, 1997;Summerfelt, Salzer, & Bickman, 1997;Weisz, Han, & Valeri, 1996. A number of publications have been written that seek to interpret the results of the study from various perspectives The controversy arising from the results of FBEP was almost as large as the project itself.…”

Effects of a clinical feedback system on client and therapist outcomes in a rural community mental health center

“…A series of articles in the Journal of Child and Family Studies (Burchard, 1996;Evans & Banks, 1996;Friedman, 1996;Henggeler, Schoenwald, & Muanger, 1996;Kingdon & Ichinose, 1996) and another series in the American Psychologist (Behar, 1997;DeLeon, & Williams, 1997;Feldman, 1997;Hoagwood, 1997;Saxe& Cross, 1997;Weisz, Han, & Valeri, 1997) raise issues and questions about the study and its conclusions, which are answered in rejoinders by Bickman and colleagues (Bickman et al, 1996;Bickman, 1997).…”