Interventions for Disruptive Behavior Disorders: Selecting Evidence-Based Practices for Children with Disruptive Behavior Disorders to Address Unmet Needs: Factors to Consider in Decisionmaking

2011·1.1 MB·English

Selecting Evidence-
Based Practices Interventions
for Disruptive
For Children with Disruptive
Behavior
Behavior Disorders to Address
Disorders
Unmet Needs: Factors to
Consider in Decisionmaking

Selecting Evidence-
Based Practices
Interventions
for Disruptive
For Children with Disruptive
Behavior
Behavior Disorders to Address
Unmet Needs: Factors to Disorders
Consider in Decisionmaking
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Acknowledgments
This document was produced for the Substance Abuse and Mental Health Services Administration
(SAMHSA) by Abt Associates, Inc., and the National Association of State Mental Health Program
Directors (NASMHPD) Research Institute (NRI) under contract number 280‑2003‑00029 with
SAMHSA, U.S. Department of Health and Human Services (HHS). Sylvia Fisher and Pamela
Fischer, Ph.D., served as the Government Project Officers.
Disclaimer
The views, opinions, and content of this publication are those of the authors and contributors
and do not necessarily reflect the views, opinions, or policies of the Center for Mental Health
Services (CMHS), SAMHSA, or HHS.
Public Domain Notice
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or copied without permission from SAMHSA. Citation of the source is appreciated. However,
this publication may not be reproduced or distributed for a fee without the specific, written
authorization from the Office of Communications, SAMHSA, HHS.
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Recommended Citation
Substance Abuse and Mental Health Services Administration. Interventions for Disruptive Behavior
Disorders: Selecting Evidence-Based Practices for Children with Disruptive Behavior Disorders to
Address Unmet Needs: Factors to Consider in Decisionmaking. HHS Pub. No. SMA‑11‑4634,
Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services
Administration, U.S. Department of Health and Human Services, 2011.
Originating Office

Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road
Rockville, MD 20857

HHS Publication No. SMA‑11‑4634
Printed 2011
Selecting Evidence-Based Practices
for Children with Disruptive Behavior
Disorders to Address Unmet Needs:
Interventions
Factors to Consider in Decisionmaking
for Disruptive
This booklet provides a comprehensive, step‑by‑step guide to
making decisions about implementing evidence‑based practices
Behavior
(EBPs). It walks readers through the process of considering EBPs
and matching them with the needs of communities, agencies,
Disorders
families, and youth. It also presents critical information that will
help readers understand and use scientific evidence when
choosing a practice.
For additional references on interventions for disruptive behavior
disorders, see the booklet, Evidence-Based and Promising Practices.
This KIT is part of a series of Evidence‑Based Practices KITs created
by the Center for Mental Health Services, Substance Abuse and
Mental Health Services Administration, U.S. Department of Health
and Human Services.
This booklet is part of the Interventions for Disruptive Behavior
Disorders KIT, which includes six booklets:
How to Use the Evidence-Based Practices KITs
Characteristics and Needs of Children with Disruptive
Behavior Disorders and Their Families
Selecting Evidence-Based Practices for Children with
Disruptive Behavior Disorders to Address Unmet Needs:
Factors to Consider in Decisionmaking
Implementation Considerations
Evidence-Based and Promising Practices
Medication Management
What’s in Selecting Evidence-
Based Practices for Children with
Disruptive Behavior Disorders
Interventions
to Address Unmet Needs: Factors to
Consider in Decisionmaking
for Disruptive
Introduction to the Six‑Step Decisionmaking Process .............1 Behavior
Case Illustrations ..............................................................17
Disorders
Hints on Understanding Research Study Designs .................20
References .......................................................................23

Selecting EBPs
Introduction to the Six-Step Decisionmaking Process
This booklet walks readers through the This booklet can serve as a shortcut
process of considering EBPs and matching for indepth browsing through the 18
them with the needs of communities, EBPs presented in Evidence-Based
agencies, families, and youth. It also and Promising Practices of this KIT
presents critical information that will help to narrow the search to match your
readers understand and use scientific population of interest, your agency,
evidence when choosing a practice. and your staff and, most important, to
satisfy the needs of families and children
The information available for each of the
served. Figure 1 presents the six steps in
18 EBPs defined in Tables 3 and 4 of How
selecting a specific EBP or set of EBPs
to Use the Evidence-Based Practices KITs
to add to a service array:
can be overwhelming. Even after educating
yourself about the details of each EBP,  Determining the evidence for the EBP;
deciding which EBP to implement in  Determining the target population
an organization and how to implement
of the EBP;
that EBP can be daunting. To help you
 Determining if the outcomes
in the selection process, this booklet gives
of the EBP are meaningful to a
you examples of implementation factors
local population;
to be considered at each step in the
decisionmaking process. Characteristics
of the EBPs that influence decisionmaking
are also summarized.
Selecting EBPs 1 Introduction to the Six-Step Decisionmaking Process
Figure 1: Decisionmaking in the selection of evidence-based practices
1. Evidence “Best Support” 2. Study 3. Are 4. Consistent 5. Acceptable 6. Acceptable
 2+ group‑design studies by Y population Y outcomes Y with Y and Y and
multiple investigative teams comparable meaningful? agency’s feasible to feasible to
 > Placebo or alternative to yours? function? staff? clients?
treatment to established
N N N N Y
treatment Y Y
OR
Modify Strategies
 Large series of single‑case
Function? to enhance
design studies (n > 9)
feasibility/
N acceptability?
N
“Good Support” Better EBPs N
 2 group‑design studies available?
but a single investigator
 2 studies with outcomes >
no treatment control
 Small series of single‑case
design studies (n > 3)
N
Search for and evaluate other EBPs Adopt EBP
Adapted from Selecting an evidence‑based practice (pp. 1‑15), by P. A. Areán and A. Gum, in S. E. Levkoff, H. Chen, J. E. Fisher, & J. S.
McIntyre (Eds.), Evidence-based behavioral health practices for older adults, 2006, New York, NY: Springer. Copyright 2006 by Springer.
 Determining if the practice is consistent with an The prevention EBPs are also described in the
agency’s function; table headings as Prevention/Multilevel because
many have program components aimed at different
 Determining if implementation is feasible to
levels of prevention. For example, some prevention
staff; and
programs are considered to be universal because
 Determining if the EBP is acceptable to clients. they focus on an entire population to prevent
disruptive behavior disorders. Examples of such
Specific characteristics of the individual EBPs programs could be outreach or media programs.
are presented in the tables in this booklet. The
decisionmaking process for selecting an EBP Several other prevention programs are called
entails matching characteristics found in these selected because they focus on a specific
tables with the process illustrated in Figure 1. subpopulation to improve behavior problems
that could turn into disruptive behavior disorders
Tables 1A and 1B and all of the summary tables among that group of youth. Still others, labeled
that follow are organized into the following indicated, provide treatment or intervention as
two groups: well as prevention services.
 EBPs that focus primarily on prevention; and
Intervention usually refers to the treatment of
 EBPs that focus on intervention.
a specific disorder, as opposed to the prevention
of a problem condition.
Introduction to the Six-Step Decisionmaking Process 2 Selecting EBPs