Interventions that have been demonstrated by carefully-designed research studies to be effective are called evidence-based practices. These practices describe the specific range of problems for which they are effective, the characteristics of the people they have been shown to help, and the measurable outcomes they can be expected to produce. Here, we briefly describe the three evidence-based practices MHS now uses for three different groups of clients. Additional practices are being studied for use.

For clients of homeless assistance programs who have a severe mental disorder and a co-occurring substance-use disorder, MHS uses Integrated Dual Disorder Treatment.

IDDT procedures were developed by Robert E. Drake, M.D., Ph.D., and his research team of the New Hampshire-Dartmouth Psychiatric Research Center. They demonstrated the effectiveness of the model in carefully-designed studies (Drake et al., 1997, 2001).

Results of the studies by Dr. Drake and his colleagues demonstrated that people with co-occurring disorders who worked with treatment teams using the IDDT model improved far more than those who participated in traditional treatment.

After four years of treatment, about 60% of people in IDDT treatment were abstinent from drug and alcohol use, compared with about 20% for people who in non-integrated treatment programs. People in IDDT also had fewer mental health symptoms, hospitalizations, and emergency room visits. They had more sustained housing in the community, and better job functioning.

The Ohio Substance Abuse and Mental Illness Coordinating Center of Excellence (Ohio SAMI CCOE) is providing MHS with the training and consultation needed to implement IDDT. Patrick Boyle, LISW, LICDC, the Director of Implementation Services for the Ohio SAMI CCOE, introduced the IDDT model to MHS staff members in early 2005. The IDDT model recognizes that people with addictive disorders vary in their readiness to change, and offers clients different interventions based on their current stage of readiness. IDDT also emphasizes assertive outreach, which has long been a value of MHS Outreach Programs, and easy access to comprehensive services as a client's needs change, a value that has guided the development of the continuum of MHS Homeless Assistance programs.

Eric Morse, LISW and Chris Couture, LISW lead the agency's IDDT initiative. Mr. Morse is the Chief Operating Officer. Chris Couture manages staff training and IDDT implementation across all MHS homeless assistance programs. The IDDT initiative was initially funded by United Way Services of Greater Cleveland. MHS was honored to become a United Way agency in 2004.

For female clients of the Community Women's Shelter who have a severe substance-use disorder, and who may have a co-occurring non-severe mental disorder, MHS uses the Comprehensive Case Management (CCM) model developed by the Substance Abuse and Mental Health Services Administration (SAMHSA, 1998). CCM emphasizes a "coordinated approach to the delivery of health, substance abuse, mental health, and social services, linking clients with appropriate services to address specific needs and achieve stated goals.." CCM has been found to keep clients in treatment, and to lead to better outcomes. It defines the essential functions of case management as: (1) assessment, (2) planning, (3) linkage, (4) monitoring, and (5) advocacy.

MHS is a major partner in a collaborative project to implement this evidence-based treatment model. To learn more about this initiative, click here. Also, read about the launch of the project by a visit from the Deputy Secretary of the U.S. Department of Health and Human Services.

For children of the Children Who Witness Violence Program who have experienced traumatic violence, MHS uses Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)(Cohen et al., 2004), a psychotherapeutic intervention designed to help children, youth, and their parents overcome the negative effects of traumatic life events such as child sexual or physical abuse; traumatic loss of a loved one; domestic, school, or community violence. TF-CBT has been recognized by the Substance Abuse and Mental Health Services Administration and the U.S. Department of Health and Human Services as a "Model Program." TF-CBT has been classified by the Institute of Medicine (IOM) as "Selective and Indicated".