The Critical Role for Psychology in the Children's Mental Health System: Being a Catalyst to Implement and Build Better Interventions
Schmidt, Fred, Canadian Psychology
The increasing demands for accountability, effectiveness, and use of research in the children's mental health system places psychology in a unique and important position. Psychology practitioners are highly trained in scientific and clinical methods and possess the skills needed to implement evidence-based practices in community organisations. Moreover, psychology's central role in the increasing demand to evaluate services can help to foster the development of reflective learning organisations. The current article describes current directions in evidence-based practice in the children's mental health system and the critical role psychology can play in building more effective services. Key priorities and directions for psychology's role in children's mental health are provided.
Keywords: children, implementation, evidence-based, treatment, organizations
The children's mental health field, like most sectors of our society, is in the midst of dramatic transformation. There are increasing demands for accountability, effectiveness, and integration of available empirical research into everyday service delivery. While this represents a positive shift in clinical practice, it also leaves many frontline clinicians, organisations, and policymakers in a state of uncertainty about how best to achieve such ideals. What does it mean to be "evidence-based"? Am I using the best research information possible? What constitutes a sound or adequate program evaluation? These questions, and many others like them, receive a wide range of answers by current psychology practitioners. This variability, in part, represents the nascent status of the field and the paucity of research in children's mental health. Notwithstanding these challenges, it is an exciting and important time of transition where practitioners, organisations, and policymakers are all striving toward the realisation of improved child and adolescent mental health interventions. However, much is to be learned as frontline practitioners face the challenge of incorporating new knowledge into daily clinical practice. This journey is a process which will require collaboration across multiple sectors and disciplines, and will inevitably result in some failures and mistakes along the way. Like Dr. Seuss, who was rejected by publishers 27 times before his first book, And to Think That I Saw it on Mulberry Street, was published, persistence in our efforts to implement and build more effective interventions is critical to the success of our work. The current article will attempt to describe my perspective and thoughts as a frontline practitioner on how psychology's unique skill set can be used to build more effective interventions in the children's mental health system. This will include psychology's ability to use the various approaches to evidence-based practice that currently exist in the children's mental health field. In addition to promoting the use of effective approaches, psychology can and should play an increasingly critical role in facilitating the careful implementation of evidence-based practices. Finally, in light of the current state of the field, recommendations for moving forward are provided both from the perspective of a frontline practitioner and from the personal lessons learned through implementing evidencebased programs in a community-based children's mental health centre (Schmidt & Taylor, 2002).
Effectiveness of Usual Children's Mental Health Treatment
Kutcher (2011) argues that the children's mental health field must move toward "best evidence," not "best practice," and must use interventions which are "right" rather than using what "feels right." These strong statements by Kutcher arise from the disappointing results found in past reviews of Treatment as Usual (TAU) in the children's mental healm system. As described in past studies, TAU refers to the usual provision of eclectic treatment services, by community-based clinicians, under the confines of existing available resources. …