For successful implementation, agencies must align the “fit” between BSFT, or FET, and the target client population. Agencies must investigate not only the need for the EBP, but also how realistically the EBP can be installed in their community. This brings in the crucial consideration, and preparation, of adequate funding. Such funding must be secured not only for initial services/ training, but for the long duration of the successful EBP in the community. Appropriate funding is required for the maintenance of the infrastructure needed to sustain the EBP serving the community. Agencies, stakeholders and community resources must partner closely in this process.
With respect to possible Medicaid funding streams, requirements and eligibility are state-specific. To the extent that your state’s Medicaid pays for any out-patient mental health services, then BSFT, or FET, will be covered in the same manner.
The “when” and “how” will the treatment services be provided must be realistic for the community population served and the agency’s infrastructure. Consider the adaptations that may be required, and create an Implementation Team that includes the Model disseminators/developers actively working with agency administrators and staff as well as relevant community resources. Note: adaptations are made solely by model developers.
Organizational considerations must be addressed prior to embarking on the program. Organizational changes at various levels will be necessitated. The recommendation is to create changes in a system slowly, retaining old system practices while introducing new system approaches. Align structure with intended clinical outcomes.
During the course of disseminating BSFT and FET, we have taken a good, hard look at what constitutes successful implementation of an evidence based practice in the field of service delivery, both from the “must do” and the “must avoid” perspectives. Academia is an antiseptic environment constructed to insure the integrity of the model during its development and trials. In the real world, agencies embarking on launching an EBP are charged with the complex task of bridging the science-to-service gap.
Data on model outcome helps in an agency’s selection of a program that fits their needs;
However, it is not the only component to implement that program with fidelity and assure benefits for the intended recipients. The other implementation drivers must also be present.