The New York State Office of Mental Health (OMH) and the Department of Psychiatry, Columbia University, established the Center for Practice Innovations at Columbia Psychiatry and New York State Psychiatric Institute (CPI) in 2007 to promote the widespread use of evidence-based practices developed for adults throughout New York State (NYS). CPI supports the behavioral healthcare workforce by offering free training, with continuing education, and technical assistance to staff working in not for profit behavioral healthcare agencies throughout NYS. By providing this free support to increase staff competence and support implementation of evidence-based practices, CPI also hopes decrease staff burnout and turnover. Additionally, the provision of free continuing education may help lower wage earners keep their licensure and accreditations without incurring additional out-of-pocket expenses.
CPI has six core initiatives: treating co-occurring mental health and substance use disorders (called “Focus on Integrated Treatment” or FIT), assertive community treatment (ACT), supported employment/education via individual placement and support (IPS), wellness self-management (WSM), first episode psychosis (called OnTrackNY), and suicide prevention (SP-TIE). CPI also supports other state training initiatives including Adult-BH Home and Community Based Services, the Uniform Clinical Network Provider training, increasing the use of clozapine, cognitive health, treatment of tobacco use disorder (as part of the FIT initiative), and treatment of obsessive-compulsive disorder.
CPI also offers training in clinical core competencies for the behavioral health workforce including topics like care transitions and care management, cognitive-behavioral therapy, social skills training, cultural competence, engagement and outreach, ethics, evidence-based prescribing, family and community support, group psychotherapy, integrating medical and behavioral health services, working with the LGBTQ community, justice-involved individuals, managing challenging behaviors, motivational interviewing, peer services, person-centered treatment planning, recovery, risk assessment, shared decision making, stage-wise treatment, substance use, and trauma informed care. Staff can also choose curricula that are built around these core competencies (e.g., motivational interviewing) or CPI certificate programs (e.g., violence risk management).
CPI offers both online and in-person training. Working closely with content experts and instructional designers, CPI has developed over 120 highly interactive online modules that use personal recovery stories, clinical vignettes, interactive exercises, and frequent knowledge checks to engage the learner. CPI also offers several regional and on-site agency face-to-face training across different content areas.
While training is necessary, CPI recognizes that it is rarely enough to change practitioners’ daily actions and achieve high quality implementation of the desired practice. For this reason, CPI offers empirically driven technical assistance to supervisors, managers and practitioners focused upon their implementation efforts. This often includes interactive webinars, an online resource library with practical tools (e.g., group manuals and fidelity checklists), consultations (both in person and by telephone), learning collaboratives, and monthly conference calls for participants in specific initiatives during which program staff share successes and receive expert consultation from peers and implementation experts on their implementation challenges. Consultations may follow difficulties with licensing reviews or staff turnover or are provided upon request for technical assistance. CPI’s efforts are guided by dissemination and implementation science and embedded within a practice change model that considers the policy, regulatory and financial environment of practice change as well as organization-level factors such as program-practice fit, leadership investment, organizational culture, time and resources available for practice implementation.
To join a learning collaborative, participating programs form implementation workgroups that develop an implementation plan and oversee the work toward the goals of that plan, participate in learning collaborative meetings, and collect and submit performance indicator data. In many cases, these learning collaboratives use fidelity self-assessments to help guide programs through continuous quality improvement projects. This data allows programs to identify challenges in implementation and work with CPI staff to address these challenges. It also allows OMH to identify and support quality improvement efforts.
As of March 31, 2019, 36,040 staff had completed 412,240 online modules. Programs participating in CPI initiatives are geographically dispersed through New York State, reaching 61 of the 62 counties (the remaining county, contained fully within a State Park, is the least populous in NYS).
Learn more about CPI at: www.practiceinnovations.org. If your program has not yet signed up for CPI’s training and resources, complete an application at: https://cumc.co1.qualtrics.com/jfe/form/SV_7UiDOZnSqJw7hyJ
For questions related to this article, please contact the author, Nancy Covell at: nancy.covell@nyspi.columbia.edu.
