Training and Technical Assistance

From the extensive review of the implementation literature by Fixsen and colleagues (2005) we learned that training without follow-up technical assistance is ineffective in promoting uptake of evidence-based practices by practitioners. The review also shows that some of the most critical “drivers of implementation” are:

• Pre-service training,
• In-service training,
• On-going consultation, and
• Staff evaluation

The concept of a consultant/coach is novel in mental health, though the term is being used now in management training and even to help people manage their lives to reach their goals (“life” coaching). Whereas the formal training program imparts the necessary theory, philosophy, and knowledge of the skill components and rationales; consultant/coaches are instrumental in operationalizing those principals in the work setting with clients—in client engagement, treatment planning, practicing therapeutic skills, and in exercising clinical judgment (Fixsen et al., 2005).

If administrators now must look beyond formal training as the primary in-service strategy for preparing practitioners to assume their jobs, how can administrators ensure this essential support is provided?

A number of states have built productive public-academic collaboratives for translating science to practice and for providing more of a “training and coaching” approach. For example:

• Connecticut has nested implementation of EBPs for children and youth within 27 local systems of care called community collaboratives, and partners with the University of Connecticut and Yale to operate the Connecticut Center for Effective Practices to support the collaboratives. Some of the functions of the center are: identifying, implementing and evaluating effective treatment models appropriate for the state’s system of care initiative; developing and implementing statewide training for mental health care coordinators; and developing tools and resources to empower families with children who have mental health conditions and/or are involved in the juvenile justice system. (More information is available at the Child Health and Development Institute of Connecticut.)



• Ohio has gained much recognition for instituting several “Coordinating Centers of Excellence” (CCOE). The CCOEs were built on preexisting relationships with universities to train mental health professionals in the fields of psychiatry, psychology, and social works. However, the CCOEs emphasize technology transfer through training current practitioners in EBPs. The centers each have a distinct focus. Two specialize in meeting children’s needs through disseminating technology on multisystemic therapy, diversion from juvenile justice, and mental health services in schools. To learn more about Ohio’s CCOEs, read Tools for Transformation: A Guide to Ohio’s Coordinating Centers of Excellence and Networks.



• New York is on the cutting edge in moving academia towards including evidence-based practices in their curricula. The State has a unique arrangement with several Schools of Social Work in the State to develop curriculum for EBPs and to place interns in agencies providing EBPs.