Browsing by Author "Walton, Betty A."

Now showing 1 - 10 of 41
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    Addressing Disparities through TCOM Strategies
    (2016-11) Walton, Betty A.; Harrold, Wendy
    While America is rapidly become more diverse, the human service workforce is changing more slowly. Behavioral health disparities in accessing appropriate services and in outcomes are well documented. Can TCOM strategies be leveraged to address these issues? Combining existing information (insurance claim and workforce data) with TCOM information clarifies local challenges and provides a framework to monitor progress. Moving beyond considerations of gender and age, possible access issues and lower or disrupted service use may be reflected in differences in service utilization by language, race, and ethnicity. Exploring available information can identify access and/or engagement and systematic reporting issues. Implementing recommended TCOM reports provides tools to help identify disparities in behavioral health outcomes for programs and services by geography and demographics. In reviewing outcome management reports for teenagers and transition age youth, questions arise about the significance of observed differences. In response, a predictive analysis using ANSA data asks if age, gender, race, ethnicity, current personal recovery factors (strengths and recreation), or the identification of cultural or linguistic challenges predict resolving actionable needs over time. Routinely monitoring differences in access and outcomes is recommended as a TCOM quality improvement process.
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    Addressing specialization and time to enhance adult learning: Workshop participants’ perceptions
    (The University of Texas at Austin’s Steve Hicks School of Social Work, 2020-06) Alamdari, Sara M.; Walton, Betty A.; Moynihan, Stephanie
    Interdisciplinary workshops trained and supported supervisors and coaches to implement common assessment tools in practice across social service sectors. By applying adult learning, learning transfer, and situated learning theories, this qualitative study elicited perceptions of trainers and trainees to identify improvement training and technical assistance strategies. Ten semi-structured interviews were completed. Using thematic analysis, six themes emerged (specialization, time, engagement/interest, content, marketing, and technology). Specialized training for experienced adults helped match new knowledge and skills to practice. Addressing time constraints of busy professionals required consideration of participants' availability and training duration. Consistent with applied theories, suggestions for improvement included interactive training, small group discussions, realistic examples or vignettes, and helping participants comprehend the importance of the content. The creative use of technology, pre-training need assessment, reflexive practice, and supportive organizational factors can be helpful to advance continuing education in social service professions. Utilization of suggestions to modify workshops improved engagement and the transfer of knowledge to practice.
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    ANSA: Becoming a Recovery Focused Tool
    (2014-11) Walton, Betty A.; Kim, Hea-Won
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    ANSA: Becoming a Recovery Focused Tool
    (Office of the Vice Chancellor for Research, 2013-04-05) Walton, Betty A.; Kim, Hea-Won; Park, SeonHye
    The Adult Needs and Strength Assessment (ANSA, Lyons, 2009) has been used across public mental health and addiction services in Indiana to help develop intervention plans and to monitor client progress. ANSA consists of six core domains (Life Functioning, Behavioral Health Needs, Risk Behaviors, Strengths, Acculturation, and Caregiver). Domain items are rated on a four-point scale to describe the degree to which a need interferes with functioning or a useful strength is present. Despite statewide implementation, literature related to the ANSA is scarce. The study evaluates the psychometric properties of ANSA and its role as an outcome performance measure. Adults for whom the ANSA had been rated at four points between 2008 and 2010 were included (N=6320). Internal consistency reliability was measured for each ANSA domain and outcome measure. Reliable change indices (RCI) for each domain were used to calculate significant change. At each point of assessment and across time, the Cronbach’s alphas for all domains, except Risk Behaviors, are in the acceptable to high ranges (0.71 to 0.92), indicating good internal consistency and stability. For outcome performance measures, a more realistic timeframe for assessments (12 months) was required to document reliable improvement in at least one ANSA domain for individuals with serious mental health needs. The Residential Stability outcome measure has the low internal consistency and stability. From the recovery perspective, a new Community Integration measure was proposed as an alternative outcome measure and proved to be reliable (α = .90). Study findings helped enhance the ANSA tool, create a new outcome measure, and inform state policy. Specifically, bridging research to practice, findings resulted in restructuring the ANSA Risk Domain and modifying how outcomes are measured for adults in recovery focused behavioral health services.
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    Behavioral Health Outcome Mangement Tools across the Life Span
    (Indiana Rural Health Association Conference, Indianapolis, IN., 2012-06-15) Walton, Betty A.; Moore, Matthew A.
    This research produced findings that illustrate how intensive community-based services help bridge the gap between mental health functioning of children living in both urban and rural areas.
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    Co-occurring Substance Use and Mental Health Needs: Enhancing the Adult Needs and Strengths Assessment (ANSA) to Manage Services
    (2019-10-04) Walton, Betty A.; Kim, Hea-Won
    Substance use disorders (SUD) are common, affecting one in 25 adolescents (ages 12 -17), one in seven young adults (ages 18 to 25), and one in 16 adults (ages 26 and older) during 2017. 1 While 16.7% of adults without SUD experienced mental health (MH) disorders, 45.6% of adults with SUD experienced co-occurring MH disorders.1 Related research found much higher rates of adults with MH or SUD disorders (50-75%) have co-occurring disorders. 2, 3, 4, 5 Co-occurring MH and SUD make treatment more difficult, increase use of health resources, and interfere with individuals’ life functioning.2, 3, 4 In response to the opioid crisis, SUD treatment funding and services are expanding. Effective treatment requires identification of co-occurring disorders (COD). The goal of this study was to examine how well practitioners assess and identify COD in practice.
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    Connecting the Dots: Stages of Implementation, Wraparound Fidelity and Youth Outcomes
    (2011) Effland, Vicki Sprague; Walton, Betty A.; McIntyre, Janet S.
    Several necessary system and organizational support conditions for wraparound have been identified (Walker et al. 2003). Yet, the relationship between these necessary system level conditions and wraparound fidelity has only recently begun to be examined. Similarly, few studies have included a measure of wraparound fidelity when examining the relationship between wraparound implementation and youth outcomes. The statewide implementation of a wraparound demonstration grant offers the opportunity to explore these relationships and to identify factors that predict improvement in functioning for youth receiving wraparound. Findings suggest that significant relationships exist between (1) the stage of development of necessary support conditions for wraparound and wraparound fidelity and (2) wraparound fidelity and improvement in youth outcomes. Specific elements of wraparound (i.e., outcomes based and community based) and baseline needs and strengths (e.g., high levels of anxiety and conduct issues, poor functioning at home and in school, judgment, and risks) were found to predict a reduction in youth needs. Other unexpected relationships between youth outcomes and the cultural competence element of wraparound and being multi-racial were also discovered. These findings reinforce the importance of supporting high fidelity wraparound for youth and their families in a recovery focused behavioral health system.
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    Divergent Caregiver and Youth Perspectives Regarding Behavioral Health Needs and Psychosocial Functioning: An Exploratory Study
    (2019-11-05) Karikari, Isaac; Walton, Betty A.; Bishop, Christine
    Background. To promote effectiveness in behavioral health treatment, the system of care framework and wraparound model accentuate inclusion of family and youth as important stakeholders, not just as consumers. This has challenged conventional practices; and youth and caregivers' perspectives have become integral to treatment planning and service delivery. This study explored caregivers and youth's perspectives of behavioral health needs and psychosocial functioning. Methods. This exploratory study utilized data collected in a Midwestern, suburban county as part of the national Child and Family Study of youth with complex behavioral health needs enrolled in the Child Mental Health Wraparound initiative. The sample consisted of 25 caregiver-youth pairs. Assessment measures included the Pediatric Symptom Checklist (PSC) and the Columbia Impairment Scale (CIS). Independent t-tests were used to examine differences in caregiver and youth perspectives. Results. Significant differences were identified in caregivers and youth's perspectives of youth's behavioral health on the PSC, but no significant differences between caregivers and youth on the CIS measure. Responses showed that compared to youth, caregivers perceived a higher level of functional impairment in interpersonal relationships, academic, and community functioning. Further, caregivers' views of severity of functional impairment varied based on the caregiver type. Conclusion. Divergent perspectives regarding youth's behavioral health needs and functioning between caregivers and youth have implications for behavioral health treatment planning and service delivery. Additional research is needed on collaborative assessments and implications of different views for practice and outcomes.