Best Practice

Best Practice

Network agencies provide evidenced based care and share in best practices throughout the state learning from each other and using cutting edge programming.

The services provided by our network agencies are grounded in current research and discourse on the evidence base for best practice. We draw upon external resources such as the National Registry of Evidence-based Programs and Practices, while also seeking out and reviewing promising and emerging practices that reflect the values of Vermont’s system of care. Providers participate in ongoing forums and training events where evidence-informed practices are shared and developed. The principles of community integration and recovery are integral to this work.

Dialectical Behavioral Therapy

Dialectical behavioral therapy applies a broad array of cognitive and behavioral, psycho-educational and motivational therapy strategies in a non-residential clinical setting, including:

  • Education - Helping clients develop new skills
  • Motivation - Addressing motivational obstacles to skills use
  • Cognitive-behavioral Therapy
  • Phone consultation – supporting clients to use appropriate skills in stressful life situations
  • Consultation Group – supervision to help keep therapists motivated and skilled

Supported Employment - Individual Placement and Supports

The IPS approach to supported employment assists individuals with disabilities and possibly a coexisting substance abuse disorder to become gainfully employed in an integrated community work setting. It emphasizes rapid placement of the client into a competitive, not necessarily full-time, job based on the client's preferences and skills, and the provision of ongoing supports and training to help the client maintain employment. IPS is specified in the master contract with AHS as a required capacity, and each DA reports outcome data to the Department of Mental Health.

Assertive Community Treatment

ACT is an intensive and highly integrated approach for community mental health service delivery.In the array of standard mental health service types, ACT is considered a "medically monitored non-residential service" (Level 4), making it more intensive than "high intensity community based services" (Level 3) but less intensive than "medically monitored residential services" (Level 5) on the LOCUS scale. 

Strength-based Case Management

Based on a strong working alliance with the client, the case manager helps the client identify personal skills, abilities, and assets through discussion; supports client decision-making so that the client sets treatment goals and determines how the goals will be met; encourages client participation in seeking informal sources of assistance; and works to resolve any client-identified barriers to treatment, such as lack of transportation, child care, and social support. Activities include assessment, planning, linkage, monitoring and advocacy.  Although broad system change is not the intent, the case manager also advocates with treatment providers and seeks system accommodation on behalf of the client. 

Seeking Safety

Seeking Safety is a present-focused treatment for clients with a history of trauma and substance abuse. The treatment was designed for flexible use: group or individual format, male and female clients, and a variety of settings e.g. outpatient, inpatient, residential. Seeking Safety focuses on coping skills and psycho-education. Principles include: (1) safety as the overarching goal -helping clients attain safety in their relationships, thinking, behavior, and emotions; (2) integrated treatment - working on both posttraumatic stress disorder and substance abuse at the same time; (3) a focus on ideals to counteract the loss of ideals in both PTSD and substance abuse; (4) four content areas: cognitive, behavioral, interpersonal, and case management.

Open Dialog

Open Dialog is an innovative, network-based approach to psychiatric care that was first developed in the 1980s in Tornio, Finland. In contrast to standard treatments for early psychosis and other crises, Open Dialogue emphasizes listening and collaboration and uses professional knowledge with a ‘light touch’ – rather than relying primarily on medication and hospitalization. It comprises both a way of organizing a treatment system and a form of therapeutic conversation, or Dialogic Practice, within that system. Key Principles of Open Dialogue include:

  • Immediate help that begins with a treatment meeting within 24 hours
  • A social perspective that includes the gathering of clinicians, family members, friends, co-workers and other relevant persons for a joint discussion
  • Embracing uncertainty by encouraging open conversation and avoiding premature conclusions and treatment plans
  • Creating a dialogue, or a sense of ‘with-ness’ rather than ‘about-ness’ with meeting participants by dropping the clinical gaze and listening to what people say – rather than what we think they mean

Developmental Services provides individualized services that are based on and further development of “practice based evidence.” Vermont has been considered a national leader in development of community based supports for individuals with developmental disabilities to live integrated lives within their communities. As such we help set the evidence of what is effective for people as well as utilize the experience of others. Some of the effective approaches we utilize are:

  • Dialectic Behavior Therapy – modified to meet the needs of individuals with developmental disabilities
  • Supported Employment – providing the supports necessary for people to develop their own businesses or secure and maintain employment
  • Shared Living – people residing in another person’s home to receive daily living supports
  • Community Integration – assisting people to meet and connect with others in their community
  • Offender Services, particularly Sex Offender Services – providing individual and group therapies to help people learn alternative socially acceptable behaviors and to minimize re-offending
  • Emotional Regulation – teaching people to be able to regulate their emotions to better function within their daily lives
  • Communication Therapy – supports including supported typing to assist individuals to interact with their world
  • Therapeutic Horseback Riding 

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