Consensus Building for a Consumer Operated Service Program in East Hartford, CT


Project Goals


Mary Ellen Copeland, consultant

Brian McCorkle, Evaluation Director

presentation: How Do We Promote The 'Action' in Community Action Grant?

How Do We Promote The "Action"
In "Community Action Grant"?

Presentation to Steering Committee
East Hartford Community Action Grant
July 2001

Brian McCorkle, Ph.D.
Boston University
Center for Psychiatric Rehabilitation

2001 by Brian H. McCorkle, Ph.D.
May be freely distributed as long as this copyright statement and disclaimer are included and the document is distributed in its entirety.

DISCLAIMER: The following was originally presented as a slideshow with extensive spoken commentary. Portions taken out of context and without the spoken commentary may not represent the views or intent of the author.

Goal Of This Project
"to plan for implementation of a consumer-operated recovery program in East Hartford, CT, that uses the Wellness Recovery Action Plan model." [WRAP]

Phase 1, Phase 2
- Phase 1 grant - provides funding for meetings to develop consensus about whether or not to implement a new program. (the current grant is a Phase 1 grant)
- If you decide to implement, then you also need to decide how it will be funded.
- If implementing, you can decide to apply for Phase 2 or not.
- Phase 2 grant - provides funds to assist in implementation
- For example, funds for training people in the WRAP model.
- Does NOT pay to run the new program, but only to help set it up.
- There is a time delay of at least 6 months between the end of Phase 1 and beginning of Phase 2

What are the sources of knowledge for this project?

- About the WRAP model?
- About the grant?
- About the East Hartford community?
- About different cultures in East Hartford?
- About consumers in East Hartford?
- About the service delivery system in East Hartford?
- About possible funding in the future? (after the grant ends)

In a nutshell

- Many different stakeholders, each of whom brings unique knowledge to the table.
- Two major lines of research about stakeholders can inform what we are doing:
- "Knowledge Transfer" (covered in this talk)
- Participatory Action Research (PAR) (covered in a future talk)

Knowledge Transfer

- When researchers discover something, how do they get real people to change what they do?
- The federal substance-abuse agencies have worked hard to understand how this process.
- Backer, David, & Soucy (1995). Reviewing the behavioral science knowledge base on technology transfer. Rockville, MD: National Institute on Drug Abuse.

Four essential conditions for change

(Backer, David, & Soucy, 1995)
- Awareness of new knowledge.
- Credible evidence that change will lead to improvements without unreasonable costs or ill effects.
- Resources (funds and personnel) to implement the change.
- Active interventions to "resistances, fears, and anxieties about change" while developing investment in change among the people who will implement it.

How are these met in this project?

- Awareness of new knowledge.
PLAN: The grant provides money to train people in the WRAP model.

- Credible evidence that change will lead to improvements without unreasonable costs or ill effects.
PLAN: The grant provides money for educating people about successful implementations of the WRAP model in other settings.

- Resources (funds and personnel) to implement the change.
PLAN: The grant provides funds for making a decision to implement the change. Phase II of the grant would provide funding to actually implement it (e.g., paying for training)

- Active interventions to "resistances, fears, and anxieties about change" while developing investment in change among the people who will implement it.
PLAN: The extended consensus-building process provides a forum to work through concerns while developing ownership in the proposed implementation plan.

Overall Recommendation

Address the dynamics of change at several levels:
- Individual
- Organizational
- Community
- System

Therefore, the consensus-building process will include:
- Consumers whose lives will be affected
- Providers whose jobs will be affected
- Agency management
- Town official
- Local minority community
- State government (DMHAS)

6 Specific Strategies

Again, courtesy of Backer et al. (1995)
o Interpersonal contact
o Planning and conceptual foresight
o Outside consultation on the change process
o Use-oriented transformation of information
o Individual and organizational championship
o Potential user involvement

Interpersonal contact

Contact between the people considering a new practice and experts in the practice, preferably including the developers.
PLAN: Mary Ellen Copeland, developer of the WRAP model, will conduct training and be available for consultation

Planning and conceptual foresight
A carefully-developed implementation plan, including attention to possible barriers and how best to address them.

PLAN: This is exactly what the CAG grant is funding - time for you to meet and make this plan, with participation by all stakeholders

Outside consultation on the change process
  • Feedback from the Evaluation Director about ongoing evaluation
  • WRAP developer Mary Ellen Copeland will be a consultant throughout the year
  • Consumers and professionals at the Boston University Center for Psychiatric Rehabilitation

User-oriented transformation of information

The model and information about implementation needs to be made understandable to participants.

PLAN: During the initial planning phase, the SC will identify what information is key to the success of the program. Various SC members and outside experts such as ME Copeland will prepare presentations of this material designed to be accessible to all stakeholders. Frequent check-ins during presentations and decision-making discussions will insure that all participants are comfortable in their understanding of issues.

Individual and organizational championship

Changes are more likely to succeed if influential leaders are enthusiastic about the proposed changes.

  • SC will try to include as many such leaders as possible in the Consensus-Building Task Force.
  • Influential stakeholder leaders not on the Task Force will be updated about progress on a regular basis, and will be asked to comment on the draft Implementation Plan before it is finalized.

Potential user involvement

Everyone affected by the proposed change should be involved in planning for the change, both to get the best suggestions for the method and to increase ownership (and decrease resistance).
PLAN: Each stakeholder should have several representatives, who will be encouraged to meet with their constituencies on a regular basis to review the work of the project.

Overall Project Plan

Stage 1: Planning
Stage 2: Consensus-Building
Stage 3: Review & Evaluation

Stage 1: Planning (May-August)
- Assemble Steering Committee
- Planning for Consensus
- Review list of stakeholders, adjusting as needed
- Meet with stakeholders to determine what factors would facilitate full participation
- Recruit participants from each stakeholder for the CBTF
- Planning for Evaluation
- Review literature on technology transfer, consensus-building, and evaluation
- Prepare training material for Stage 2
- Prepare assessment instruments (questionnaire & interview) for use in Stage 2

Stage 2: Consensus-Building (Sept.-Jan.)
o Meetings of Consensus-Building Task Force begin
o September & Early October - Lay the ground work
- Training of Task Force in technology transfer, consensus building, and cultural sensitivity
- Training on the WRAP model
o Late October - Explore wishes and concerns of stakeholders
o November - Seek consensus about implementing WRAP
- (target date 11/31)
o December - Task Force adjourns while SC prepares draft Implementation Plan
o January -
- Task Force convenes to discuss plan
- Everybody reviews plan with their constituents
- Draft plan circulated for comment
- Implementation Plan finalized (target date 1/31/02)

Stage 3: Review
  • February - Plan reviewed by Boston University
  • February - Plan reviewed by Mary Ellen Copeland
  • March - Revised plan submitted to stakeholder decision-makers for final approval
  • April - Executive Summary of project & plans written, distributed to all stakeholder groups
  • April - Final Project Report prepared and delivered to CMHS
  • April 30, 2002 - the grant is over.

Stage 2 & 3: Evaluation Plans
  • September - Qualitative interviews with representatives of each stakeholder group
  • September thru January - weekly questionnaires about consensus-building process
    - Results reported back to SC and Task Force
  • February - Follow-up qualitative interviews with participants
  • April - Final evaluation report prepared

Some final thoughts on evaluation

This is NOT a research project.
- There are no "subjects", only participants in the process.
- No one will be asked to reveal personal or embarrassing information, although some people may choose to reveal that information if they wish.
  • In this project, the role of evaluation in this project is to help you do your job better. Therefore, you will be getting ongoing feedback from the Evaluation Director about how the consensus-building process is going, based on what you and your colleagues report to him.
  • Part of the feedback includes having the plan reviewed by outside experts.
[end of presentation]

revised 11/1/2001

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