The Penn Beck Community Initiative
The Penn Beck Community Initiative of the University of Pennsylvania (Penn BCI) is an award-winning clinical, educational, and research partnership with community behavioral health providers, payers, and networks, all in pursuit of the same goal: placing tangible, evidence-based tools in the hands of the front-line mental healthcare providers. The Penn BCI has implemented transdiagnostic, case conceptualization–driven cognitive behavioral therapy (CBT) in a multitude of public mental and behavioral health settings including 15+ levels of care for people across the lifespan. (See this Penn Medicine Service in Action infographic to learn more about the scope of the Penn BCI.)
The Penn BCI is characterized by three areas of emphasis that set it apart from other efforts to increase broad access to mental health evidence-based practices (EBPs).
The Penn BCI’s empirically-supported approach targets the factors that impact the long-term outcomes of implementation efforts. Beginning with a collaborative implementation-readiness phase helps organizations take actions to increase their likelihood of long-term success. Tailored workshops and consultation ensure providers integrate new knowledge into their clinical practice, with feedback about their growing skills as they seek certification. After establishing a core of certified clinicians, access to our web-based training creates a conduit for adding new skilled CBT clinicians to the roster. Recertification requirements reinforce the maintenance of clinical skills over time. Advanced workshops engage clinicians in continuing to advance and refine their skills. These and other sustainability strategies ensure that the return on investment (ROI) for implementation work is high, and that community members continue to have access to excellent care.
The Penn BCI most frequently implements CBT, which is the most widely researched and empirically supported psychotherapy across a wide spectrum of presenting problems – and that is just where our focus on science begins. The Penn BCI is situated at the forward edge of implementation science, including federally-funded grants to develop and study strategies to shrink the research-to-practice gap and improve access to EBPs. Many of our research partnerships focus om the use of artificial intelligence and other technology-based tools to quickly scale up access to training, supervision, and therapy. Penn BCI data are iteratively used to evaluate and improve the outcomes of our work, which is reflected in the evolution of our processes and in our extensive research publications.
The Penn BCI is proud to have established partnerships with provider organizations and systems on a local, regional, national, and international scale. The key to establishing – and maintaining – those partnerships is sustaining a flexible, relational, trustworthy stance. We have an almost 20-year track record of successfully working with partners in the challenging landscape of mental and behavioral healthcare to identify and deliver pragmatic, practical approaches to support providers in improving the quality of care.
Implementation of CBT
While we have partnered with groups to implement a range of evidence-based practices, our primary focus is on a transdiagnostic, case-conceptualization driven CBT centered on wellness and strength. This goal-directed treatment is evidence-based and adaptable to a wide range of treatment settings and populations. Using a personalized approach, clinicians learn to support individuals in articulating their own meaningful goals, breaking down goals into short-term steps, and reframing symptoms and impairment as challenges to be resolved in service of their recovery. In turn, individuals build hope for the future, develop skills to strive for their goals, and live the lives they choose for themselves.
Clinicians participating in the BCI receive instruction in CBT through 22 hours of intensive workshops and 6 months of weekly in-person group CBT consultation with review of session recordings and evaluation of competence. Non-clinicians with client contact receive additional training to create a CBT-infused treatment milieu, creating a shared lens and language among services. Certified Peer Specialists receive specialized training to augment their skills in working with specific populations (e.g. older adults). The training model has evidenced success across a broad range of settings and populations, strengthening individual service delivery and providing clinical teams with a shared understanding of the individuals they serve. Careful attention to organizational factors, including facilitators and barriers for sustained practice build long-term CBT capacity for service programs and systems.
Selected Training and Implementation Outcomes
- The Penn BCI has implemented CBT in more than 100 behavioral health programs, 4 state systems, and several low- and middle-income countries, adapted for the level of care and population served. These services are available in both English and Spanish, and have been refined to be culturally responsive.
- More than 2,000 clinicians (therapists, social workers, psychologists, psychiatrists) and 400 milieu staff (nurses, behavior techs, peer specialists, teachers) have been trained to apply CBT principles within their scope of work for a programmatic approach.
- Clinicians’ average CBT competency scores double and an unprecedented 84% demonstrate full CBT competence equivalent to that in clinical trials by end of training.
- Outcomes are equally strong across levels of care (traditional outpatient versus less traditional settings).
- Among those who attempt recertification, close to 90% of clinicians sustain competence for at least 2 years after certification.
- Retention is excellent (fewer than 5% drop out), and turnover among participating clinicians (13.5%) is lower than is typical in community settings (30-60%).
- After initial training, web-based training supports sustainability and increased capacity with less than 7% of the resources required for in-person training, creating a real-world model for long-term access to CBT.
- Experiential learning encourages staff to apply their new skills with themselves, targeting burnout and professional quality of life.
- In milieu settings, CBT skills are applied in daily interactions with individuals, leading to decreased need for costly 1:1 staffing and reduction of the use of mechanical restraint by almost 50%.
Please see Creed et al., 2014 for a full description of the Penn BCI model. For more information about Penn BCI implementation outcomes, see Creed et al., 2016 and Creed et al 2021 – or contact us to learn more!
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