ADAMH Week: Gisele Tchamba on the Transtheoretical Model (TTM): An Evaluation Tool for Organizational Change within Behavioral Health Services

My name is Gisele Tchamba and I work for a faith-based organization where I lead in evaluation capacity building. I am also one of the ADAMH TIG leaders.  Today I want to share my experience with the implementation of a new treatment model for behavioral health providers in my county.

The Recovery Oriented Systems of Care Model (ROSC) model is a network of formal and informal services developed and mobilized to sustain long-term recovery for individuals and families impacted by severe substance use and mental health disorders. This model was created to replace the Acute Care model that was not very successful at providing long-term recovery outcomes.

Lesson Learned: The ROSC model is the dream treatment for behavioral health field. However, its implementation has been in process for over 10 years without success. I compared the implementation of the recovery-oriented systems of care model to the Transtheoretical model of behavior change and evaluated my county’s efforts to create its own recovery oriented systems of care model.  This model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. I used this model because of the complex process in the county’s attempt to implement the process. The evaluation revealed that the county was in the second stage of the TTM model (the contemplation stage). But today my county is in the Action stage of the implementation and ready for another evaluation. In reality the ROSC is not a myth, it’s just very difficult to implement.

Hot Tips

  • Each state can create its own ROSC model by forming a task force that can comprise four workgroups (funding, prevention, screening and assessment, and treatment and recovery). These workgroups represent segments of the recovery oriented systems of care model.
  • A successful way to implement the ROSC model in a given community requires commitment from each provider.
  • To facilitate dialogue between providers, there must be funding for liaison. That element is currently missing in my county. I think that must be the reason for the slow progress noted so far.

Lesson Learned: A successful implementation of the recovery oriented systems of care model in this county will lead to the following:

  • Best practice, increase knowledge and facilitate evaluation
  • The county will become a recovery community with sustained long-term recovery outcomes for individuals and families; and
  • There will be better allocation of resources, better community involvement, and honest dialogue among providers.

Rad Resources

The Role of Recovery Support Services in Recovery-Oriented Systems of Care White Paper.

Willam White, an experienced researcher, offers a definition of the ROSC Model.

The American Evaluation Association is celebrating Alcohol Drug Abuse and Mental Health (ADAMH) TIG Week. Do you have questions, concerns, kudos, or content to extend this aea365 contribution? Please add them in the comments section for this post on the aea365 webpage so that we may enrich our community of practice. Would you like to submit an aea365 Tip? Please send a note of interest to aea365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators.

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