Lessons learned from evaluating 15 children’s behavioral health practices in New Hampshire
- Jim Fauth
- Feb 14
- 2 min read
Over three years, the Behavioral Health Improvement Institute assessed 15 evidence-based and promising practices [1] serving children and families through New Hampshire's publicly funded mental health system. What we learned offers valuable insights for behavioral health systems nationwide.
The assessment challenge
How do you meaningfully compare a trauma therapy with a care coordination model when data are thin? We developed a common set of metrics (inspired by RE-AIM) that allows meaningful comparison across diverse practices – from early childhood wraparound to first-episode psychosis models – even when data infrastructure is limited.
System-level lessons learned
Providers care – Staff embrace evidence-based practice and bright-spots abound, but resources are insufficient to deliver high-fidelity practice to all who need it in timely fashion
Context matters – Small agencies serving highly dispersed rural populations face inherent implementation and sustainability challenges that require creative and differentiated support
Resources drive results – When resources are available to attract and retain sufficient workforce and support the “unbillable” aspects of EBPs, implementation fidelity and reach improve
Implementation is ongoing – Up front investment to install a practice does not create a perpetual motion machine – ongoing training, coaching, and performance monitoring are essential
Practice-level lessons learned
We generated lessons learned and recommendations for each practice. A few examples:
CBT – feasibility and flexibility are signature strengths; operational clarity and quality standards needed
Early Childhood Wraparound – a promising practice; stronger integration with NH's broader early childhood system needed
MST and Intercept – Excellent implementation; clearer referral pathways needed
Read the reports for detailed findings and recommendations
15 practices: CBT (generic), Child Parent Psychotherapy, Dialectical Behavior Therapy for Adolescents (DBT-A), Early Childhood Wraparound, Eye Movement Desensitization and Reprocessing (EMDR), FAST Forward (NH Wraparound), Intercept (Youth Villages), Modular Approach to Therapy for Children (MATCH), Multisystemic Therapy (MST), NAVIGATE (for 1st episode psychosis), RENEW, 7 Challenges, Transitional Enhanced Care Coordination, Trauma-Focused CBT, Trust-Based Relational Intervention.
Implementation settings: Care Management Entities, Community Mental Health Centers, Intensive In-Home Support providers, SUD treatment providers, Residential Programs
Assessment team: Jim Fauth, PhD (BHII); Mason Haber, PhD (Lamplighter Evaluation and Consulting, LLC)
These assessments were conducted by the Behavioral Health Improvement Institute at Keene State College, on behalf of the Children's Behavioral Health Resource Center (JoAnne Malloy, PI) at the Institute on Disability, University of New Hampshire. Funded by NH Department of Health and Human Services, Bureau of Children's Behavioral Health (Award #05-95-92-921010-20530000/RFP-2021-DBH-05-TECHN-01).
Questions about system of care evaluation or BHII's assessment approach? Contact us or connect with Jim Fauth on LinkedIn.
Jim Fauth is the Director of the Behavioral Health Improvement Institute (BHII) at Keene State College.
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