TCI: Study About Fidelity & Effectiveness

1. The TCI SAFE Project: Strategies, Challenges, and Implications in Measuring Training and Program Fidelity • Lisa A. McCabe, Ph.D. • Jack C. Holden, Ph.D. • Residential Child Care Project • Family Life Development Center • Cornell University • National Human Services • Training Evaluation Symposium • Cornell University, Ithaca, NY • June, 2011

2. TCI: Study About Fidelity & Effectiveness • 30 years of The Therapeutic Crisis Intervention (TCI) System • Early research* suggests its effectiveness, but need to better understand how TCI training and implementation relate to programmatic practices *(Nunno, Holden, & Leidy, 2003)

3. TCI: Study About Fidelity & Effectiveness • Process/fidelity of TCI training and implementation in residential child care agencies • Organizational culture and climate around issues of restraint use • How organizational climate and TCI implementation relate to programmatic practices (e.g. number of restraints used)

4. TCI: SAFE Case Studies TCI Agencies in the US • Document review (e.g. program handbooks, incident records) • Agency profile survey • Staff interviews • Training observation • Anonymous staff surveys • TCI Implementation • Reducing Seclusion and Restraint Organizational Questionnaire (Colton & Xiong, 2010) • TCI fidelity checklist

5. What is the TCI System? Crisis prevention and intervention model • Prevent crises • De-escalate potential crises • Reduce injury and risk of injury to young people and staff • Reduce use of physical interventions • Teach young people new coping skills • Develop a learning circle with in the organization

6. Skills Building Pyramid Skills Building for Co-regulation Strategies in TCI Co-regulation skills and strategies

7. TCI Training • TCI Training of Trainers Program (5 days) • Associate and Professional Certification Levels • TCI Core Training (20-28 hours) • TCI Updates (1-2 days) • Adapting the LSI for Proactive Aggression • Conflict Resolution • Post Crisis Response • TCI Trainer Support • Developing Professional Level TCI Training Skills

8. Effective TCI Implementation Includes Leadership and program support Clinical participation Supervision and post crisis response Training and competency standards Documentation and incident monitoring and feedback

9. Today’s TCI: SAFE Workshop • When measuring fidelity to a program, should the goal be certification/assessment, program improvement, or both? Is it possible to have one instrument that accomplishes both goals? • Can you conduct an authentic evaluation of a program in the absence of in-depth observations of program implementation? • How are TCI training, implementation and organizational climate related and how do they relate to training goals (e.g. critical incident rates)?