Managing and Adapting Practice (MAP)

The MAP system was designed to address a concrete problem encountered in modern behavioral healthcare—improving outcomes and quality of care. MAP achieves these aims through structured collaboration, a framework for coordinating individuals and information around key decisions. MAP provides a unifying set of concepts and resources to organize and guide activity across a diverse service array, across levels of care, across populations, and across health care settings.

MAP offers detailed solutions for the following areas:

Direct Service

The MAP direct service model is a powerful collection of resources that organize and coordinate care, focusing on a wide diversity of treatment targets and ages. MAP can help identify and select best fitting evidence-based treatments, but more often it operates more like a treatment design, implementation, and evaluation toolkit. That is, providers, youth, and families can select, build, organize, and implement treatment based on the most up-to-date research evidence and can personalize care by incorporating real-time evidence of practice history and youth outcomes.

MAP’s collection of information resources, detailed guides, and decision and process models help address such key questions as what practices to use, when to use them, how to know they are being done with integrity, and of course, how to know whether they are achieving the desired outcomes. The primary MAP information resources are:

PracticeWise Evidence-Based Services (PWEBS) Database: A searchable database offering youth-specific summaries from published treatment research that meets specific standards for scientific quality.
Practitioner Guides: A collection of two-page Practice Guides, representing common procedures among evidence-based practices, along with one-page Process Guides, representing logic models for organizing key aspects of service delivery.
Clinical Dashboards: A library of Microsoft Excel™ based tools that present a convenient visual summary of individual client progress along with the history of clinical practices delivered. PracticeWise encourages service systems to integrate the functionality of the dashboards into local information systems, such as outcome management or electronic health record systems. Learn more about dashboard integration.

Workforce Development

MAP offers an organized sequence of training and consultation experiences using state-of-the-art curricula, portfolio evaluations, and credentialing systems to build the expertise and competency of behavioral healthcare professionals. The MAP professional development program offers defined curricula for direct service providers, supervisors and consultants, and training professionals, with multiple options for completing curricula and achieving professional development goals. These options include mechanisms for integration with academic programs as well as agency-based train-the-trainer models for instructors, supervisors and training professionals. Portions of the MAP curriculum are also available to complete in an . For more information, refer to the latest version of the MAP Professional Development Program.

System Development

MAP offers an overall architecture for informed collaboration among different parts of the system, which can include a variety of coaching and consultation services to integrate the MAP resources throughout the service organization. MAP resources may be productively integrated into system operations, such as strategic planning, service design, clinical standard setting, information systems design, utilization management, and performance management. Because MAP is based on an incremental quality improvement strategy, it supports progressive implementation of its various component modules that ultimately converge into a comprehensive, integrated system of care. Accordingly, simultaneous implementation of all components is not required, but may be appropriate when undertaking large-scale system reform. Solutions can include speaking engagements, strategic planning sessions, and specialized consultation. Customized solutions can also include integrative analysis of local system data with PracticeWise information resources (for example, using methodology for applying the evidence base to local system data to determine who can be served with appropriate evidence-based treatments and what treatments are optimal for implementation under a variety of program-driven assumptions). Please contact us for more information.

The MAP Framework

Across all of these endeavors, MAP employs the following principles

1. Is Outcome-Centered

Progress and practices are measured and systematically monitored at the indicated level, whether that activity involves youth outcomes, workforce development outcomes, or system-wide outcomes.

2. Is Information-Oriented

MAP emphasizes the common roles that information serves in decision-making, rather than dictating a specific set of instruments or procedures. For example, in the direct service context, a MAP decision guide identifies where indicators of client progress commonly inform expert decision-making in evidence-based practices rather than require that a particular measure be used with a particular benchmark at particular intervals.

3. Supports a Common Language

By identifying common elements of interventions with scientific evidence of effectiveness across the behavioral health service domain, the MAP system provides a unifying language to which the terminology of specific programs and disciplines is readily translated.

4. Integrates Multiple Evidence Bases

The MAP system highlights four sources of evidence that are regularly referenced during decision-making: case-specific information (e.g., youth outcomes), case aggregate information (e.g., practice-based evidence), treatment outcome research (e.g., evidence-based treatments), and research on causal mechanisms (e.g., clinical or behavior change theory). MAP explicitly labels information from these four sources, brings them into the decision-making situation, and provides guidance for determining their relative priority with respect to key decisions.

5. Coordinates Observed and Expected Values

As a strategy to guide decision making, MAP facilitates comparison of observed values (e.g., client response, provider expertise) with the expected outcomes (e.g., research-informed benchmarks, professional development milestones).

6. Is Self-Correcting

Implicit in its routine functioning, MAP generates new data, promotes reflection and analysis, and supports adaptive responding, whether in direct service delivery, professional development, or system change contexts.

Even the core MAP resources are routinely updated based upon ongoing review of the scientific literature. As new evidence and practices appear in the scientific literature, these innovations are delivered directly to service providers, supervisors, and trainers through the existing infrastructure.

7. Is Developmental

Whether in the context of direct service, professional training, or organizational change, MAP is designed to “meet people where they are,” to build on current strengths and capacities, and to offer only those components needed to achieve collaboratively established goals.

8. Is Dynamic

MAP anticipates regular surprises, roadblocks, and exceptional circumstances, offering structured solutions to resolve the interference and to transition efficiently back to the pursuit of the original, overarching goals.

9. Promotes Public Visibility

MAP offers multiple strategies to promote transparency and public scrutiny of (a) the underlying evidence used to inform decisions and (b) the underlying logic used to reach a final decision and course of action.

10. Process Management

MAP adopts a continuous quality improvement strategy for managing the process of change. Common steps include setting goals, assembling supports, implementing procedures, testing results, and adapting the course of action as needed.