Strategies to Support Successful Implementation

Leadership sets the tone for a shift to strength-based, trauma-sensitive communication. 

Leadership stands behind the implementation as a strategy that takes an initial investment of time but that pays off in critical ways.  They make it clear that our settings are excellent at preparing for and reacting to emergencies; and they recognize that in any given moment it may feel more efficient to problem-solve. However, they reinforce that:

• Investment in prevention pays off in ways that are not immediately seen but become evident over time.
• Increased patient and family satisfaction
• Decreased conflict with patients and families, which improves care and saves time.
• Improved self-care and job satisfaction.
• This is a key strategy towards integrating self-care with our real lives. As staff has more effective interactions and fewer conflicts, they themselves have lower stress, improved sense of meaning, and increased satisfaction.

Leadership addresses head-on the resistance to any new initiative. People are fatigued and spread too thin. They resist new initiatives that are the flavor-of-the month. They also resent anything that takes more time. To address this resistance, leadership can reinforce:

• Time in prevention pays off (see above).
• Reaching Teens does not replace any other initiative. In fact, it will likely support every other initiative in being effectively initiated. It is rooted in creating effective relationships, and relationships undergird all meaningful initiatives.
• Reaching Teens is certainly about better serving others.  But it is deeply rooted in creating an environment where staff well-being is addressed with the same fidelity and intensity with which we commit to caring for others.
• Reaching Teens is an interdisciplinary initiative that recognizes that each of us play a critical role in creating a strengths-based environment for patients. It begins with recognizing each of our strengths and contributions!

A champion model is implemented.

‍Implementation of this toolkit offers youth-serving staff the opportunity to gain expertise in a wide variety of ideas and concepts. 

The champion model offers leadership to a team of individuals who can then divide the content among themselves. Champions take responsibility to gain facilitator-level expertise for a section of content for which they become the teachers and reinforcers.

• This model prevents leadership fatigue and ensures continuity if leadership shifts.

Ideally, the champion teams are interdisciplinary, and inclusive of leadership and front-line staff. 

Relevant content is chosen and prioritized

‍The leadership and champion teams determine what content is most needed to affect cultural change and support effective communication and/or staff well-being and professionalism.

The team does not need to start from scratch as they consider most relevant topics.  There are several ways in which the Reaching Teens editorial team has simplified the process.

• The Table of Contents gives instant access to any chapter for a quick scan. It is organized in units that are typical for a “book.”
• A section called “Skill-based Units” accessible through the platform home page offers 17 collections of chapters and concepts so sites can focus on a topic of interest and instantly grasp which chapters for the backbone of the topic.
• A section called “Setting-specific portals” accessible through the platform home page has a navigational pathway for varied settings. Note that when chapters are accessed through a setting-specific portal, all group learning and discussion or personal reflection topics will have setting-specific cases.

Content is reinforced

‍Consistent with adult-learning theory, learning occurs best when connected to cases and discussion or practice is encouraged.  Cases can be discussed from the framework, “How can we handle this through a strength-based lens per Reaching Teens?”

• A section called “Skill-based Units” accessible through the platform home page offers 17 collections of chapters and concepts so sites can focus on a topic of interest and instantly grasp which chapters for the backbone of the topic.

In daily personal sign-offs or in huddles, discussions can be presented in a strengths-based way, ideally referencing the “reaching teens” or “strength-based” philosophy. This type of reinforcement will take no added time and may contribute to better satisfaction and effectiveness.

For example, we can discuss all cases choosing not to focus only on the stated concern. The following is a suggested format:

• Strengths of youth
• Current concern
• What has worked thus far in alleviating concern
• How strategy moving forward will use what has worked while building on existing strengths

Critical topics, such as the Language of Resilience, that are presented in longer format also have 10-minute booster sessions added on to other meetings. 
Staff are given opportunities in meetings to share “success stories” achieved through incorporating strengths-based communication into their practices. 

‍There is orientation material that all new hires go through to set the tone for working in a strengths-based, trauma-sensitive culture.

The champion teams determine which topic areas serve as orientation to the unit regardless of discipline.

• This solves one of the largest problems of any initiative which is that a given topic may be discussed yearly, but people onboard at various times and can miss important content until it is represented.

Each setting can determine what is included in orientation materials. 

For example: 

We recommend the following chapters for all staff as orientation to our practices. They can be read by individuals who engage with the material in a self-reflective manner. Ultimately, these topics should be revisited in ongoing professional development sessions with their colleagues.

• "Reaching Teens: Preparing You to Become the Kind of Adult Young People Need in Their Lives" (Chapter 1)
• "Boundaries (Chapter 24)
• "De-escalation and Crisis Management When a Youth Is Acting Out" (Chapter 34)
• "Trauma-Sensitive Practice: Working with Youth Who Have Faced Adverse Childhood (or Adolescent) Experiences" (Chapter 37)
• "Reframing Youth Who Have Endured Trauma and Marginalization" (Chapter 38)
• "Focusing and Building on Existing Strengths: A Strategy to Overcome Risks and Prepare Adolescents to Be Their Best Selves" (Chapter 44)
• "Helping Youth Overcome Shame and Stigma - Doing Our Best to Not Be a Part of the Problem" (Chapter 49)
• If new staff does not have a youth-development background: "Understanding and Supporting Healthy Adolescent Development" (Chapter 13).

People are incentivized to participate.

‍We’d hope that the greatest incentives are building new skill-sets.

We also hope that all the points made by leadership team mentioned in the first section serve as incentives! 

Up to 95 CEUs are available to MDs, RNs, PAs, Social Workers, and Counselors. Other settings have developed CEUs or certificates to meet their professional or setting standards.