Using name in the hat to increase transitions from residential to outpatient with CM

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michael boyle
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Joined: 03/06/2012 - 12:23
Using name in the hat to increase transitions from residential to outpatient with CM

I contacted Nancy Petry to ask her advice on introducing the name in the hat technique to people in residential treatment to increase transition to outpatient and about procedures for using the approach in an IOP. Below are my email to her and Nancy’s responses. If you have specific questions for Nancy regarding implementation, please post them on this discussion board.

Hi Nancy- There was a couple discussions on the Network of Practice call that occurred after you left. Most of the providers said they would have to start collecting baseline data after they select a group. I think they probably can retrospectively retrieve the data but may not be aware where it exists in their systems. We are trying to follow-up on this. That said, one provider probably will need to collect some baseline data as they are focusing on transitions from a residential program to an OP program that has a mix of patients. They said almost none of the referrals from residential go to this OP. Obviously, we will want the name in the hat procedure to be introduced before they leave residential. The handout explaining the program could be used. Have them also do a mock drawing with pictures of prizes shown? Do you have a brief video on the procedure that could be shown? Any other ideas? One provider said they wanted to use the procedure in an IOP. What are the protocols for using in that setting? Daily draws could become very expensive (although increased revenue could potentially offset this). Is there a method for weekly draws in an IOP? If so, what is the criteria? The providers also wanted to see all the steps ahead of time rather than receiving one at a time. That makes sense. I have edited the steps again, combined purchasing supplies and prizes (a single shopping spree at wal mart can purchase most at same time, edited the forms for each step - some are in two places such as the prize inventories and added step 6 - implement and monitor. I would appreciate your review of these materials. After any edits, I would like to have Dave format these in a PDF that cannot be modified and the contents cannot be copied and pasted. That will protect the integrity of your materials. We could then electronically distribute to participants along with your book that is ordered for each. Any other thoughts? Mike

Hi, Mike, I think your plan sounds fine. Using CM during the bridge from residential to OP is good. The key is to make it salient. Showing the actual prize cabinet, letting them handle the prizes in it, talk about what they'd like to win etc. would be best. Even an actual trip to the OP facility (if it differs from the residential building) is appropriate. All that could be done prior to leaving residential. (Sorry I don't have any videos of the procedure.) It can be used in IOP as well. It should be integrated into the first group of the day (not every group during the day). They can do something like just 1 draw per attendee, and just 1-2 names drawn per day on Tues, Wed, Thurs, and Fridays. Then, the escalating names in the hat are awarded for weeks of perfect attendance. So, on Mondays, everyone's name goes in the hat at least once plus a bonus # of times based on how many weeks in a row of attendance at all groups (with excused absences not breaking the string). On Mondays (termed "Big Mondays" by patients), half as many names are drawn as there are people in the group, and maybe the last person's name who is drawn gets 3 draws (instead of just 1). The caveat about adding it to an IOP group is that often (but certainly not always) attendance is relatively high in IOP groups (at least relative to initiating aftercare groups). So, they need to be sure there is room for improvement or that is not a good setting. I hope that's clear, Nancy