Identifying an individual solution for each family

"I don't know what to do with her anymore." Ms. Martinez and I sat knee to knee on her black vinyl couch. "Maybe she would be better off living somewhere else. A place where she has lots of rules."

Ms. Martinez's words may have seemed callous but sending her daughter away appeared to be the only viable option to keep her safe. I placed my clipboard on the seat next to me and looked at her face. "I know how overwhelming this all seems right now. We know Gabriela is using drugs, not going to school, and maybe involved in a gang. Sending her away might make some problems go away temporarily but what will happen when she comes home to the same environment? I think we have a better chance of helping Gabriela by looking at all the pieces of the puzzle." 

I knocked on a family’s door. The mother answered, simultaneously shoving the dog aside with her foot and pushing a stack of papers into my hands. Her hair looked rumpled and she wore the same blue t-shirt from the day before.  

“Miss  Longo, the system is broken!” she shouted up at me. I looked at the papers and noted her welfare case had been closed again. The family’s entitlements would be suspended until she endured another full-day battle just to begin the process of reapplication. I could feel her looking at me expectantly. My eyes met hers and I raised one side of my mouth in shared disappointment. “Frustrating,” I said. “I wish you didn’t have to go through the whole process again.”

Evidence-based practice, evidence-informed practice, practice-based evidence . . . to the average Joe, these all sound so much the same that most folks just quit listening and do what is easiest. I am referring to how communities decide which services we deliver to children and families and how they determine whether something actually works, or more importantly, does not. If the information was clear and better options available, wouldn’t most people choose what works and stop choosing what does not? Unfortunately, this is not necessarily the case. 

Full disclosure first. I work for one of the top evidence-based practices in the United States (and 14 other countries)—Multisystemic Therapy (MST). Some might ask, doesn’t that skew my perceptions? To which I would answer, maybe, but it also gives me an inside look at the problems and solutions offered by these treatments. I see a close-up of their efficacy. I see their work. And that’s what this article is all about.