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The TCI:SAFE Project

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Evidence based programs often tout the importance of implementing their program with fidelity. But what exactly does program fidelity mean? How do community agencies know when they are (or are not) implementing with fidelity? As part of the Residential Child Care Project, (RCCP) the Therapeutic Crisis Intervention: Study About Fidelity and Effectiveness (TCI: SAFE) project, aims to answer this question to ensure effective implementation of the TCI system in real world use. Widely used in residential child care and schools settings in both the U.S. and abroad, the TCI system presents a crisis prevention and intervention system designed to assist organizations in preventing and de-escalating potential crises, managing acute physical behavior, reducing injuries to children and staff, teaching staff how to help children learn constructive ways to handle crisis, and creating a learning organization.

To explore fidelity, the TCI: SAFE project collected information about TCI implementation through case studies with 5 individual agencies. Project staff then built a “TCI fidelity assessment tool” designed to document an agency’s implementation of core TCI system components. Early versions of the tool were tested by both agency and Cornell staff, resulting in a multi-item assessment that rates progress toward implementation (from no action to fully met) of core TCI program components such as leadership, clinical participation, training, supervision, and quality assurance. The TCI fidelity tool provides objective information that helps agencies reflect on their practice and improve how well they implement the TCI system. The tool can also be used to feed back information to the TCI developers so that they can improve the program. Finally, the tool will facilitate research efforts that explore how TCI implementation relates to outcomes of interest (e.g. reductions in use of restraints, improved child coping abilities, treatment goals being met). In these ways, the TCI SAFE project reflects many points along the translational research cycle. For more information, see the RCCP web site.

 

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