Blueprints Program Rating: Model
A group- or individual-based parent training program that teaches effective family management strategies and parenting skills, including skill encouragement, setting limits/positive discipline, monitoring, problem solving, and positive involvement, in order to reduce antisocial and behavior problems in children.
Initial Training and Technical Assistance
The approach of PMTO is a full transfer model; the program developer (ISII) provides extensive training and coaching to local practitioners, who are eventually certified as leaders, mentors, trainers, coaches, or fidelity raters for the following generations of PMTO clinicians. Initially more training is involved but this process provides staff in the community with the skills and knowledge necessary to deliver PMTO independently over time.
During the first phase, therapists are trained and certified over a period of 18-24 months. Estimated total training and technical assistance costs for Phase 1 for a cohort of 16 clinicians is $515,000 during Year 1 and $310,000 during Year 2. These estimated costs include:
- Pre-planning activities including developing a plan and contract, ISII staff time for on-site visits, review of readiness checklists, and preparation for program delivery
- Five training workshops including a total of 18 training days
- A comprehensive set of materials including training curricula and one set of parent materials that sites can duplicate and share with parents
- Video-taping equipment to support the observation model of training in which trainees videotape practice sessions and sessions with trainee families for review and coaching by ISII
- A HIPAA compliant password protected online training database. This database allows practitioners to upload written material and video recordings. Trainers and coaches can view the sessions and provide feedback on the sessions to practitioners.
- Coaching by ISII coaches including at least 12 individual coaching sessions.
Curriculum and Materials
Included in Phase 1 cost above.
Materials Available in Other Language: Program materials are available in the following languages at no additional cost: Spanish, Dutch, Norwegian, Icelandic, and Danish. Parent materials are available for Ugandan parents who do not read.
No separate cost; included in training package.
Other Start-Up Costs
The costs for travel for ISII staff for onsite training workshops are not included above. ISII staff would likely have a minimum of five trips for on-site workshops during Phase 1. Also not included are the costs of staff and administrators' time while they participate in workshops.
Intervention Implementation Costs
Ongoing Curriculum and Materials
Curricula expenses for the first two years are included in initial training and technical assistance costs above. There are no additional costs for curricula and materials beyond Phase 1 costs noted above. Continuing to use the HIPAA compliant online database beyond Phase 3 will cost an estimated annual charge of $12,000. The implementing agency would also have to pay for costs of duplicating parent materials.
- Groups—6-16 participants per group. Two facilitators per group.
- Individual families—Caseloads depend on agency requirements.
Qualifications: Certified PMTO practitioners hold Bachelors or Masters Credentials.
Time to Deliver Intervention:
- Groups - Sessions last 90-120 minutes. Agencies determine session length. 30 minutes prep time/group session. Supervision meeting 60 minutes/twice monthly. Depending on program, number of sessions varies from 10-16.
- Individual families - 50 minutes, prep time, supervision/twice monthly. Number of sessions varies depending on population served, need, seriousness of problem. Mean is 20 sessions. Booster sessions may or may not be delivered, as determined by family need and agency policies.
- Mid-week calls with families (approximately 15 minutes) are provided between sessions during treatment.
Other Implementation Costs
Administrative and clinician salary costs are not included in numbers above. Space for parent sessions and training workshops is also not included.
Implementation Support and Fidelity Monitoring Costs
Ongoing Training and Technical Assistance
Once initial certification is complete, Phase 2 and Phase 3 involve training and support of selected PMTO clinicians as PMTO coaches, PMTO fidelity raters, PMTO trainers. Phase 2 and Phase 3 typically occur over a two-year period with estimated costs of $355,000 in Year 3 and $175,000 in Year 4 for a program supporting 16 clinicians.
Fidelity Monitoring and Evaluation
A self-sustaining fidelity rating infrastructure will need to be built in order to support ongoing fidelity without drift. A fidelity rating team (FIMP Team) is created and responsible for rating the practitioners and certifying and recertifying practitioners in the program in Phase 2 and Phase 3. Once the team can reliably rate the program they will be supported by ISII for three years which allows them to be considered a qualified independent FIMP team at a cost of $11,780 total (Phase 4 of PMTO). Annual FIMP reliability tests are required as long as the implementation site uses the PMTO name, materials, and program.
Ongoing License Fees
Once a community has completed Phase 4 and is operating independently, they must complete an annual reliability test on the FIMP rating program at an annual cost of $2,500-$4,000, depending on the services provided. This is to ensure that drift from competent adherence to the model has not occurred.
Other Implementation Support and Fidelity Monitoring Costs
Other Cost Considerations
Purveyor can provide referrals of sites which have implemented PMTO for more insight on financing experience.
Year One Cost Example
An organization beginning implementing of PMTO, with 16 clinicians could expect to incur the following estimated costs in Year 1.
Note that clinicians serve families during the training period and as they are trained ramp up to serving more families. It is not possible to estimate a cost per individual served in the first year because communities focus on building staff capacity and they don't fully implement the intervention during that year.