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Moving from Water into Sand to Solution-Oriented Changes that Last: Activating Teams to Build and Retool for Co-Occurring Disorder Services

May 17, 2022

by Laura Cooley, Northwest ATTC

By having the right tools, you can turn water and clay into an object that lasts.

Often supervisors and managers know they need to make a change but don’t think they or their teams have the bandwidth to do it. Or they may proceed with some plans but have little to show for their efforts at the end.  

Northwest ATTC consultant and organizational change leader Mathew Roosa, LCSW-R, likens this to pouring water into sand: As resources disappear, there is little or no return on the energy invested. 

But Roosa and others observe that the results change when managers and supervisors and their teams are equipped with the tools they need – like when they are trying to quickly implement care for co-occurring disorders in their agencies.

To better support behavioral health agencies in this process, the Northwest ATTC has twice sponsored learning collaboratives on “Rapid Implementation of Co-Occurring Disorders (CODs)” in our region. Through these sessions, agency leaders have learned to make use of critical process tools and effective team engagement that they then deploy to both implement and sustain the changes they seek.

A Step-by-Step Process toward Planning for Change

This organizational change process is goal-oriented from the outset, working to meet the needs of busy supervisors who have competing demands. Before the series starts, an open invitation to leaders and their staff from the region is sent out. Interested teams are asked ahead of time what goals they hope to accomplish as a result of their participation. 

They are also requested to commit to a three-month series that begins with four interactive workshops focusing on:

  • introduction/review of the core elements of COD services
  • tools used to support the process from needs assessment all the way to effective service development
  • strategies leaders can use to devise plans and share those plans with others

Participants are then invited take part in 1 to 2 individualized coaching sessions to discuss and enhance their plans for implementation. 

Organizational leaders from the region responded positively to their experiences with these coaching series, and the model has evolved based on feedback received. A majority of participants indicated that they felt either “confident” or “extremely confident” about both their capacity to make use of the change-planning process tools and their confidence to be able to use those tools. Some of the highlights they underscored following training are provided below.

Increased Awareness of Process Change Tools

Survey results from February 2022 revealed that participants identified a myriad of tools and experiences they found useful, such as: 

  • Creating a successful plan with staff
  • Tracking a client’s experience
  • Improving on the practice of person-centered telehealth
  • Working on flow charts
  • Learning more about how to implement the DDCAT approach 
  • Learning how to do PSDAs (Plan, Study, Do, Act) and walk-throughs


Increased Confidence and Expanded Appreciation for Process Change Tool

At the end of the learning collaborative, the majority of survey respondents indicated they felt “confident” or “extremely confident” about their ability to implement COD care in their health systems. And in one confidential survey, 16 out of 18 reported that they were likely to use a similar change-planning process to guide their work in the future to initiate changes. 

Quote that reads "The learning collaborative gave us the tools we needed to successfully integrate COD into our programs"Others responded with comments such as these about the experience, writing that it:

  • Helped to identify gaps in the system and analyze the cost-effective and client satisfaction improvement
  • Allowed me to view the areas where the program can ask for more from community providers
  • Gave us the tools we need to successfully integrate COD into our program

And one of the best parts anecdotally? A good number find that it energizes them! They gain exposure to the tools for change they need, and they are able to see tangible results in a relatively short amount of time. 

Interested in exploring organizational change to support your agency?  Contact the Northwest ATTC at [email protected]


By having the right tools, you can turn water and clay into an object that lasts.
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