White Papers

Our white papers communicate research, theories, and our position on particular topics connected to our mission and vision, with the intent to educate, inform, and influence policy.

Joyful Together©: Addressing & Preventing Childhood Toxic Stress in Ohio (2019)

Toxic stress occurs as a response to prolonged, adverse experiences without adequate adult support that impairs brain development and functioning. The 2016 National Survey of Children’s Health found that as many as 1 in 7 Ohio children had experienced three or more adverse childhood experiences (ACEs), higher than the national average. Childhood adversity often leads to toxic stress, which has multifaceted deleterious implications across a lifespan; however all hope is not lost. Children’s brains are highly susceptible to negative experiences, but are also strongly impacted by positive experiences as well, leaving opportunities to build adequate defenses against toxic stress.

Expand Insurance Coverage of the PLAY Project to Support Developmental and Relationship-based Treatment of Young Ohioans with ASD (2020)

To treat autism spectrum disorder (ASD) in children, most clinical practices have focused on using a limited toolbox of behavior-targeting treatment modalities. Due to the nature of ASD and variance along its spectrum, individualized care may require a number of different techniques, which can be time consuming, costly, and overwhelming. In addition, some therapies that are more common in treatment—such as applied behavioral analysis (ABA)—may not be as effective for certain populations.

Parent-implemented models (PIM), such as the PLAY Project can offer an evidence-based ASD treatment that is cost-effective and flexible. PIMs intentionally engage and empower caregivers, which in turn positively impact results for children. Insurance coverage for the PLAY Project is an important component to gaining comprehensive care for young children with ASD.

“Just Try Harder” Doesn’t Heal: Addressing the Therapeutic Needs of Clients in Community Mental Health Treatment with Evidence-Based Innovation (2020)

Clients in community mental health treatment often face barriers and stress factors that limit the impact of treatment. Therapy-interfering conditions (TICs) such as housing, education, employment, and transportation are common unfulfilled needs for populations that utilize community mental health. Meanwhile, toxic stress and trauma often are heightened by clients’ contexts. Therapy, therefore, must take these factors into account in order to be effective and focus on clients’ basic needs—physical, social, and emotional—in addition to cognitive-behavioral treatments. Cognitive behavioral therapy (CBT) alone may not be adequate in this admittedly gargantuan task. Instead, by addressing therapeutic needs with a matrix of upstream interventions, contextual training for mental health professionals, and innovative therapies such as the Institute of Family & Community Impact’s CBT Plus©, we have an opportunity to close disparity gaps in health, both psychological and physiological, and empower marginalized, underprivileged, and impoverished communities.

Lead Poisoning & Behavioral Health: Increased Referrals for Treatment Can Mitigate Long-term Consequences of Childhood Lead Poisoning (2020)

For decades, childhood lead poisoning has been a persistent problem in certain neighborhoods in Ohio, particularly putting at risk African-American children, children from impoverished families, and/or children living in older homes. The effects of lead poisoning in children can be wide-ranging and long-lasting, leading to a variety of health issues—including behavioral. In this paper, we assert that it is necessary to mitigate the long-lasting consequences of lead poisoning by examining lead poisoning through a psychosocial lens, and include in its treatment the expansion of behavioral health treatments. We call for required referrals to behavioral health services for any children identified to have elevated blood lead levels.

OhioGuidestone’s Impact on Ohio’s Health Value: A Response to HPIO Strategies to Improve Ohioans’ Health (2020)

Recently, the Health Policy Institute of Ohio (HPIO) released its 2019 Health Value Dashboard, which placed Ohio at 46th out of 51 in health value among U.S. states and the District of Columbia. Ohio’s low ranking was not due to lack of access to care, HPIO found. Instead, the policy group identified nine strategies that would help improve Ohio’s score and thereby improve health outcomes and quality of life for all Ohioans, particularly those most at risk due to disparities. These strategies target downstream care delivery systems rather than costly upstream care, including evidence-based home visiting, lead abatement, housing, public transportation, and investment in Ohio’s behavioral health workforce. As one of Ohio’s largest behavioral health organizations and social service agencies, OhioGuidestone has investment in many of the strategies outlined by HPIO. Either through OhioGuidestone’s continuum of services or through innovations produced by its Institute of Family & Community Impact, we have an opportunity to be integral partners in efforts to improve Ohio’s health value—and thus help Ohio’s children, families, and communities  grow stronger and healthier.

Push for PROMs: Patient-Reported Outcomes Are Necessary for Evidence-Based & Client-Centered Community Mental Health Treatment (2020)

Patient-reported outcome measures (PROMs) are useful tools for clinicians and researchers working in behavioral health fields, as well as for the clients they serve. These measures allow programs and treatment to be tailored carefully to the client’s needs and offer a necessary client-centered perspective for developing evidence-based practices. Therefore, we advocate for routine measurement and monitoring of patient-reported outcomes.

In this paper, we detail how OhioGuidestone has implemented and developed PROMs in community mental health treatment, what domains we focus on and why, which barriers to implementation have arisen and how we’ve addressed them, what goals organizations should keep in mind when implementing PROMs, and what implications for future treatment and research PROMs data can offer.

Statewide Demonstration of the Effectiveness of Mental Healthcare via Telehealth Required Before New Rules and Presentation of “An Algorithm of Tele-Mental Health Care” (2020)

In March 2020, health agencies coordinated with government officials throughout the U.S. to offer telehealth services during the COVID-19 pandemic. For mental health providers such as OhioGuidestone,  this offers an opportunity to evaluate our services and continue to build client-centered approaches to care. While telehealth can offer greater accessibility, even after emergency lockdown orders expire, we need to demonstrate the efficacy of services delivered via telecommunication, compare modes of delivery, and ensure clients and clinicians have necessary technological tools. Behavioral health experts can help guide researchers and policymakers toward evidence, evaluation, and implementation of expanded telehealth service delivery for mental health clients. This paper offers our preliminary experiences with expanded telehealth service, driving questions for research, and paths forward for future directions.