MTB Implementation

Agencies or funders interested in pursuing MTB implementation are encouraged to contact us to discuss various implementation considerations and agency requirements, and to receive the MTB Replication Planning Guide. As outlined in the Planning Guide, there are a number of issues to consider prior to making the decision to implement MTB. This process should begin with a thorough review of the MTB model for appropriateness to the agency, community, and client population; as well as the essential elements and requirements for implementation. 

As the initial community-based tasks are undertaken, MTB National Office staff members are available to answer questions and discuss program fit. Once the decision to proceed with implementation has been made, discussions begin with the MTB National Office with regard to timeline, costs, and contractual needs. It is imperative that hiring of staff does not take place until an agreement is in place and/or the model developers are consulted with regard to clinician and supervisor selection. Some important hiring considerations are also included in the Planning Guide. 

While the replication process and timeline varies from site to site and from one organization to another, there are six main phases to replication that are required for full program implementation, extending over at least a 30-month period. All phases are required in order to implement MTB and use the Minding the Baby® trademarked program name.    

Replication Phase 1: Planning and Start-up Consultation
The purpose of this phase is to provide the support necessary to plan and organize the initial stages of an MTB replication prior to hiring and training. This support can be provided on-site to local programs, and via phone and videoconference for other locations. These consultations are used to discuss program set-up, hiring, staff development and training, cultural factors, and community outreach. A minimum of 30 hours of consultation is required prior to the initial introductory training required for all program staff; another 30 hours of consultation is required in the 3-6 month roll out period following the initial training. Consultation is provided by the model developers, senior MTB clinicians, and the MTB Operations Director, who provides input on a range of administrative and organizational matters.  

Replication Phase 2: Introductory Training 
An intensive multi-day training modeled largely after the MTB Introductory Training Institute is adapted to address specific needs of MTB model implementation, and delivered either at Yale or on-site for all clinical and administrative staff, with a preferred maximum enrollment of 25-30. This is typically delivered over three consecutive days, with an additional half-day of training and technical assistance scheduled within a few weeks following the initial training to review evaluation measures, administrative forms, and the individual roles of each discipline. MTB National Office staff members are also available for individualized consultation throughout the initial training.

Replication Phase 3: On-going Distance Supervision and Clinical Consultation 
Once the first MTB families have been enrolled, all clinical staff involved in the MTB replication begin regularly scheduled consultation/supervisory sessions through the MTB National Office. These sessions are conducted via phone or videoconference, and continue through the first 27-month intervention cycle at minimum. This time is used to discuss cases, general program issues, and service delivery concerns. Typically, these take place in the form of either Discipline Specific (DS) calls, one for mental health staff and another for health/nursing staff, or Interdisciplinary (IDS) calls for the full team. Each of these calls typically take place around 10 times per year, on a semi-monthly basis. Additional consultation time with the MTB Operations Director is provided for program administrators. Once a full intervention cycle has been completed, ongoing consultation and supervision are provided as needed and agreed.

Replication Phase 4: On-going Supervisory Consultation 
As phase 3 begins, families are enrolled, and implementation gets underway, the nursing and mental health supervisors also begin regularly scheduled consultation calls with MTB National Office consultants. These sessions initially focus on the intended purpose of the calls, the needs of the supervisors and their teams, implementation questions, and getting to know one another. Once cases are enrolled, topics vary from call to call based on the needs of the supervisors, and the format is flexible. These calls typically take place around 10 times per year, on a semi-monthly basis.

Replication Phase 5: Distance Training and Optional Train-the-Trainer Component
Within 3-6 months of the initial enrollment of families, quarterly 90-minute distance learning sessions are provided for all clinical and supervisory staff via video conference. Topics are determined based on the implementation phase and needs of the team. These sessions continue regularly, scheduled at a mutually convenient time approximately every three months through at least the first intervention cycle. During this phase of implementation, an optional train-the-trainer component may also begin, wherein qualified supervisors participate in a 4-day intensive training program through the MTB National Office on the Yale Campus, or equivalent number of in-service hours via distance learning sessions if necessary. Delivered over 4 days, this includes a focus on team building skills, training lectures, attendance at MTB team meetings, case discussion with experienced practitioners, and possible shadowing opportunities at home visits. The aim of this training is to provide additional guidance in the MTB model and to address specific supervisory issues and ongoing hiring/training needs. This is intended for up to 6 supervisors. Web-based access to training lectures by the MTB model developers may also be included for one year if needed. 

Replication Phase 6: Site Monitoring and On-going Consultation
Approximately 10-15 months after the initial families are enrolled, two MTB National Office staff members return to the program site to conduct a required site visit. The purpose and goals of this visit include presenting and discussing cases, providing information to the agency to help answer any questions or concerns, assessing implementation of the model (including a review of fidelity benchmarks and competencies as well as a discussion of gaps or needs), and addressing issues related to replication, including discussion of procedures and practices, and the required evaluation component. Specific goals and an agenda for the visit are developed in collaboration with site administration in advance of the site visit.  

For more information, including pricing, a sample calendar for full scale replication, or our MTB Replication Planning Guide, please contact us