Patti Chamberlain
Appearances
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
And I do research and implementation of evidence-based practices in child welfare, juvenile justice, mental health, and education systems.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
You're far better off to situate your RCT in a real-world setting than a university clinic so that you're learning from the beginning what's feasible and what's not feasible. There might be something that you think would be great, but it's never going to be able to be implemented in the real world. I've been at this now for, oh, probably 25 years, and I learned sort of through failing.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
Kids tend to commit crimes together. It's a team sport. Oddly, the way that we're set up to deal with kids who reach the level where they're really being unsafe to themselves and to the community is we put them in group homes together. We're putting kids in a situation where they're isolated. more likely to commit crimes.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
So we decided, what if we placed a child singly in a family that was completely devoted to using evidence-based parenting skills to help that child do well with peers in school and in the family setting? What if we gave the parents, the biological parents of that kid, the same kind of skills that the treatment foster care family had? What if we gave the kid individual therapy?
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
The biological family was getting family therapy. We were giving the kids support at school. So we were basically wrapping all these services around an individual child in a family home. What we found was, yeah, the kids do a lot better. They have a lot fewer arrests. They spend less days in institutions. They use fewer drugs. And guess what? It costs a lot less as well.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
Because you do not have a facility. You do not have 24-7 staff that you're paying in shifts. You do not have all of the stuff that it takes to run an institution. You have a family.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
And so we got this call saying, you know, we want you to implement your program in 15 sites.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
I went in thinking that it wouldn't be that hard because we had good outcomes. We showed that we could save money. And yet... We were absolutely not ready. It wasn't because we didn't have enough data. We had, at that point, plenty of data. But we didn't have the know-how of how to put this thing down in the real world. And it blew up. One reason?
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
The three systems, child welfare, juvenile justice, and mental health, all put some money in the pot to fund this implementation. I was completely delighted. I thought, oh, this is going to be great because we have all the relevant systems buying into this.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
Well, what happened was when we tried to implement, we ran into tremendous barriers because if we satisfied the policies and procedures of one system, we were at odds with the policies and procedures in the other system.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
Measures of fidelity. That's a really critical part of the implementation process. That, again, is Patty Chamberlain, founder of Treatment Foster Care Oregon. You've got to be able to measure, is this thing that's down in the real world the same, you know, does it have the same components that produce the outcomes in the RCTs?
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
We got this call saying, we want you to implement your program in 15 sites.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
It wasn't the kumbaya moment that we thought it was going to be.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
Thank you. Thank you very much. Thank you very much.
Freakonomics Radio
Policymaking Is Not a Science — Yet (Update)
There might be something that you think would be great, but it's never going to be able to be implemented in the real world. We need to know what is the magic sauce.