Mental & Behavioral Health Support Services CQI Cycle
PLAN
Beginning of 90-Day CycleTier 1 (Basic):
- Review Logic Model
- Set TBRI®-aligned goals
- Develop intervention strategies
MH-Specific:
- Schedule weekly therapy per T3C p.77
- Develop TBRI®-informed crisis protocols
- Plan therapeutic family engagement
- Review psychotropic medications
- Set behavioral intervention goals within TBRI®
DO
Days 1-75Tier 1 (Basic):
- Implement TBRI® Connecting daily
- Document all services
- Family engagement per TBRI®
MH-Specific:
- Conduct weekly individual therapy (required)
- Facilitate family therapy with TBRI® integration
- Monitor medication compliance daily
- Implement behavioral plans using TBRI® Correcting
- Provide 24/7 crisis response per protocol
STUDY
Days 76-85Tier 1 (Basic):
- Analyze data
- Compare to model
- Identify trends
MH-Specific:
- Review 90-day CANS results
- Assess therapy attendance (≥90%)
- Analyze crisis incident patterns
- Evaluate medication effectiveness
- Determine step-down readiness
ACT
Days 86-90Tier 1 (Basic):
- Refine TBRI® implementation
- Adjust service approaches
- Enhance training as needed
MH-Specific:
- Adjust therapy frequency/modality per needs
- Update behavioral plans with TBRI® strategies
- Revise crisis protocols based on data
- Modify medication regimens (with psychiatrist)
- Plan transitions or aftercare services
- Document Program Director confirmation (15-day)
Mental & Behavioral Health
Logic Model
TBRI® Foundation
+ Therapeutic Services
90-Day Review Cycle
Mental & Behavioral Health CQI Timeline
Beginning of 90-Day Cycle
Program Director, Treatment Director, QA Team
- • Review MH service delivery
- • Set therapeutic targets
- • Plan therapy schedules
- • Review medication protocols
- • Update crisis plans
Days 1-75
Therapists, Case Managers, Foster Parents
- • TBRI® implementation
- • Weekly individual therapy
- • Family therapy sessions
- • Behavioral interventions
- • Crisis management
- • Medication monitoring
Days 76-85
QA Coordinator, Treatment Director
- • Compile therapy data
- • Analyze CANS results
- • Review therapy attendance
- • Assess crisis incidents
- • Evaluate medication compliance
- • Determine continued stay
Day 86-90
Full MH CQI Team
- • Treatment team meeting
- • Review all outcomes
- • Adjust treatment plans
- • Modify therapy frequency
- • Update behavioral plans
- • Plan aftercare services
Mental & Behavioral Health CQI Metrics
| Logic Model Component | MH-Specific Metrics | Target/Threshold | Review Frequency |
|---|---|---|---|
| TBRI® Implementation | • Staff TBRI® Practitioner competency • TBRI® fidelity in therapy sessions • Caregiver TBRI® implementation scores • Crisis de-escalation using IDEAL Response® | ≥90% competency Documented in sessions ≥85% fidelity 100% utilization | Quarterly assessment Monthly review |
| Therapeutic Services | • Weekly individual therapy attendance • Family therapy participation • Group therapy engagement • Psychiatric consultation frequency | ≥90% attendance Monthly minimum As indicated Quarterly minimum | Weekly monitoring Monthly review |
| CANS Assessment | • 90-day CANS completion (vs 6-month Basic) • Behavioral domain improvements • Risk behavior reductions • Strengths development | 100% on time ≥20% improvement Decrease in scores Increase in scores | Every 90 days |
| Crisis Management | • Crisis intervention frequency • Response time to crisis • De-escalation success rate • Psychiatric hospitalization rate | Decreasing trend <1 hour ≥80% ≤2 per year | Monthly |
| Medication Management | • Medication compliance rate • Medication effectiveness • Side effect monitoring • Psychiatric follow-ups | ≥85% Clinical improvement Weekly checks Monthly minimum | Weekly/Monthly |
| Behavioral Interventions | • Behavioral plan implementation • Incident frequency • School behavior reports • Positive behavior increases | 100% fidelity ≥40% reduction Improving trend Documented gains | Weekly data Monthly analysis |
Program Director - MH Responsibilities
- • Oversee MH service package delivery per T3C Blueprint
- • Monitor TBRI® implementation across all services
- • Review continued stay criteria every 90 days
- • Provide written confirmations within 15 business days
- • Lead MH-specific CQI reviews with TBRI® focus
- • Approve Logic Model modifications based on CQI
Treatment Director - MH Specific
- • Supervise all licensed therapists
- • Review treatment effectiveness
- • Oversee behavioral interventions
- • Coordinate psychiatric services
- • Lead clinical team meetings
- • Approve step-down transitions
Licensed Therapists - MH Team
- • Provide weekly individual therapy using TBRI® principles
- • Conduct family therapy with TBRI® integration
- • Lead group therapy programs as appropriate
- • Document treatment progress per T3C requirements
- • Collaborate on TBRI®-informed behavioral plans
- • Participate in 90-day Service Plan reviews
Case Managers - MH Enhanced
- • Implement TBRI® in all therapeutic contexts
- • Coordinate all MH services per Service Plan
- • Ensure therapy attendance (≥90% target)
- • Monitor medication compliance daily
- • Document behavioral incidents using TBRI® framework
- • Facilitate family engagement per TBRI® Connecting
Mental & Behavioral Health CQI Outcomes
🧠 Clinical Stabilization
Achieved through intensive therapy and behavioral interventions
💊 Treatment Adherence
Supported by coordinated medication management and therapy
🏥 Crisis Reduction
Accomplished via 24/7 response and preventive interventions
📊 Step-Down Success
Enabled by therapeutic progress and comprehensive aftercare
TBRI® is a registered trademark of the Karyn Purvis Institute of Child Development at Texas Christian University
"A home is in the heart of every child."
Last Revised: September 2025