Over the last three decades there has been a growing concern regarding the poor outcomes for the large number of children and youth with serious emotional disturbances (SED) in the United States. The System of Care model has been adopted as a central strategy to address the fragmented, costly, and inaccessible nature of the mental health service delivery systems that has been attributed to these poor outcomes. Yet despite years of research and millions of dollars in federal support, many system of care efforts struggle in transforming their systems to adequately meet the needs of SED youth. One strategy to improve these efforts is the promotion of inter-professional collaboration. While research suggests that inter-professional collaboration is associated with positive outcomes for SED youth, front-line service providers often lack the capacity to engage in these collaborative processes (Fraser & Greenhalgh, 2001; Walker & Shutte, 2005) and there is little research available to guide communities in how to facilitate the process of inter-professional collaboration in their own systems. Drawing upon theories from complexity science, this study aimed to address this gap by introducing the IDeAL Partnerships Framework, an integrated model describing how inter-professional collaboration comes about through the development of four self-organizing capacities (knowledge of the service delivery system, knowledge of provider differences, reflective dialogue skills, and beliefs about collaboration) and the initiation of transformative learning exchanges. The IDeAL Partnerships Framework was used to develop an intervention to increase service providers' self-organizing capacity, transformative exchanges, and collaborative behavior. The IDeAL Partnerships Intervention was implemented with front-line service providers and was evaluated using a longitudinal experimental design. Two waves of data were collected from a total of 33 providers (17 in the intervention, and 16 in a control group). Results found some support for the overall conceptual model within the IDeAL Partnerships Framework: all four self-organizing capacities were predictive of transformative learning exchanges, and transformative learning exchanges were predictive of collaborative behaviors. However, transformative learning exchanges did not fully mediate the relationship between capacity and collaboration as proposed in the framework, and analyses suggested additional relationships between variables in the model. Results also provided some support for the intervention's efficacy. Quantitative results suggested a trend indicating that intervention participants experienced increases in two of the four self-organizing capacities (knowledge of the service delivery system and knowledge of provider differences) and their case-related transformative learning exchanges compared to control group participants. While intervention participants' collaborative behaviors also increased compared to the control group in these analyses, the interaction was driven by a decrease in the control group's behaviors over time. These findings were triangulated by focus groups and follow-up interviews with intervention participants. In addition, these qualitative findings expanded upon the quantitative findings by suggesting that at least some intervention participants also gained reflective dialogue skills and shifted their beliefs about collaboration as a result of the intervention. Follow-up interviews also suggested that many intervention participants were still using many of the self-organizing capacities they gained from the intervention to improve their collaborative exchanges 4 months after the intervention ended. The quantitative and qualitative findings from the study are discussed, as well as their implications for future research.
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