Evidence-Based Practice as a Competitive Advantage | EP 13

In this episode of Healthcare Marketing Edge, Tim Bouchard, Owner/CEO of Luminus, and Steve Wiland, Addiction Certificate Program Director at University of Michigan and practicing trauma and addictions therapist, discuss the critical gap between cutting-edge addiction research and frontline clinical practice in behavioral health. They explore how this “science-to-services gap” costs practices their competitive advantage and prevents patients from receiving optimal care. Stephen shares insights on why proper training alone isn’t enough without clinical supervision, how to implement outcome monitoring systems that prove effectiveness, and why master’s degree programs often fail to prepare clinicians for real-world addiction treatment. The conversation emphasizes how evidence-based practice excellence creates a triple win: better patient outcomes, higher staff retention, and measurable results that practices can market as a true competitive differentiator in the behavioral health marketplace.

Tim Bouchard (00:06.19)
Welcome to Health Care Marketing Edge, where we share stories and strategies to grow your practice. I’m Tim Bouchard from Luminus, a health care marketing agency specializing in helping practices acquire patients and grow their practice. Today, we’re exploring something that could transform behavioral health practices using evidence-based interventions as a true competitive advantage. Our guest is Steve Weiland, Addiction Certificate Program Director at University of Michigan and a practicing trauma and addictions therapist. Steve’s going to show us why the gap between research and practice is causing behavioral

Health practices, growth opportunities, and how proper training, supervision, and outcome monitoring can create better patient outcomes and stronger market position. If you’re on a behavioral health practice or work in addiction treatment, this episode will definitely connect with you. And Stephen, welcome for coming on. Why don’t you first start with just telling us who you are and what you do and how you got to being so great at this aspect.

Steve Wiland (01:01.915)
Right, so thanks for having me on. Yeah, so I spent 25 years of my career working in the community mental health kind of realm, focused on co-occurring addictions, which is, know, dual disorders of a mental health disorder and a substance use disorder. And after that, I kind of branched off into a combination of teaching and training.

clinical supervision and private practice. And so that’s what I’ve been doing for the past several years now. And having been on the front lines as a practitioner, still in private practice, having supervised and directed different treatment programs, and now being involved on the education and training side as well, I think it’s given me a very well-rounded set of perspectives that are pertinent to our topic today.

Tim Bouchard (01:59.074)
Yeah, you actually, it’s very unique. You’re both on the academic side and you have some frontline clinical practice experience too. What uniquely have you seen from that vantage point that’s led you down this idea of the cutting edge knowledge that practitioners should always be on top of?

Steve Wiland (02:18.685)
Yeah, focus or the topic of what’s been dubbed the science to services gap first really started hitting hard around 2000, 2001. was that year in 2001, there was an Institute of Medicine landmark report entitled Crossing the Quality Chasm. And it was proposing a new health system for the 21st century.

exposed pretty directly for the first time that I had seen it, that research findings are established and yet the application or the implementation of good research findings doesn’t make it to the front lines of the practice world, sometimes up to 15 to 20 years later. And so that’s been dubbed the science to services gap, particularly in behavioral health as we’re speaking of.

That’s what really caught my interest because I was already working on the front lines, supervising other clinicians, but I was also teaching part-time at the University of Michigan, the School of Social Work. And I would talk to my students who were just about to enter the field and I would be hiring and training clinicians fresh out of school who didn’t have much really under their belt yet in terms of good

cutting edge practice, knowledge and skill. And so I was seeing the gap in real time and it made all the difference in my work at that point at Communal Health to start to put into play better training or retraining or backfilling of training deficits with new hires so that they could actually know what to do when they sat down with their first.

real life client and then not only know what to do but be able to contribute, facilitate positive outcomes that better serve our clientele at the time.

Tim Bouchard (04:28.459)
Yeah, why do you think that this gap exists? Are there certain barriers or I wouldn’t necessarily say steps that are being skipped but maybe not understood early on?

Steve Wiland (04:40.701)
Well, I think some of it is philosophical. think some of it is quite frankly, economic. You know, I’ve worked at both the public sector and the private sector and the public sector is, you know, public funding. There’s usually not enough funding for what any, you know, good high excellence, you know, practitioner would like to do or program would like to do. And so I think there’s kind of a, you make do with what you’ve got.

and you cut corners cost-wise where you can in order to still serve as many people, because the referral stream doesn’t stop in the public sector. You take on everybody who’s eligible. so, given those kind of conditions, let’s see, I can either serve all the people that are on everybody’s caseload, or I can carve out some of that precious service time and instead dedicate it to training, dedicate it to…

know, clinical supervision, yikes, you can understand the tension there that, you know, managers and supervisors experience on a regular basis. And oftentimes just the sheer volume, and again, in the public sector kind of displaces, we really don’t need as much clinical supervision, or we really don’t need as much training. And then, but then you get the substandard results.

So those are some of the limitations on the publicly funded side. the privately, private insurance funded side, there is typically a greater emphasis placed on training and good clinical supervision that helps newly trained clinicians implement what they’ve learned, the practice knowledge and skills that they’ve learned. But even there, things hit hot, you got some high needs clients and

Even there, in my experience, it becomes a little easier to skip the weekly supervision or to downplay the training until the license needs to be renewed and you gotta hurry up and cobble together a bunch of CEUs just to renew your license. But by that point, it’s not a more intentional, structured, effective way of equipping frontline practitioners with what they need that’s actually gonna improve their practice.

Tim Bouchard (07:00.951)
Does that result in any consequences on the patient side? Does the gap affect them the same way it affects the practice?

Steve Wiland (07:09.379)
Absolutely, I mean, in my observation, it affects the end user, the client, because they don’t get the better outcomes that they otherwise would get if their, you know, their practice practitioner, their treatment team was better versed and more skilled and more experienced in cutting edge interventions. And so, and some of the blind spot there is that if I’m a client,

and I’m in need, I’m in crisis, I don’t know that I’m not getting the best care, I just know I’m getting something and something is greater than zero. And so a lot of clients and even their family members and referral sources don’t necessarily have the perspective to say, okay, that’s cutting edge quality, we’ll go with that practitioner or that practice, or saying, well, gosh, this seems kind of primitive and old school, traditional, it doesn’t take into.

account the more innovative practices that research has identified and supports. So that level of discernment is typically not there on the part of the client or a lot of the referral entities that bring clients to care. And so it’s a blind spot and that’s what allows it to the whole kind of dynamic to be perpetuated.

Tim Bouchard (08:31.852)
What do you think the biggest difference is for the people that take the time to do this on the clinician side? they’re trained in the evidence-based interventions. They’re doing CMEs versus one that can actually take out the next step and then also implement them effectively too.

Steve Wiland (08:50.909)
Well, I think it’s a short-term pain for long-term gain kind of philosophy. If you want to be a cutting edge practice and you want to be recognized as such, you just can’t claim that without coming up with the practice evidence that you actually can perform at that high level. And so it really necessitates an upfront investment in training dollars and having…

caseloads arranged so that you serve less clients because you’re spending time developing the practice excellence of your staff. Then and only then do you have what it takes to generate the superior outcomes that if you’re measuring them, you can then mark it on the basis of those several years down the road. And then by the time a practice gets well established, if they keep that up, then that’s where they gain the high quality reputation.

in their area and that’s where they become set. That’s the long-term gain for the short-term kind of investment pain. that takes enlightened leadership, it takes everybody on that same page from administration down to frontline staff in order to execute that kind of multi-year kind of a plan. And you can understand why with whatever crisis need.

that is presenting itself why a lot of people go with, or lot of practices go with the short-term gain for long, what I’m gonna argue is long-term pain because they get the short-term, yeah, serve as many people as possible, generate as many dollars, reimbursement dollars as possible, but with what quality of care and how is that gonna impact your longer-term reputation? How is that gonna impact longer-term kind of referral streams? How is it gonna impact your…

reputation in the treatment community, and how’s it gonna lead to greater outcomes for your clients that then, if you don’t have that, how can you market on the basis of that, that you actually know what you’re doing and people who come to your place get better?

Tim Bouchard (11:03.468)
Yeah, for the implementation side, are there outside resources that can help someone move through this too, if they’re struggling to do it on their own, even if they do the research and the CME and they’re trying to implement on their own? Is it like coaching or how can you build like a sustainability model for implementing this?

Steve Wiland (11:25.863)
Yeah, those kind of resources are absolutely available. There are training and consultation entities I’ve been a part of some of those over the years that can be brought in from the outside, oftentimes funded by grant dollars because a lot of grant funding is in fact available to help raise the bar, right, the quality of care. And so that’s a very…

well-practiced and effective way to try and improve the quality of care, have one of those kind of training consultative bodies come in and work with staff, even if, or especially if you don’t have the time in-house to be able to, or the expertise in-house to have one of your supervisors or your director be able to provide that kind of training consultation to get the implementation in a good place so that it can be self-sustaining moving forward.

Tim Bouchard (12:24.892)
We work with one in New York State called Project Teach. through the Office of Mental Health. And they do a large series of CMEs, and they’re always developing resources. But they help build the referral network, too, to try and keep all of these things connected. So I’m pretty in tune with that. And they put a lot of work into their, even at this point, self-serve CME system as well.

which still takes some initiative to get involved with, get into, and things like that. But the resources are definitely out there. And like you said, largely, there is lot of government-funded programming that’s meant to help, especially in the mental health and behavioral health systems and addictions and things like that. I guess the next phase after this would be, so if someone has taken these steps, they’ve done an implementation, they’ve started developing their own practice-based evidence cases.

Steve Wiland (13:05.873)
Yeah.

Tim Bouchard (13:18.112)
How can they monitor what these outcomes are maybe, or how can they build that case story from within their practice for what they’re doing once they see things starting to move?

Steve Wiland (13:29.117)
Sure. Yeah, so that’s a great question. And that’s really part of the necessary infrastructure to make this kind of vision come to reality. The place that I’ve seen it done the best was a clinic that I was directing and we had symptom scales and we had that people who came into care as part of their initial assessment.

they were able to rate themselves with various different symptoms and indicators of either the problem or the successful overcoming of whatever the symptom problem may be. And then there were regular checkbacks throughout the course of care. And in order to make that as user-friendly as possible, both for staff and for clients, we ended up buying a bunch of tablets and using a SurveyMonkey kind of a

know, repository of data, know, database. So we’d replicate the symptom scales and hand that to the client as they’re waiting for their appointment or whatever. And they would check off where they’re at that particular day with those symptoms. And then the SurveyMonkey would pull it back into a backend database that was then available for analysis and, you know, reporting out on aggregately, hey, how are we doing as a program?

And there’s just so many pluses with that kind of a system. One of which is, found out as the director of that program, I found out who my superstar clinicians were that were generating the most positive outcomes. And previously I only knew maybe, I didn’t really know that clearly, but after learning something like that clearly, then guess what? I can deputize them, maybe give them a little raise, a little bump, deputize them to be the coach.

Tim Bouchard (15:07.403)
Mmm.

Steve Wiland (15:24.231)
for their less effective colleague so that the bar can be raised across the whole practice in terms of the efficacy of the services. But then you’re also generating the outcome data to feedback to the client. A lot of times clients are too close to themselves. They don’t notice incremental change. And yet if you can say, hey, a few weeks ago it was this and now it’s this.

It gives them encouragement, gives them, you know, kind of confidence, really helps the morale, not only of the client, but of the staff too, because they’re working hard and they’re trying to help and they don’t really have necessarily without outcome measuring, they don’t have a way to know if what they’re doing is actually having the positive intended effect. So it’s good for the clients, it’s good for the staff. And that’s the kind of aggregate data that you can, you know, market on the basis of.

Tim Bouchard (15:55.285)
Mm-hmm.

Steve Wiland (16:22.19)
I can put on my website, know, this percentage of people, you know, had this kind of progress against, you know, their addictive disorder, against their co-occurring post-traumatic stress, you know, whatever the domain of symptomology is that’s being addressed, I can have hard evidence that my staff, my clinic knows what we’re doing. And unless another clinic down the street can say that they…

have that data too, guess who has the marketing advantage at that point.

Tim Bouchard (16:57.011)
And it’s quantifiable. And what’s nice about that, too, is if you do it that way, it’s generalized enough that you’re only marketing outcome based results and it’s now like individualistic and you’re clearing all this compliance hurdle stuff to be able to effectively communicate that. Right. And there are a lot of even just from the data retention systems, there’s a lot of, you know, these names that we all know about from the PHIEHR systems that are out there that’ll do some of this collection for you along the way, too.

Steve Wiland (17:12.721)
Yeah.

Tim Bouchard (17:25.883)
as well. And then you can satisfy the data compliance, the patient experience, and be able to compile all that data for your marketing messaging. So that’s definitely a piece to put in there. Is there anything, you’re also probably using that data to effectively bring along the patient through the journey too. It’s not just for the marketing side. You’re able to probably figure out one from an operations and process standpoint or care standpoint, I mean.

Steve Wiland (17:27.132)
True.

Tim Bouchard (17:55.286)
to how to improve things. You’re also improving staff and you’re improving your messaging and differentiation in the market.

Steve Wiland (18:02.554)
Yeah, all the above. It truly is a win, win, win kind of arrangement. And some of the ways that that happens with individual clients is that, there is such a thing as goodness of fit between practitioner and client. And sometimes the initial assignment doesn’t end up being the goodness of fit that you can otherwise offer if you have choice among a team of practitioners at your place. And so,

if it’s just not working out and I get early kind of warning system, I get wind of that because, the outcome measures aren’t trending positively like I would expect them to, then I can do an early intervention and say, hey, maybe you guys just aren’t the best fit for each other and how about trying either a different practitioner or trying a different intervention approach because there’s goodness of fit with regard to.

clients and particular interventions versus other ones. And it’s just such a benefit to have an early warning system where you can make those adjustments without losing the person who votes at their feet because they’ve been there for a long time and it hasn’t been working for them. So yeah, that’s absolutely. And it’s like you’ve mentioned, it’s HIPAA proof, you know, in terms of the aggregated data. And it can also be used as the…

a part of the data upon which you can apply for grants and curry favor with what’s happening in your state’s capital in terms of decisions being made for funding for behavioral health. If you have data that shows that yes, what we’re doing actually works.

Tim Bouchard (19:45.365)
Mm-hmm.

Steve Wiland (19:53.051)
you know, a lot of people in the general public, and I think maybe even some politicians who haven’t necessarily become more informed, kind of, there’s like this mystification around behavioral health and, you know, mental health and addictions care. It’s like, it just seems like you’re throwing darts and hoping something sticks. And the reality is, the reality is, that with, you know, evidence-based practice, you have,

the ability to say, we can demystify it for you. We can show you that these symptoms decline over time when you use this intervention by a practitioner who’s appropriately trained and supervised. We can kind of build the confidence of anybody who’s a stakeholder at whatever level, especially at the systems level, anybody who’s a stakeholder whose opinion and position may help to unlock additional funding moving forward or continue.

existing funding if it’s necessary.

Tim Bouchard (20:56.169)
Yeah, we see that too. We’re getting feedback through the CME programs, back to OMH. They’re getting their funding through the states, going back through to the programs and the practitioners. It’s a big eco cycle. The one thing you touched on, and I wouldn’t say glossed over, but we can dig one more step deeper into it, from a practice growth standpoint, you obviously want patient retention in the sense that if they need help, you’re always there to help them. But staff retention is a big deal too. And sometimes we just forget that good teams

are always looking to make sure they’re doing the best for the people that they serve.

Steve Wiland (21:30.841)
Absolutely, absolutely. And, you know, there’s a particular trend line since COVID where, you know, good professionals are hard to find. A lot of people retired. A lot of people, you know, kind of bowed out of, you know, high needs kind of therapy, you know, behavioral health care practices. And so that just ups to Annie even more. If I get a good person, I want them to be so satisfied working at my shop.

that they don’t wanna go anywhere else. And how do you do that? Well, you know, lot of people don’t self-select into human services to get, you know, filthy rich. So why do they self-select? Well, they self-select because they have, they wanna be helping people and they wanna be effective at helping people. And if I can give my staff the training and the supervision, the support that they need to do really, really good jobs with their clients, then it’s another part of that win-win-win. You know, they get to have a

a professionally satisfying, fulfilling experience, they get to see the clients that they’re working with get better. I get to compensate them well because they’re generating the kind of quality that attracts a steady stream of referrals and whatever other ancillary funding that I can attract with those good outcomes. And it ends up being kind of the best of all behavioral health worlds.

Tim Bouchard (22:55.433)
Yeah, you can’t be a practice that supports patients that doesn’t support the providers supporting those patients. It’s a whole ecosystem of support from the top down. It’s a really big deal. Is there anything that we haven’t brought up yet that you wanted to make sure we touched on before we wrapped up on this aspect of it?

Steve Wiland (23:06.94)
Absolutely.

Steve Wiland (23:17.958)
Well, I think one thing just to raise some awareness, one thing that people might believe is that somehow like master’s degree programs at universities in helping professions like social worker psychology or professional counseling, some people have the belief or the expectation that that’s where all the good training takes place that should equip a graduate to be able to hit the ground running.

And that simply is not true for a number of reasons. It is not true. I mean, the standardized accreditation of standardized programming in master’s programs, you talk about a science to services gap that we’ve been talking about. There’s a lag time in terms of new research findings making their way into accredited curricula. that just, is what it is. And part of…

why I work as part-time faculty is I’m kind of helping to fill that gap, right, with practice courses that haven’t made their way into the accredited curricula yet. And so thankfully universities do make that kind of accommodation and they offer, in some cases, a pretty robust assortment of electives that students can at least get some of that practice now and some of that beginning practice skill.

while they’re still earning their master’s degree. And that’s why, like the addiction certificate program that I oversee, that’s why, that’s where that came from, right? A lot of universities especially do not offer addictions training that’s significant enough, robust enough to graduate somebody who can hit the ground running and know what they’re doing with a case load of folks who are

struggling with addiction. And so the Addiction Certificate Program is one, there’s any number of solutions or partial solutions, but the Addiction Certificate Program kind of emerged to help fill that gap in the marketplace. And it started out as live webcasts on Saturday afternoons, and it has since become a podcast itself paced kind of a program of 90 hours. And the difference there is instead of somebody just

Steve Wiland (25:43.015)
hodgepodging together a bunch of CMEs on topics that sound like they have interesting titles. It’s a 90 hours altogether of very carefully thought out and integrated training at the core knowledge and practice skills that somebody would need in order to be able to do good work with an addictive population. The original team that I had brought together had 120 years, I think, of

collective experience in the field as providing addictions treatment. And so our vision was, what are we gonna do? What would we like to have learned when we were at the beginning of our careers? What training would we have loved to have had? And that’s what informed the putting together of those 90 hours. And so that’s just one of any number of examples. And I think some universities are making an investment in having a more robust.

degree program in addictions or certificate programs in addictions, but We’re in a new era. I mean the old-school addiction, you know, there wasn’t much reimbursement for the services many people Were in recovery themselves and not to diminish that at all but many of those folks were Able to pass on to clients what they had experienced themselves, but they didn’t have other training necessary to flesh out or

you know, more comprehensively offer, you know, different interventions for different goodness of fit with different people. And so, you know, the universities, they’re in the system that they’re in, in terms of the time it takes to update your accreditation. But right now, it’s not really serving the behavioral health front lines as well as many people make the assumption. So I’m not, you know, banging on them. I got no knacks to grind.

but I think people need to be aware. And so just because somebody has a degree in a helping profession doesn’t automatically mean that they’re effectively trained and to implement evidence-based, especially innovative, cutting edge evidence-based practice skills. so until we can figure out as a system how to backfill and do better, some of these ideas we’re talking about are

Steve Wiland (28:06.02)
are measures that can in fact move the needle in the shorter term.

Tim Bouchard (28:09.916)
Mm-hmm. And it always changes. And you always have to be on top of it and keep up to speed, especially with the pace of how health care systems change and just the scenarios that people are finding themselves in these days. Before we go, there anywhere, would you like to tell people where they could find out more about you, maybe the certificate program, anything like that?

Steve Wiland (28:15.996)
For sure.

Steve Wiland (28:36.752)
Yeah, so the University of Michigan has a number of different certificate programs. And if you Google addiction certificate program at the University of Michigan, it’ll take you to the pages that describe, you there are three tracks of 10 modules with three hours per module. So there’s lecture, there’s readings, there’s, you know, different kinds of handouts and even tools and techniques.

technique supportive stuff that you can print down and take in and use with your clients. So it’s really designed to fit people where they’re at, whether you’re a ranked beginner, you can get a lot of information and download and that’s part of what’s featured there. Have your own electronic library to refer to as you go forward. Or if you’ve been a practitioner in the field for many years.

There’s still a focus on evidence-based, innovative, kind of cutting edge stuff that will hopefully update or bring current anybody’s understanding of their practice knowledge and skills. So that’s available. mean, we’ve had students from China, had students from all over the continental United States in its current form, given that it’s podcasted and self-paced.

People can move through it in their own pace. And then every month I’m online with every participant who wants to participate in a kind of a consultative Q and A. So once a month, at least for an hour and a half, I get to get together online with wherever people are tuning in from and answer their questions and crunch cases that are properly de-identified and just talk about.

know, things that are happening in the addiction realm and their place of employment, their community, or even national headlines. So, obviously I’m biased, but I would encourage anybody who’s interested to check it out.

Tim Bouchard (30:40.724)
Cool. Well, this has been really eye-opening and awesome and super interesting. And for anyone that wants to turn clinical excellence into real competitive advantage, I think this was super valuable to them. So thanks for connecting the dots between that whole research, training, outcomes, and growth kind of sequence in this. And I appreciate the time on that. Listeners, if you want to grow your practice based on some of these measurable patient-centric marketing strategies,

Check out our Patient Pipeline Blueprint Session Offer. It’s a workshop to uncover how you can attract new patients, convert more inquiries into appointments for your practice, and grow your practice. Learn more at luminus.agency/blueprint. And lastly, don’t forget to subscribe to Healthcare Marketing Edge on Spotify, Apple, or YouTube. We’ll see you on the next episode. And Steve, thanks for being on. This was a blast.

Steve Wiland (31:29.308)
Thank you, Tim.