The Norwegian Labour and Welfare Directorate
The HPMT project
Model, methods and program
Core components
Implementation and fidelity
Terje Lillehaug, Program Manager
What is HPMT? (HPMA in English)
 The HPMT (HPMA) model
– The Holistic model - a model for comprehensive client follow-up of
unemployed individuals living on welfare support, and with complex
social problems (clients recruited on a set of predefined criteria)
– Principle-driven - 10 principles that contribute to the quality and
direction of the work
– A methodical approach based on systematized knowledge (and
evidence), and practical, practice relevant methodological tools
 The HPMT (HPMA) program:
– Target group – primary intervention level: Client supervisors (the
social workers) in local welfare offices
– Teaching and training (9 (3+2+2+2) + 2 days (four sessions in 4 – 6
months), and systematic supervision every one week / fourtnight
 HPMT project - Two plans – one project
– Teaching and training (see above)
– Research and evaluation
NAV, 02.07.2016
Side 2
The project framework and design
 Duration
2010 – 2013
– Core intervention and implementation
– In 9 welfare offices with a total of apr. 40 service providers/social
workers. Teaching and training sessions in 2011 – Full
implementation with supervision and ”fidelity follow-up” every
week/or fortnightly on office level during 2012.
– The research
– RCT / cluster design: 18 welfare offices randomly selected in 9
intervention offices and 9 control offices (business as usual)
– Process evaluation – multi methodical
– Culture-Anthropological – Post-doc project – Focus on “Action
competence”
NAV, 02.07.2016
Side 3
Implementation and fidelity maintainace
Multilevel activities and responsibility

Level 1: Primary intervention level
Service Providers (Client supervisors/social workers) in welfare offices on
Municipality level)
Get: Teaching, training and supervision
Give: Client supervision, support and follow-up, multi-systemic process
management, case
progress analyzes and management

Level 2:
Senior service providers (client supervisors/social workers) in welfare offices on
Municipality level
Get: Teaching, training and supervision
Give: Supervision and support to level 1. General problem-solving analyses
interventions on welfare-office level. Process documentation
NAV, 02.07.2016
Side 4
Implementation and fidelity maintainace
Multilevel activities and responsibility

Level 3:
Coordinators / Supervisors – County level
Get: Teaching, training and supervision
Give: Supervision and support to level 2. Readiness mainteinance, and
interventions on welfare-office level

Level 4:
Resource group / Supervisors – Directorate level
Give: Teaching and training. Supervision and support to level 3. Readiness
maintenance, and interventions on all levels on a request and “need to
be done basis
NAV, 02.07.2016
Side 5
Project purpose and objective
 Improved - more effective services (measurable)
 Improvement and strengthening of the service providers /
social-workers methodical competence (C = knowledge,
skills, attitude and values)
 Test the effect and relevance of the HPMT model,
program and methodical tools on both service and client
level
 Generate scientific evidence on which future methodical
recommendations can be based
NAV, 02.07.2016
Side 6
Results – Output on client level (to be
tested in the effect evaluation)
– Increased numbers of clients in positive activity
– Increased numbers of clients employed
– Strengthening of client inclusion (and social capital)
– Improved life-skills and quality of life
– Reduced drug abuse
– Improved, mental health
– Improved client satisfaction (service delivery)
The work and research hypothesis is that HPMT can have a
measurable effect on these variables given that the
methodology is implemented fully and with good quality.
Correlation will be tested at both program and method /
implementation fidelity level
NAV, 02.07.2016
Side 7
Basic questions in teaching,
training and presentation of HPMT
and during work process:
 What do we do?
 Why do we do it?
 How do we do it?
NAV, 02.07.2016
Side 8
The HPMT implementation process
Manual based, planned and systematic
6 stages og implementation: (Fixsen et. al 2005)

Exploration and Adoption

Program Installation

Initial Implementation

Full Operation

Innovation

Sustainability
Documented and verifiable
Organizational readiness required
NAV, 02.07.2016
Side 9
Readiness
Dean L. Fixsen (2009) defines “readiness” as follows:
“Readiness” is defined as a developmental point at which
a person, organization, or system has the capacity and
willingness to engage in a particular activity. Creating
readiness for change is a critical component of both
initiating and scaling up the use of evidence-based
practices and other innovations in education.”
NAV, 02.07.2016
Side 10
Implementation – core activities

Initial implementation
–
Securing management support and
responsibility
–
Teaching and training
–
Organizing and practical problem solving

Full operation (but still not full scale due to project
limitations)
–
Maintenance of management support
–
Integration and use of methodical tools
–
Supervision and documentation
–
Practical and organizational problem solving
and interventions
NAV, 02.07.2016
Side 11
HPMT – Core activities

Innovation and evaluation
- A continuous development process where core components are
fixed, with room for adjustments and improvements

Maintenance and sustainability – lasting change
- Maintenance of management support
- Implementation of achieved experience from what works and what
improves methodical fidelity (org. and provider level) and results
(on client level).
- HPMT ”Booster-seminars” at least twice a year.
NAV, 02.07.2016
Side 12
The Holistic/comprehensive
client follow-up model
Workflow:
Client request
and referral
Collecting initial
client information
Initial client need
analyses and
service level
definition
Extended need
analyses
Three intervention areas with three sets
of selected methodical tools
Individual supervisor/
client interaction
Professional comunication, / client dialog (MI)
Defining problems,
client resources,
needs, and
possibilities
Identify network
resources
Planning
Implementation
Evaluation
NAV, 02.07.2016
Agree on activities
and responsibilities
Client oriented
follow-up interventions
Multi-systemic
interaction and
intervention
Case management and
documentation
• Securing client
as the key
actor in system
interaction
•Securing client
as the key
actor
• Quality control of
documentation
legal rights etc.
• Progress analyses
• Intervention planning
(multi-level/multi-task)
•Process management
to Involve and mobilize:
- Relevant professionals
- Private network and
family
- Employers and
colleagues
•
Side 13
10 methodical principles in HPMT
1. Be prepared
6.
Focus on achievements and
resources
7.
Gather information about
network resources
8.
Draw unambiguous conclusions
and agreements
9.
Be reliable and predictable
2. Acknowledge clients definition
of problems and situation
3. Clarify roles and expectations
4. Give sufficient and relevant
information
5. Stay focused on goals/objectives
and actions leading to change
10. Secure availability, continuity
and flexibility
Behind each of the methodical principles are one or more methodical tools,
that makes the social worker act in accordance with the principles. The
principles to help supervisors to remember the methodological tool and works
as a cognitive check-list
NAV, 02.07.2016
Side 14
Methodical tools and theoretical perspectives
 Tools
– Communication based om ”Motivational Interview” (MI)
– Motivation and change interventions using both MI and tools from
cognitive psychology
– System interventions and process-management based on
”Appreciative Inquiry” (AI) and process-structuring tools like ”The
5D-model” and a 4 point process check-list
– Manuals and templates for planning, documentation, analyses and
interventions
 Theoretical perspectives based on:
– Pragmatism – what do we think is the possible and appropriate
action - what’s in it for me?
– Social and symbolic Interactionism – It’s all about how and about
what we interact
NAV, 02.07.2016
Side 15