Community-based addiction treatment staff attitudes about the usefulness of evidence-based addiction treatment and CBO organizational linkages to research institutions (original) (raw)
Related papers
Journal of Addictive Diseases, 2011
A national sample of addiction treatment Program Directors (N = 296) were assessed regarding their attitudes about pharmacological treatment for addiction disorders. Multivariable analyses indicate that directors who worked in organizations affiliated with research institutions and who had more professional experience had significantly more positive attitudes about a range of pharmacological therapies. Also, directors in organizations serving higher percentage homeless clients and clients with severe and persistent mental illness had more negative attitudes toward use of buprenorphine. Community-based organizations providing addiction treatment to specific vulnerable client groups exhibit more negative attitudes about pharmacological evidence-based practices and may underutilize those practices.
Treatment programs in the National Drug Abuse Treatment Clinical Trials Network
Drug and Alcohol Dependence, 2008
Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are underrepresented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice.
Staff beliefs about addiction treatment
Journal of Substance Abuse Treatment, 2001
In 1999, the National Institute on Drug Abuse established a researcher/provider partnership designed to test the effectiveness of researchbased innovations in community-based treatment settings and facilitate the transfer of those innovations throughout the national treatment system. As a preliminary step in developing their local Clinical Trials Network, researchers and treatment providers within the Delaware Valley Node surveyed 317 staff members concerning their beliefs about addiction treatment. More than 80% of respondents supported increased use of research-based innovations, 12-step/traditional approaches, and spirituality in addiction treatment, while only 39% and 34%, respectively, endorsed the increased use of naltrexone and methadone maintenance. Also, 35% of respondents indicated that confrontation should be used more, and 46% agreed with discharging noncompliant patients. Individuals with more formal training tended to be less supportive of confrontation and more supportive of the increased use of medications. Implications for the clinical trials and technology transfer are discussed. D 0740-5472/01/$ -see front matter D 2001 Elsevier Science Inc. All rights reserved. PII: S 0 7 4 0 -5 4 7 2 ( 0 1 ) 0 0 1 7 3 -8
Barriers to implementation of evidence-based addiction treatment: A national study
Journal of Substance Abuse Treatment, 2012
Prior studies have identified that working in an addiction treatment unit with higher levels of organizational capacity is a factor associated with positive staff attitudes about evidence-based addiction treatment practices (EBPs). The study presented here explored whether staff perceptions about the organizational capacity of their treatment unit are also associated with staff experience of barriers to implementing EBPs. Multivariate regression methods examined the relationship between the clinical staff (n = 510) and director (n = 296) perceptions of organizational capacity (Texas Christian University Organizational Readiness for Change [TCU ORC]-staff and TCU ORC-director) and level of barriers experienced when implementing a new EBP controlling for a range of treatment unit characteristics, staff characteristics, and type of EBP implemented. For both samples, reporting higher levels of stress in their organizations was significantly associated with reporting higher levels of barriers when implementing a new EBP. For clinical staff only, experiencing lower levels of program needs in their organization, working in a program that had been in existence for a shorter period, and implementing motivational interviewing techniques compared with other EBPs were all factors significantly associated with experiencing lower levels of barriers with EBP implementation.
Journal of Substance Abuse Treatment, 2007
Researchers and policymakers are increasingly focusing on factors that facilitate or impede the diffusion of evidence-based treatment techniques into routine clinical practice. One potentially fruitful avenue of research is the influence of involvement in research networks as a predictor of organizational innovation. The Clinical Trials Network (CTN) is examining a number of behavioral and pharmacological treatment techniques in controlled multisite studies. Using data from participating CTN treatment programs and large samples of programs outside the CTN, these analyses examine the influence of exposure to clinical trials on the subsequent adoption of buprenorphine and voucher-based motivational incentives. The analyses show that, controlling for a variety of organizational characteristics, direct exposure to buprenorphine clinical trials in the CTN significantly increased the odds of subsequent adoption. By contrast, the adoption of motivational incentives was entirely explained by organizational characteristics. The findings suggest that adoption of treatment innovations is a function of exposure, organizational resources, nature of innovations, and stage of the diffusion process.
Cognitive and Behavioral Practice, 2013
One barrier to widespread public access to empirically supported treatments (ESTs) is the limited availability and high cost of professionals trained to deliver them. Our earlier work from 2 clinical trials demonstrated that front-line addiction counselors could be trained to deliver a manualized, group-based cognitive behavioral therapy (GCBT) for depression, a prototypic example of an EST, with a high level of adherence and competence. This follow-up article provides specific recommendations for the selection and initial training of counselors, and for the structure and process of their ongoing clinical supervision. We highlight unique challenges in working with counselors unaccustomed to traditional clinical supervision. The recommendations are based on comprehensive feedback derived from clinician notes taken throughout the clinical trials, a focus group with counselors conducted 1 year following implementation, and interviews with key organization executives and administrators.
Evidence-Based Care in Substance Abuse Treatment: Comparing the Public and Private Sectors
2000
Substantial recent efforts have been made at the Federal, state and local levels to facilitate the transfer of evidence-based addiction treatment technologies from the research arena to everyday clinical practice. The substance abuse treatment field has historically been fairly isomorphic in terms of its core treatment technology, relying heavily on 12-step approaches and with relatively little emphasis on pharmacotherapies. With several new developments in the field, however, the diffusion of new technologies to the field bears watching. This paper describes the rate and correlates of adoption of nine evidence-based approaches to substance abuse treatment, including four medications (naltrexone, disulfiram, buprenorphine, and selective serotonin reuptake inhibitors) and five psychosocial counseling techniques (motivational enhancement therapy, contingency management, cognitive-behavioral therapy, dual-focus schema therapy, and the Matrix model). Data from national samples of public-and private-sector treatment facilities gathered between 2002-2004 provide evidence of measurable levels of adoption of these techniques, with significant differences across sectors and organizational forms.
Journal of Substance Abuse Treatment, 2008
Underutilization of evidence-based treatments for substance abuse represents a longstanding problem for the field and the public health of our nation. Those who would most benefit from research advances (community treatment agencies and the clients they serve) have historically been the least likely to be exposed to innovative evidence-based methods for substance abuse treatment. To help address this gap, the Addiction Technology Transfer Center of New England (ATTC-NE), located at Brown University, has adapted and implemented an organizational change strategy intended to equip substance abuse treatment organizations and their employees with the skills needed to adopt evidence-based treatment practices. Since 2003, the ATTC-NE has worked with 54 community-based substance abuse treatment agencies from across New England using this model, which is called Science to Service Laboratory (SSL). Twenty-eight of 54 agencies completed all of the SSL components, and 26 of these 28 completer agencies (96%) successfully adopted and implemented contingency management as a result. Survey data comparing completer and dropout agencies' satisfaction with the quality, organization, and utility of the SSL indicate that both groups rated the SSL favorably. However, differences emerged with respect to organizational characteristics between completer and dropout agencies. Specifically, dropout agencies were more likely to report turnover in staff positions vital to training effort. Future directions for the model are discussed.