Training and exposure to evidence-based practices: Changing attitudes among the addiction treatment workforce

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Training and exposure to evidence-based
practices Changing attitudes among the addiction
treatment workforce

• J. Aaron Johnson, Ph.D.
• Meredith Huey Dye, MA
• The University of Georgia
• With research grant support from the National
  Institute on Drug Abuse (R01DA14976 and
  R01DA14482)

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Background

• Significant efforts devoted to moving
  evidence-based treatment from research settings
  into community-based treatment programs
• Development of treatment techniques, including
  medications and psycho-social approaches
• Testing and disseminating these EBPs NIDA CTN,
  SAMHSA ATTCs, RWJF initiatives
• Our research devoted to identifying barriers as
  well as factors facilitating adoption/implementati
  on

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Background (cont.)

• Research in other organizations - attitudes of
  members critical to successful implementation of
  new innovation
• Previous research on innovation adoption in
  addiction treatment
• Exposure to buprenorphine through specific
  training or use by program led to more positive
  attitudes among counselors (Knudsen et al., 2005)
• Counselor computer access relatively high, use of
  internet to learn about new techniques low
  possible technology gap in diffusion of EBPs
  (Ducharme et al, 2005)

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Research Questions

• What is the impact of training and exposure to
  EBPs on counselor attitudes toward pharmaceutical
  and behavioral interventions?
• What are the implications of these findings on
  current efforts to disseminate EBPs into
  community-based treatment programs?

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The National Treatment Center Study

• Monitoring the organization, management,
  delivery, and content of addiction treatment in
  the U.S.
• Includes Nationally Representative Samples of
• Privately-funded treatment programs (N401)
• Publicly-funded treatment programs (N362)
• Programs must offer a level of care for addiction
  treatment at least equivalent to structured
  outpatient as defined by ASAM
• Excludes methadone maintenance-only facilities,
  clinicians in private practice, DUI-only
  programs, halfway houses

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NTCS Instrument Design

• Multiple data collection methods used
• Detailed on-site interviews with program
  administrator
• Focus - organizational characteristics, services
  offered, use of innovations
• Mail questionnaire from program administrator
• Focus - leadership and management practices
• Mail questionnaire from counselors
• Focus - services received by clients, attitudes
  toward innovations
• Brief telephone follow-ups w/ program
  administrator at six month intervals
• Focus - major program changes
• Todays presentation data from counselor
  questionnaires collected between November 2004
  and July 2006 (N880)

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Counselor Demographics
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Counselor Training and Accessto Computers w/
Internet
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Prevalence of Exposure to EBPs
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Counselor Exposure and Attitudes toward EBPs

• In each case counselors report significantly more
  positive attitudes toward EBPs when exposed to
  those practices.

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Computer Access Attitudes toward EBPs

• Counselors report significantly more positive
  attitudes toward EBPs when provided with their
  own computer/internet access

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Regression Models
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Discussion

• Regardless of whether pharmacological or
  psychosocial, Exposure to specific EBPs has
  significant impact on counselors attitudes
  toward those practices
• Only attitudes toward psychosocial therapies
  impacted by counselor education
• Having access to computer w/ internet has limited
  impact on attitudes
• Males have significantly more negative attitudes
  toward use of MET and vouchers than females?

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Conclusion/Implications

• On-site training and testing of EBPs will likely
  have significant positive impact on counselor
  attitudes
• Dissemination of information via computer
  (CD-ROM, website, etc.) will likely have little
  impact (limited access, limited time)
• For Psychosocial EBPs, might consider tailoring
  training to specific genders

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For more information

• Visit us at www.uga.edu/ntcs
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