Evidence Based Practices

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Evidence Based Practices

• Gaps in Substance Use Treatment
• Presented by
• Rhonda G. Patrick, LCSW, MPA
• Amy C. Traylor, MSW, Ph.D.

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Evidence based practice

• What is it?
• What is it not?
• Not only for clinical practice

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Steps of evidence based practice

• Convert the need for information into an
  answerable question.
• Track down the best clinical evidence to answer
  that question.
• Critically appraise the evidence.
• Integrate your appraisal with your expertise and
  the clients values.
• Evaluate the effectiveness of the process.

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Integration is key

• What does the literature say?
• What do I bring?
• What about my client?

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Evidence Based Practices

• Why EBP?
• Concerns related to cost and effectiveness of
  substance abuse treatment.
• Delineation of a rational approach to allocation
  of scarce resources.
• Mitigation against a system in which treatment
  practices are based solely on practice wisdom.
• Finding the best available treatment or policy
  that reduces the harm and costs of substance
  abuse.

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Research Knowledge

• What do we know?
• What dont we know?

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Bridging the Gap Community

• Characterize the local community
• Understand community factors
• Develop community research partners
• Utilize a community participatory research
  framework

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Bridging the Gap Service Delivery

• Test the effectiveness of community-based
  therapeutic approaches that take advantage of
  natural supports (religious organizations) and of
  those that bring evidence-based treatments to
  non-clinical environments (e.g., academic
  community-partnerships).
• Evaluate and test collaborative research
  partnerships with community members that identify
  new and innovative approaches to drug abuse
  treatment services.
• Test community-level interventions that
  facilitate recovery and reintegration of drug
  users within their communities.

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Bridging the Gap Linkages

• Generate information that can be used to develop
  and test a workable model of community-based
  delivery in communities, including research that
  identifies untapped, informal community-based
  resources.
• Develop and evaluate best practices that focus on
  the integration of social, health and drug abuse
  services and that can optimize treatment outcomes
  for service users.

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Bridging the Gap Other Issues

• Speaking a Common Language
• How we define the problem
• How we define the outcome
• How we define the measurement
• Documenting Effectiveness
• Informal Publications
• Formal Publications
• Increasing Funding for Research and Services
• Making Addiction a Priority
• Economic Costs
• Social Costs

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Evidence Based Substance Use Treatment Where do
we find them?

• National Registry of Evidence-Based Programs and
  Practices
• Created in 2007
• Lists SAMSHA Model Treatment Programs
• Defines EBP as approaches to prevention or
  treatment based in theory and have undergone
  scientific evaluation.
• Submissions are reviewed by experts with
  doctoral degrees, evaluation research experience,
  and clinical experience.
• Many more prevention/intervention programs.
• Searchable by target population needs

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Evidence Based Substance Use Treatment Where do
we find them?

• Agency for Healthcare Research and Quality
• National Guidelines Clearinghouse
• Search by topic area.
• Can compare multiple guidelines across variety of
  criteria and classifications.
• Can download information to PDAs.
• Rigorous selection and review process

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Evidence Based Substance Use Treatment Where do
we find them?

• Co-Occurring Disorder Center for Excellence
• Created in 2003 to foster infusion and adoption
  of evidence and consensus based treatment and
  program innovation into clinical and
  organization practice.
• Intended for the co-occurring disorder service
  system
• Provides descriptions of interventions
• Describes intervention implementation
• References related to EBPs

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Evidence Based Substance Use Treatment Where do
we find them?

• Technology Transfer Centers
• 14 regionally-based addiction technology transfer
  centers
• Bridging the gap between science and practice
• Addiction Science Made Easy Program
• Intended for addiction treatment professionals
• Provides descriptions of interventions
• Describes intervention implementation
• References related to EBPs

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Evidence Based Substance Use Treatment Where do
we find them?

• National Drug Abuse Treatment Clinical Trials
  Network
• Conducting studies of behavioral,
  pharmacological, and integrated behavioral and
  pharmacological treatment interventions of
  therapeutic effect in rigorous, multi-site
  clinical trials to determine effectiveness across
  a broad range of community-based treatment
  settings and diversified patient populations and
  
• Ensuring the transfer of research results to
  physicians, clinicians, providers, and patients.
• Regional Nodes
• Service providers attached to various regional
  nodes

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Discussion