Differences in self and independent ratings on an organisational dual diagnosis capacity measure
ABSTRACT There are a number of tools to assist services to measure their capacity to respond to co-occurring substance use and mental health disorders. This study aimed to examine whether services could accurately self-rate their dual diagnosis capacity.
Data were collected from 13 alcohol and drug services across Australia that participated in a comorbidity capacity building initiative. The organisations provided a range of services, including pharmacotherapy and counselling services, residential and outpatient services, youth and adult services and withdrawal. There was a mix of government and non-government services.
Services rated themselves substantially higher than the independent raters at both baseline and follow up.
The results suggest that services may not accurately assess their own capacity. For organisations trying to make improvements in their services, independent assessment may be more helpful than self-assessment in accurately determining service gaps. Overestimation of capacity may lead to failure to address important service needs.
Full-textDOI: · Available from: Nicole Kathleen Lee, Aug 30, 2015
- SourceAvailable from: Erick Guerrero
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- "Finally, we relied on a key informant model with crossvalidation to collect data. Some studies have suggested relying on multiple informants to identify significant variability among staff members on organizational climate variables (Courtney et al. 2007) or reduce response bias from managers when asked to rate implementation of EBPs (e.g., Adams et al. 1999; Lee and Cameron 2009). However , other studies have found that the organizational readiness-for-change scales did not discriminate between responses of staff and supervisors, using aggregates in the final analysis (Saldana et al. 2007). "
ABSTRACT: Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed.Evaluation and program planning 06/2013; 40C:74-81. DOI:10.1016/j.evalprogplan.2013.05.002 · 0.89 Impact Factor
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- "This study examined changes in organisational capacity among drug and alcohol services after a whole of workforce capacity building approach. Although the study is limited by the pre-post test evaluation design and the small sample size, the DDCAT itself has been shown to be a robust measure of change in organisations (McGovern et al., 2007; Lee and Cameron, 2009; Matthews et al., 2011). It has been used in a number of community-based services, its psychometric properties have been confirmed and it is being increasingly used as a measure for quality improvement (McGovern et al., 2010). "
ABSTRACT: Purpose – Dissemination of good practice information to practitioners is one of the great challenges of the substance abuse treatment sector. The authors' understanding of the process by which research is translated is limited, but a whole of workforce approach is considered best practice. This paper aims to examine organisational change as a result of a workforce capacity-building program over six months. Design/methodology/approach – A total of 195 staff (nine service managers, 39 supervisors and 147 clinicians) in 13 alcohol and other drug (AOD) services across Australia participated in mental health screening and brief intervention training using PsyCheck. PsyCheck is designed to detect and address common mental health symptoms among drug treatment clients. The Dual Diagnosis Capability in Addiction Treatment (DDCAT) index was used to measure capacity before and after training. Findings – There was no significant difference between baseline and follow-up DDCAT scores; however, the level of PsyCheck implementation indicated improvement in DDCAT scores. Practical implications – The results show that where organisations implement the program successfully, capacity improves; where the program is not well implemented, capacity reduces. Successful implementers report a number of common elements: the screening tool was implemented into routine assessment; there was a single onsite ''champion'' supporting the implementation; and they worked with the staff and persisted with the implementation even where there was initial worker resistance. Originality/value – This paper provides the opportunity to assess workforce capacity building and the feasibility of utilising the DCCAT to measure co-occurring mental health and substance use disorders in Australian AOD services.11/2011; 4(4):190-197. DOI:10.1108/17570971111197201
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ABSTRACT: The Dual Diagnosis Capability of Addiction Treatment (DDCAT) index is used to assess the capacity of substance abuse services to work with individuals with co-occurring mental health problems. The current study aimed to: (i) examine the dual diagnosis capability of residential substance abuse programs in Australia; (ii) identify managers' perceptions regarding both priorities and confidence for change following the completion of the DDCAT; and (iii) to examine the usefulness of the DDCAT to residential substance abuse programs. The DDCAT was completed across 16 residential substance abuse units. An external researcher administered and scored the DDCAT. A Unit Manager from each site completed the Comorbidity Priorities and Confidence Survey following the completion of the DDCAT review. This survey examined the usefulness of the DDCAT, and the unit's priorities to improve its capability, and confidence to improve its DDCAT score. Across the services, program structure and staff training were the DDCAT domains that required the most improvement. While training was the highest endorsed priority area for improvement, program structure was the lowest priority. Overall the Unit Managers reported positive attitudes towards use of the DDCAT and were confident that their unit could improve their DDCAT scores. DDCAT scores of Australian residential substance abuse programs are comparable with previous published results. However, there is still substantial work required to improve the capability of these programs. Future research should examine strategies to promote sustained improvements in the capability of residential substance abuse programs.Drug and Alcohol Review 08/2010; 30(2):195-9. DOI:10.1111/j.1465-3362.2010.00215.x · 1.55 Impact Factor