Addressing the science-service gap, we examined in this study the amenability of a large heterogeneous sample of community-based therapists in the state mental health and substance abuse treatment sectors to learn about an evidence-based practice (EBP) for adolescent substance abuse (i.e., contingency management [CM]) when such learning was supported administratively and logistically. Leadership in most (44 of 50) public sector agencies supported practitioner recruitment, and 432 of 543 eligible practitioners subsequently attended a 1-day workshop in CM. Workshop attendance was predicted by organizational factors but not by practitioner demographic characteristics, professional background, attitudes toward EBPs, or service sector. Moreover, the primary reason for workshop attendance was to improve services for adolescent clients; the primary barriers to attendance, for those who did not attend, were practical in nature and not due to theoretical incompatibility. The findings demonstrate a considerable amount of interest practitioners showed in both the substance abuse and mental health sectors in learning about an EBP.
"Experimental manipulations of specific parameters of prize CM procedures await further investigation, but these results, in conjunction with those of Ghitza et al. (2008), indicate that a better understanding of how probabilities and earnings impact outcomes is important. As CM is growing in acceptability (Kellogg et al., 2005; Henggeler et al., 2007, 2008; Squires, Gumbley, & Storti, 2008), results from such studies may have substantial clinical implications for the design and dissemination of the most efficacious and costeffective CM procedure for use in community settings. "
[Show abstract][Hide abstract] ABSTRACT: Contingency management (CM) treatments that provide patients with the opportunity to earn chances of winning prizes of varying magnitudes are becoming increasingly popular. In the CM literature, magnitude of reinforcement is linked with effect sizes, such that CM treatments that provide larger magnitude reinforcement are more efficacious than those that provide lower magnitude reinforcement. With prize CM, even when magnitudes of overall expected prize earnings are constant, some patients win more prizes than others. Thus, patients who win larger overall amounts of prizes during treatment may have better outcomes than those who win fewer prizes. This study evaluated the impact of overall amounts of prizes won on long-term abstinence outcomes. The dollar amount of prizes won during prize CM treatments was determined from 78 cocaine-abusing methadone-maintenance patients who were randomized to prize CM treatments in three clinical trials. Abstinence three months following the end of the CM intervention was the primary dependent variable. The dollar amount of prizes won during CM treatment was a significant predictor of submission of cocaine-negative urine samples and self-reports of cocaine abstinence at the follow-up evaluation, even after controlling for other variables associated with long-term abstinence, such as pretreatment urinalysis results and longest duration of abstinence achieved during treatment. These results suggest that magnitudes of earnings during prize CM may impact outcomes and call for further experimentation of parameters related to the efficacy of prize CM.
[Show abstract][Hide abstract] ABSTRACT: A better understanding of clinicians’ attitudes toward evidence-based treatments (EBT) will presumably enhance the transfer of EBTs for substance-abusing adolescents from research to clinical application. The reliability and validity of two measures of therapist attitudes toward EBT were examined: the Evidence-Based Practice Attitude Scale (Aarons, 20041.
Aarons , G. A. ( 2004 ). Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS). Mental Health Services Research , 6 , 61 – 74 . [CrossRef], [PubMed]View all references), and Attitudes Toward Psychotherapy Treatment Manuals Scale (Addis & Krasnow, 20003.
Addis , M. E. , & Krasnow , A. D. ( 2000 ). A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. Journal of Consulting and Clinical Psychology , 68 , 331 – 339 . [CrossRef], [PubMed], [Web of Science ®], [CSA]View all references). Participants included 543 public sector, master's-level mental health and substance abuse therapists who treat adolescents. Factor analyses generally corroborated factor structures of the instruments found previously. Beliefs that EBTs negatively affect treatment process were associated with relatively low openness to new treatments and with beliefs that EBTs do not produce positive outcomes.
"While several studies have reported that treatment staff interest in and attitudes toward treatment services, including EBPs, influence the extent to which they are adopted by treatment agencies (Fuller et al., 2007; Henggeler et al., 2007; Kirby et al., 2006; Simpson et al., 2007), the literature examining administrator attitudes is limited except for recent work by Fuller et al. (2007), Moore et al. (2004), Munoz-Plaza et al. (2006), and Willenbring et al. (2004). These studies tend to find that administrators support EBP adoption but also perceive that in order to effectively adopt EBPs, they would need to address barriers such as insufficient staff time and staff's lack of knowledge or skills in EBP use. "
[Show abstract][Hide abstract] ABSTRACT: This study applied latent class analysis (LCA) to examine heterogeneity in criminal justice administrators' attitudes toward the importance of substance abuse treatment relative to other programs and services commonly offered in criminal justice settings. The study used data collected from wardens, probation and/or parole administrators, and other justice administrators as part of the National Criminal Justice Treatment Practices survey (NCJTP), and includes both adult criminal and juvenile justice samples. Results of the LCA suggested that administrators fell into four different latent classes: (1) those who place a high importance on substance abuse treatment relative to other programs and services, (2) those who place equal importance on substance abuse treatment and other programs and services, (3) those who value other programs and services moderately more than substance abuse treatment, and (4) those who value other programs and services much more than substance abuse treatment. Latent class membership was in turn associated with the extent to which evidence-based substance abuse treatment practices were being used in the facilities, the region of the country in which the administrator worked, and attitudes toward rehabilitating drug-using offenders. The findings have implications for future research focused on the impact that administrators' attitudes have on service provision as well as the effectiveness of knowledge dissemination and diffusion models.
Drug and alcohol dependence 08/2009; 103 Suppl 1:S7-16. DOI:10.1016/j.drugalcdep.2008.10.001 · 3.42 Impact Factor
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