If you build it, they will come: statewide practitioner interest in contingency management for youths.
ABSTRACT 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.
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ABSTRACT: Propensity score matching (PSM) is used to examine the effectiveness of Multisystemic Therapy compared with Functional Family Therapy (FFT) in a multiyear statewide sample of juvenile offenders. Outcomes include offenses and violations of probation during service and 12-month recidivism. Salient selection effects including delinquent peer associations, substance use, and lack of adherence to parental rules, as well as strong correlates of the outcome measures (risk assessment scores, age at first offense, most serious prior offense) and pertinent demographics, were controlled for in the PSM. Results indicate few significant differences in the effectiveness of the two modalities, with the exception that female youth receiving FFT have lower recidivism and low risk youth receiving FFT have fewer offenses/violations of probation during service provision.Criminal Justice and Behavior 01/2015; 41(9):1033-1056. DOI:10.1177/0093854814543272 · 1.71 Impact Factor
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ABSTRACT: In 2011, the Veterans Administration called for nationwide implementation of contingency management (CM) in its intensive outpatient substance use disorders treatment programs, and this study evaluated the impact of the initial 1 and ½ day training workshops on knowledge and perceptions about CM among 159 clinical leaders from 113 clinics. Workshop attendance significantly increased CM-related knowledge (d=1.88) and changed attendees' perceptions of CM (ds=0.26-0.74). Endorsement of barriers to CM adoption decreased and positive impressions of CM increased. These perceptions about CM emerged as key correlates of post-training preparedness to implement CM. Results suggest that training workshops can be an effective avenue for increasing CM-related knowledge, as well as addressing persistent misperceptions about CM that may impede adoption efforts. Continued efforts to introduce educational materials and offer training and consultation opportunities may increase understanding about this evidence-based intervention among clinicians, thereby leading to improved patient outcomes.Journal of substance abuse treatment 09/2013; 45(3):306-12. DOI:10.1016/j.jsat.2013.03.003 · 2.90 Impact Factor
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ABSTRACT: In the treatment of addictions, the gap between the availability of evidence-based therapies and their limited implementation in practice has not yet been bridged. Two empirically validated behavioral therapies, contingency management (CM) and cognitive behavioral therapy (CBT), exemplify this challenge. Both have a relatively strong level of empirical support but each has weak and uneven adoption in clinical practice. This review highlights examples of how barriers to their implementation in practice have been addressed systematically, using the Stage Model of Behavioral Therapies Development as an organizing framework. For CM, barriers such as cost and ideology have been addressed through the development of lower-cost and other adaptations to make it more community friendly. For CBT, barriers such as relative complexity, lack of trained providers, and need for supervision have been addressed via conversion to standardized computer-assisted versions that can serve as clinician extenders. Although these and other modifications have rendered both interventions more disseminable, diffusion of innovation remains a complex, often unpredictable process. The existing specialty addiction-treatment system may require significant reforms to fully implement CBT and CM, particularly greater focus on definable treatment goals and performance-based outcomes.Annals of the New York Academy of Sciences 09/2014; 1327. DOI:10.1111/nyas.12501 · 4.31 Impact Factor