Research on the diffusion of evidence-based treatments within substance abuse treatment: A systematic review

Chestnut Health Systems, 448 Wylie Dr., Normal, IL 61761, USA.
Journal of substance abuse treatment (Impact Factor: 2.9). 12/2008; 36(4):376-99. DOI: 10.1016/j.jsat.2008.08.004
Source: PubMed


This article provides a comprehensive review of research studies that have examined the diffusion of evidence-based treatments (EBTs) within the field of substance abuse treatment. Sixty-five research studies were identified and were grouped into one of three major classifications: attitudes toward EBTs, adoption of EBTs, and implementation of EBTs. This review suggests significant progress has been made with regard to the advancement of the fields' knowledge about attitudes toward and the extent to which specific EBTs have been adopted in practice, as well as with regard to the identification of organizational factors related to EBT adoption. In an effort to advance the substance abuse treatment field toward evidence-based diffusion practices, recommendations are made for greater use of methodologically rigorous experimental or quasi-experimental designs, psychometrically sound instruments, and integration of quantitative and qualitative data collection.

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Available from: Bryan R Garner, Jul 28, 2014
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    • "The ''gap'' between the use of treatment practices that have been shown to be effective in the empirical literature and what is being practiced by clinicians (Arthur & Blitz, 2000) appears to be narrowing at least for some EBPs and under certain conditions. A review of the research published between 1998 and 2008 generally found more positive attitudes and support for psychosocial EBPs than pharmacological EBPs (Garner, 2009). National surveys of attitudes toward buprenorphine, which was approved by the FDA in 2002 for the treatment of opiate dependence, have changed from 81% of physicians being uncomfortable prescribing buprenorphine (West et al., 2004) and 86% of counselors not being aware of the effectiveness of buprenorphine to more positive attitudes toward and greater knowledge about the effectiveness of pharmacological EBPs following trainings and involvement in research networks (Knudsen, Ducharme, & Roman, 2007; McCarty, Rieckmann, Green, Gallon, & Knudsen, 2004). "
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    ABSTRACT: Over the past decade, substance abuse treatment professionals have begun to implement evidence-based practices (EBPs) into the treatment of substance use disorders. There is a growing body of research on the diffusion of EBP in addiction treatment; however, less is known about individual state initiatives to implement EBPs among community providers. The current study aimed to evaluate the progress of an initiative of the Mississippi Department of Mental Health (MDMH) to increase the implementation of evidence-based substance abuse treatment practices by certified providers. In addition, the study examines potential barriers to implementing these practices. To accomplish this goal, we reported the findings of two surveys of Mississippi addiction professionals conducted in 2010 and in 2013. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jun 2015 · Evaluation and program planning
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    • "Through this initiative, the treatment planning M.A.T.R.S. guidelines (Measurable , Attainable, Time-limited, Realistic and Specific treatment objectives) were developed to promote the use of evidence-based instruments and the activation of appropriate treatment services (Condon et al., 2008;Garner, 2009;NIDA, 2012;Rossello et al., 2010;Stilen et al., 2007). The guidelines have been used to align evidence-based practices endorsed by NIDA and SAMHSA, including assessment of persons in the criminal justice system, and have also been used by the United Nations' " Treatnet " network to help disseminate evidence-based practices internationally (Garner, 2009;Rossello et al., 2010). A continuum of four core assessment practice domains (Measurement/Instrumentation, Case Plan Integration, Conveyance/Utility , Service Activation/Delivery) were identified for use in the current study as practical focal areas in which to implement the M.A.T.R.S. guidelines (Shafer et al., 2014). "
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    ABSTRACT: This implementation study examined the impact of an organizational process improvement intervention (OPII) on a continuum of evidence based practices related to assessment and community reentry of drug-involved offenders: Measurement/Instrumentation, Case Plan Integration, Conveyance/Utility, and Service Activation/Delivery. To assess implementation outcomes (staff perceptions of evidence-based assessment practices), a survey was administered to correctional and treatment staff (n=1509) at 21 sites randomly assigned to an Early- or Delayed-Start condition. Hierarchical linear models with repeated measures were used to examine changes in evidence-based assessment practices over time, and organizational characteristics were examined as covariates to control for differences across the 21 research sites. Results demonstrated significant intervention and sustainability effects for three of the four assessment domains examined, although stronger effects were obtained for intra- than inter-agency outcomes. No significant effects were found for Conveyance/Utility. Implementation interventions such as the OPII represent an important tool to enhance the use of evidence-based assessment practices in large and diverse correctional systems. Intra-agency assessment activities that were more directly under the control of correctional agencies were implemented most effectively. Activities in domains that required cross-systems collaboration were not as successfully implemented, although longer follow-up periods might afford detection of stronger effects. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Apr 2015 · Drug and alcohol dependence
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    • "In contrast, use of medications in other psychiatric illnesses is common (Pincus et al., 1998; Wu, Wang, Katz, & Farley, 2013). Potential reasons for underutilization of addiction medications include patient and clinician-related barriers, such as doubts about treatment effectiveness by both clinicians and patients, clinicians' lack of knowledge or comfort in delivering the treatment, differing philosophies about the role of addiction medications in assisting addiction recovery, stigma, and patients' reluctance to take them (Friedmann & Schwartz, 2012; Garner, 2009; Roman, Abrahama, & Knudsen, 2011). Systems-related barriers for underutilization may include separate and uncoordinated systems of medical and addiction care, limitations in access to care, lack of institutional support, and inadequate administrative and personnel infrastructures (McLellan & Meyers, 2004; Samet, Friedmann, & Saitz, 2001; Walley et al., 2008). "
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    ABSTRACT: People with addictive disorders commonly do not receive efficacious medications. Chronic care management (CCM) is designed to facilitate delivery of effective therapies. Using data from the CCM group in a trial testing its effectiveness for addiction (N=282), we examined factors associated with the prescription of addiction medications. Among participants with alcohol dependence, 17% (95% CI 12.0-22.1%) were prescribed alcohol dependence medications. Among those with drug dependence, 9% (95% CI 5.5-12.6%) were prescribed drug dependence medications. Among those with opioids as a substance of choice, 15% (95% CI 9.3-20.9%) were prescribed opioid agonist therapy. In contrast, psychiatric medications were prescribed to 64% (95% CI 58.2-69.4%). Absence of co-morbid drug dependence was associated with prescription of alcohol dependence medications. Lower alcohol addiction severity and recent opioid use were associated with prescription of drug dependence medications. Better understanding of infrequent prescription of addiction medications, despite a supportive clinical setting, might inform optimal approaches to delivering addiction medications. Copyright © 2014 Elsevier Inc. All rights reserved.
    Full-text · Article · Dec 2014 · Journal of Substance Abuse Treatment
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