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The Treatment Effectiveness Assessment (TEA)

Authors:
Walter Ling at University of California, Los Angeles
Walter Ling
David Farabee
David Farabee
David Farabee
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Dagmar Liepa
Dagmar Liepa
Dagmar Liepa
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Li-Tzy Wu at Duke University School of Medicine
Li-Tzy Wu
  • Duke University School of Medicine
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Abstract

Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu3 1Integrated Substance Abuse Programs, University of California, Los Angeles, CA, 2Valley Care Medical Center, Panorama City, CA, 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA We have been surprised and gratified by the readers’ responses to our article, The Treatment Effectiveness Assessment (TEA): an efficient, patient-centered instrument for evaluating progress in recovery from addiction, which was published in December 2012.1 In the six months since that time, we have received numerous questions and observations about the article, and about the TEA instrument. Respondents were clinicians: physicians, counselors, therapists, nurses; as well as administrators and policy makers. View original paper by Ling W, Farabee D, Liepa D, Wu LT.
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Substance Abuse and Rehabilitation 2013:4 73–74
Substance Abuse and Rehabilitation
The Treatment Effectiveness Assessment (TEA)
Walter Ling1
David Farabee1
Dagmar Liepa2
Li-Tzy Wu3
1Integrated Substance Abuse
Programs, University of California,
Los Angeles, CA, 2Valley Care
Medical Center, Panorama City,
CA, 3Department of Psychiatry
and Behavioral Sciences, School of
Medicine, Duke University Medical
Center, Durham, NC, USA
Correspondence: Walter Ling
Integrated Substance Abuse Programs,
University of California, Los Angeles,
CA, USA
Tel +1 310 267 5888
Fax +1 310 312 0552
Email lwalter@ucla.edu
Dear editor
We have been surprised and gratified by the readers’ responses to our article, The
Treatment Effectiveness Assessment (TEA): an efficient, patient-centered instrument
for evaluating progress in recovery from addiction, which was published in December
2012.1 In the six months since that time, we have received numerous questions and
observations about the article, and about the TEA instrument. Respondents were
clinicians: physicians, counselors, therapists, nurses; as well as administrators and
policy makers. The comments below respond to several of the frequently asked ques-
tions and issues.
Can the form that appears at the end of the article be used to administer the
TEA? Yes, the form can be used to record the TEA scores and there is no fee or
charge to use it.
How do you use the TEA for baseline assessment? The TEA can be used at any
evaluation point, including at baseline, and all you need to do is specify for yourself
the timeframe, and for what purpose you are using it. For baseline, you merely note
that the form is a first TEA, thus constituting baseline data. The questions can be
asked as to how serious the problems are in the four domains, in which case a higher
score means the problem is worse, which is the opposite of the TEA scoring during
treatment, when reporting a higher score means more improvement since last TEA (or
other timeframe). To make the scores consistent across administrations, the questions
can be phrased at baseline to indicate how well the respondent is managing or coping
with the four life domains.
What kind of validation has been done to establish the TEA as a useful instru-
ment? As mentioned in the article, future research can validate the TEA with actual
objective data, such as urine drug tests, health records, employment records, pay stubs
and tax returns, arrest records, etc. We have baseline TEA and ASI data on about
300 patients in a recently completed trial. A preliminary examination of the data sets
showed significant correlation in the right direction between the two instruments,
recognizing that while the data reflect similar life dimensions they are not exact
comparisons, except in urine drug testing, where the two perform equally well. Future
research will be needed to validate TEA with other independently collected data.
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What is the best use of the TEA? The TEA is meant first for
clinicians, but it can be adapted for research, provided that
the researchers agree on some standardization of operational
matters. The TEA can help the clinician focus on the critical
issues in the patient’s life, especially the most relevant mat-
ters (as identified by the patient). The TEA allows clinicians
to also ask the patients to voice what they think is the most
important change in their lives. You can think of others as
well.
Can the TEA be used as a diagnostic instrument? The TEA
was not designed as a diagnostic instrument which requires
specifics; it is a guided global assessment tool that is meant
to measure patient-oriented, patient-centered changes.
Why is the TEA seemingly so simple? The simplicity of the
TEA is highly deceptive because the approach actually takes
advantage of the most complex structure and function in the
universe: the computing power of an individual’s brain. It has
been estimated that there are more neuronal connections in
the human brain than there are stars in the Milky Way.2 This
massive power couched in a “simple” instrument ensures
that the TEA can be used with anyone having mild to severe
substance use disorders, as long as he or she can find his or
her way to their doctor or clinic. The chronic drug effects
that we see in our patients should not distort the value of
the results. While the TEA may seem simple and quick, its
efficiency has not come by way of sacrificing quality. The
simplicity of the TEA is, in fact, an acknowledgment of the
power of the brain. Moreover, a brief instrument will likely
appeal to clinicians more than a lengthy one.
What’s Next? We believe the general approach used by the
TEA can be adapted to quickly screen for drug use problems
among individuals in settings such as primary care clinics
and student health facilities. We hope to have something to
offer our readers in the near future.
Disclosure
The authors report no conflicts of interest in this work.
References
1. Ling W, Farabee D, Liepa D, Wu LT. The Treatment Effectiveness
Assessment (TEA): an efficient, patient-centered instrument for
evaluating progress in recovery from addiction. Subst Abuse Rehabil.
2012;3:129–136.
2. The Astronomist. Available from: http://theastronomist. fieldofscience.
com/2011/07/cubic-millimeter-of-your-brain.html. Accessed May 20,
2012.
submit your manuscript | www.dovepress.com
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74
Ling et al
... Shortly after the 2012 publication we received many queries about the TEA, some of which were addressed in a Letter to the Editor published in 2013. 2 One frequent question has to do with its use at "baseline" and its subsequent use as a status report. To address that issue more definitively, we are presenting this updated TEA (see Supplementary Materials), which has been slightly rephrased to make it more suitable for use at baseline while remaining wholly suitable for subsequent use to measure the patient's progress during treatment and recovery. ...
An Updated Version of the Treatment Effectiveness Assessment (TEA) [Letter]
Article
Full-text available
  • Feb 2020
Walter Ling,1 David Farabee,2,3 Vijay R Nadipelli,4 Brian Perrochet3 On behalf of the TEA Development Group1Department of Family Medicine, Center for Behavioral and Addiction Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA; 2Department of Population Health, New York University School of Medicine, New York, NY, USA; 3Department of Psychiatry and Biobehavioral Sciences Semel Institute, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA; 4Global Health Economics and Outcome Research, Indivior Inc., Richmond, VA, USACorrespondence: Walter Ling Tel +1 310 993 8111Email lwalter@ucla.edu The authors are pleased to provide this updated version of the TEA to the community of clinicians and researchers using the TEA. Previous to its original publication in 2012,1 the TEA had been used for five years by clinicians in office-based and hospital-based treatment settings, as well as by researchers in pilot projects. The TEA’s utility and psychometrics were recently studied in a large clinical trial of extended-release buprenorphine for opioid use disorder, demonstrating moderate to strong reliability and validity.3 The TEA has been widely adopted by researchers and clinicians in the United States and around the world. It has been translated into Spanish, Chinese, Lithuanian, and Arabic, and is being used in Europe, Asia, the Americas, and the Middle-East.View the original paper by Ling and colleagues
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The fields of addiction medicine and addiction research have long sought an efficient yet comprehensive instrument to assess patient progress in treatment and recovery. Traditional tools are expensive, time consuming, complex, and based on topics that clinicians or researchers think are important. Thus, they typically do not provide patient-centered information that is meaningful and relevant to the lives of patients with substance use disorders. To improve our ability to understand patients' progress in treatment from their perspectives, the authors and colleagues developed a patient-oriented assessment instrument that has considerable advantages over existing instruments: brevity, simplicity, ease of administration, orientation to the patient, and cost (none). The resulting Treatment Effectiveness Assessment (TEA) elicits patient responses that help the patient and the clinician quickly gauge patient progress in treatment and in recovery, according to the patients' sense of what is important within four domains established by prior research. Patients provide both numerical responses and representative details on their substance use, health, lifestyle, and community. No software is required for data entry or scoring, and no formal training is required to administer the TEA. This article describes the development of the TEA and the initial phases of its application in clinical practice and in research.
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Available from: http://theastronomist. fieldofscience. com/2011/07/cubic-millimeter-of-your-brain.html. Accessed
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  • The Astronomist
The Astronomist. Available from: http://theastronomist. fieldofscience. com/2011/07/cubic-millimeter-of-your-brain.html. Accessed May 20, 2012.