Moving empirically supported practices to addiction treatment programs: recruiting supervisors to help in technology transfer.

Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001 ; Roman and Johnson, 2002 ; Willenbring et al., 2004 ). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported practice (ESP) for addiction. Federal funding supports this Web course and a randomized controlled trial to evaluate its effectiveness. Since supervisors often play a pivotal role in helping clinicians transfer learned skills from training courses to the workplace, the authors recruited supervisor-counselor teams, engaging 54 supervisors and 120 counselors. Lessons learned focus on supervisor recruitment and involvement, supervisors' perceptions of CBT, their own CBT skills and their roles in the study, and implications for technology transfer for the addiction field as a whole. Recruiting supervisors proved difficult because programs lacked clinical supervisors. Recruiting counselors was also difficult because programs were concerned about loss of third-party reimbursement. Across the addiction field, technology transfer will be severely hampered unless such infrastructure problems can be solved. Areas for further investigation are identified.

Training substance abuse treatment organizations to adopt evidence-based practices: the Addiction Technology Transfer Center of New England Science to Service Laboratory.

Underutilization of evidence-based treatments for substance abuse represents a longstanding problem for the field and the public health of our nation. Those who would most benefit from research advances (community treatment agencies and the clients they serve) have historically been the least likely to be exposed to innovative evidence-based methods for substance abuse treatment. To help address this gap, the Addiction Technology Transfer Center of New England (ATTC-NE), located at Brown University, has adapted and implemented an organizational change strategy intended to equip substance abuse treatment organizations and their employees with the skills needed to adopt evidence-based treatment practices. Since 2003, the ATTC-NE has worked with 54 community-based substance abuse treatment agencies from across New England using this model, which is called Science to Service Laboratory (SSL). Twenty-eight of 54 agencies completed all of the SSL components, and 26 of these 28 completer agencies (96%) successfully adopted and implemented contingency management as a result. Survey data comparing completer and dropout agencies' satisfaction with the quality, organization, and utility of the SSL indicate that both groups rated the SSL favorably. However, differences emerged with respect to organizational characteristics between completer and dropout agencies. Specifically, dropout agencies were more likely to report turnover in staff positions vital to training effort. Future directions for the model are discussed.

Partnerships and pathways of dissemination: the National Institute on Drug Abuse-Substance Abuse and Mental Health Services Administration Blending Initiative in the Clinical Trials Network.

Since 2001, the National Drug Abuse Treatment Clinical Trials Network (CTN) has worked to put the results of its trials into the hands of community treatment programs, in large part through its participation in the National Institute on Drug Abuse-Substance Abuse and Mental Health Services Administration Blending Initiative and its close involvement with the Center for Substance Abuse Treatment's Addiction Technology Transfer Centers. This article describes (a) the CTN's integral role in the Blending Initiative, (b) key partnerships and dissemination pathways through which the results of CTN trials are developed into blending products and then transferred to community treatment programs, and (c) three blending initiatives involving buprenorphine, motivational incentives, and motivational interviewing. The Blending Initiative has resulted in high utilization of its products, preparation of more than 200 regional trainers, widespread training of service providers in most U.S. States, Puerto Rico, and the U.S. Virgin Islands and movement toward the development of Web-based implementation supports and technical assistance. Implications for future directions of the Blending Initiative and opportunities for research are discussed.

A novel CBT Web course for the substance abuse workforce: community counselors' perceptions.

This article describes (a) a Web-based course for substance abuse counselors on cognitive behavioral therapy (CBT), and (b) the evaluation of a prototype module from the Web-based course to determine the feasibility of the e-learning program for a community-based counselor audience. The course is part of a unique study that trains counselor-supervisor teams to increase the transfer of learned skills to the agency. Following curriculum design, the authors sought counselor reactions to the prototype module on strengths/limitations of the design, functionality, and effectiveness. Results showed that counselors learned new information, found this format effective compared to other training, and wanted to complete a full CBT Web course. Counselors' evaluation led to content and technology changes: the authors added and segmented material aimed at the advanced, more theoretically oriented counselor, and housed these topics behind an "advanced concept" graphics button; added seven screens to accommodate text broken into smaller units; and increased the difficulty of the end-of-module quiz.

Report of recommendations: the Annapolis Coalition Conference on Behavioral Health Work Force Competencies.

In May 2004, the Annapolis Coalition on Behavioral Health Workforce Education convened a national meeting on the identification and assessment of competencies. The Conference on Behavioral Health Workforce Competencies brought leading consumer and family advocates together with other experts on competencies from diverse disciplines and specialties in the fields of both mental health care and substance use disorders treatment. Aided by experts on competency development in business and medicine, conference participants have generated 10 consensus recommendations to guide the future development of workforce competencies in behavioral health. This article outlines those recommendations. A collaborative effort to identify a set of core or common competencies is envisioned as a key strategy for advancing behavioral health education, training, and other workforce development initiatives.