Development and initial evaluation of the Brief Addiction Monitor (BAM).

This project developed and tested a 17-item monitoring instrument covering important substance use related behaviors to support measurement-based care and outcomes assessment. The study consisted of two phases, an instrument development phase and an initial study to examine its psychometric properties. Participants were 175 patients entering VA outpatient substance abuse treatment. The findings revealed that this Brief Addiction Monitor (BAM) exhibited acceptable characteristics. Exploratory factor analysis yielded three summary factors; recovery protection, physical and psychological problems, and substance use and risk. The root mean square error of approximation estimate was acceptable and the factors had alpha values exceeding or approaching 0.70. All three factors were sensitive to change and had excellent test-retest reliability. Predictive validity was demonstrated for two factors; recovery protection, and substance use and risk. At the item level, there was little indication of inappropriate response patterns. Change over time was significant for most items, and test-retest reliability was acceptable for nearly all items. Additional research is warranted to further establish the BAM's reliability, validity and usefulness.

What does not work? Expert consensus on discredited treatments in the addictions.

Evidence-based practice promotes those research-supported treatments that have proven effective, but it rarely identifies discredited treatments that are to be avoided. We sought to establish a professional consensus on discredited addiction treatments using Delphi methodology. A panel of 75 experts participated in a 2-stage study, reporting familiarity with 65 treatments and rating these on a continuum from "not at all discredited" to "certainly discredited." We report their composite opinions and significant differences that occurred as a function of the panelists' theoretical orientation. The results require careful interpretation, but do offer a cogent first step in identifying a professional consensus of discredited treatments for addictions.