diffusion of research in practice in substance abuse treatment: a knowledge adoption study of gender...
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Diffusion of research in practice in Substance Abuse Treatment: A knowledge adoption study
of gender sensitive treatment
Deborah Rugs, Ph.D.
Holly Hills, Ph.D.
Roger Peters, Ph.D.
University of South Florida
Louis de la Parte Florida Mental Health Institute
Department of Mental Health Law and Policy
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Tampa PIC
This CSAT/SAMHSA funded project seeks to “bridge the gap” between researchers, treatment providers, criminal justice professionals, policy makers, and consumers to improve service delivery to persons with substance use disorders involved the criminal justice system.
Funded Collaborative Partners include: FMHI/USF, DACCO, Inc., ACTS, Inc., Operation PAR, Inc., FADAA, and the Hillsborough County Sheriff’s Office
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Project Partners
Stakeholders Treatment Providers Researchers Policymakers Consumers
Liaison Groups Education/Training Community Support Services Self-Help, Faith Community
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Recruit stakeholders Establish formal organization Conduct needs assessment Develop locally defined
practice/research agenda Develop stakeholder-endorsed
implementation plan
Phase I: PIC Development
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Phase II:PIC Implementation
Infrastructure Support Network Enhancement Implement Knowledge Adoption Studies
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Knowledge Adoption (KA) Study Approach
KA Study foci identified through Community Needs Assessment
• Gender-Sensitive Treatment (GST)• Co-Occurring Disorders Treatment (CDT)
KA Study Goal: Test the effectiveness of implementing evidence-based clinical protocol identified in Pilot Study, through use of an Opinion Leader network
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Dissemination Method: Use of Opinion Leaders
Opinion Leaders are identified by peer counselors as respected for their knowledge in a particular topic area
Opinion Leaders are trained in the use of an evidence-based treatment curriculum
Opinion Leaders then train their peer counselors and supervise the application of the curriculum
Changes in counselor behaviors and attitudes are measured to determine the effectiveness of the Opinion Leader model
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Training & Consultation Activities: GST
1. Foundations training – 4 hours for Opinion Leaders and program counselors
2. Opinion Leader training – 1.5 days
3. Treatment counselor training conducted by Opinion Leaders– How to implement treatment protocol– For GST, up to four 2-hour sessions to cover all 25
topics
4. Group /Individual supervision – once a week– Conducted by Opinion Leaders for treatment
counselors
5. Ongoing supervision provided to Opinion Leaders– Conducted by Site Coordinators / Project staff– GST: Brown Bag Luncheons
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TrainedCounselors
N=30
Study Design: GST
Experimental GroupTampa N=42 Comparison Group
Orlando N=55
Opinion Leaders
N=9
CounselorsN=33
CounselorsN=55
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Model Interventions
Seeking Safety (Najavits, 2001) Concurrent Treatment of PTSD and
Cocaine Dependence (Brady et al., 2001)
Substance Dependence PTSD Therapy (Triffleman et al., 1999)
Triad Women’s Project (C. Clark, PI) Trauma Recovery and Empowerment
(TREM) (Harris, 1998)
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Seeking Safety (Najavits, 2002)
Structured interventions in manual format Organized around 25 trauma-related topics Integrates trauma & substance abuse For more information: Seeking Safety: A
Treatment Manual for PTSD and Substance Abuse (Guilford Press, 2002)
www.seekingsafety.org
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Where would you go for information about treating a female client with a history of trauma and substance abuse? How Helpful? (1) Not at all to (10) Extremely
0 1 2 3 4 5 6 7 8
Co-workers in Program
Books
Training Materials
C-workers w/in Agency
Conference Materials
Websites
Co-workers outside ofAgency
Tips
Consultants
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Where would you go for information about treating a female client with a history of trauma and substance abuse problems? How Often? (1) Never (2) Monthly (3) Weekly (4) Daily
0
0.5
1
1.5
2
2.5
3
3.5
Co
-wo
rker
sin
Pro
gra
m
Tra
inin
gM
ater
ials
Co
nfe
ren
ceM
ater
ials
Co
-wo
rker
so
uts
ide
of
Co
nsu
ltan
ts
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0
10
20
30
40
50
60
70
80
90
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
# Clients in Group
# G
rou
ps
Number of Clients in Seeking Safety Groups (405 Total Groups)
Average = 7.25 Clients per Group
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0 0 1 1
20 20
87 87 83 84
0102030405060708090
# O
L R
ati
ng
s
Reception of Manual
By Counselors
By Clients
Opinion Leaders’ Impressions of How Well the Modules Were Received?
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GST Counselor (N=38) Feedback on OL Process at Post
0
2
4
6
8
10
12
14
16
18
20
# C
oun
selo
rs
StronglyDisagree
Disagree Neutral Agree StronglyAgree
Using OL's is an Effective Way toTransfer Knowledge
I Would Recommend Using OL's as aRoutine Knowledge Transfer Strategyin my Organization
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Counselor (N=38) Difficulties with Implementing the Seeking Safety Groups
% N
Changing the Daily Schedule 40% 15
Preparing for the Groups 29% 11
Removing other Clinical Material from the Schedule
26% 10
Participating in Training 11% 4
Participating in Supervision 11% 4
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GST: Did Change Occur?
Post 6 Mo. follow-up
TPA Orlando TPA Orlando
Have you used the manual “Seeking Safety” in the past 6 months?
95% 41% 85% 41%
Will you be using the manual in the future 6 months
97% 82% 100% 93%
N 38 46 27 29
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GST: What Parts of the Manual will you be Using?
Percent saying "yes"
0
20
40
60
80
100
All of theManual
Some of theManual
InformationOnly
Post Tampa 6 mo Tampa Post Orlando 6 mo Orlando
**
Tampa vs. Orlando at post .001 signif
Tampa vs. Orlando at post .001 signif
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GST Post 6 mo % Opinion Leaders Remaining
100% 75%
% Counselors Remaining 72% 76%
Staff Attrition from Post Implementation to Follow Up