Barriers to implementing evidence-based practices in addiction treatment programs: Comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy

2011 ◽  
Vol 34 (4) ◽  
pp. 382-389 ◽  
Author(s):  
M. Amodeo ◽  
L. Lundgren ◽  
A. Cohen ◽  
D. Rose ◽  
D. Chassler ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Motivational Interviewing ◽  
Assertive Community Treatment ◽  
Addiction Treatment ◽  
Behavioral Therapy ◽  
Community Treatment ◽  
Treatment Programs ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Community Reinforcement Approach

A Model for Sustaining Evidence-Based Practices in a Statewide System

2017 ◽  
Vol 98 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Jason M. Lang ◽  
Kellie G. Randall ◽  
Michelle Delaney ◽  
Jeffrey J. Vanderploeg
Keyword(s):  
Public Health ◽  
Cognitive Behavioral Therapy ◽  
Quality Indicators ◽  
Behavioral Therapy ◽  
Health Impact ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
The Public ◽  
The Past ◽  
Large Systems

Over the past 20 years, efforts have been made to broadly disseminate evidence-based practices (EBPs). However, the public health impact of EBPs has yet to be realized and most EBPs are not sustained. Few structured models exist for disseminating and sustaining EBPs across large systems. This article describes the EBP Dissemination and Support Center (DSC) model and how it was used to sustain trauma-focused cognitive behavioral therapy (TF-CBT) across Connecticut. More than 600 clinicians at 35 agencies have been trained and nearly all agencies have sustained TF-CBT for up to 9 years. More than 6,200 children have received TF-CBT and have shown improvements in outcomes and quality indicators. Recommendations are made for using or adapting the DSC model.

Commentary

2016 ◽  
pp. 108-118
Author(s):  
Lauren J. Hoffman ◽  
Elaina A. Zendegui ◽  
Brian C. Chu
Keyword(s):  
Mixed Methods ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Evidence Base ◽  
Cognitive Behavioral ◽  
Treatment Programs ◽  
Evidence Based ◽  
Unique Role ◽  
Youth Anxiety ◽  
New Directions

The work of Thastum and his colleagues (this volume) presents exciting new directions for improving the robustness and accessibility of evidence-based services. Their chapter describes efforts to replicate evidence-based cognitive-behavioral therapy (CBT) treatment programs from one country, Australia, to another, Denmark, which contributes to the ever-expanding evidence base for global applicability of CBT for youth anxiety. We comment on the contributions of this replication trial and its implications for further dissemination of evidence-based practice across the globe, in addition to the unique role that mixed methods can play in this effort....

scholarly journals Statewide implementation of high-fidelity recovery-oriented ACT: A case study

2021 ◽  
Vol 2 ◽  
pp. 263348952199493
Author(s):  
Heidi Herinckx ◽  
Alyssa Kerlinger ◽  
Karen Cellarius
Keyword(s):  
Assertive Community Treatment ◽  
Technical Assistance ◽  
Outcome Data ◽  
Community Treatment ◽  
Evidence Based ◽  
High Fidelity ◽  
Minimum Level ◽  
High Quality ◽  
Evidence Based Practices

Background: Assertive Community Treatment (ACT) is a recognized evidence-based practice, but the use of Translation Science to ensure the broad implementation of high quality ACT services has not yet been fully explored. This single intrinsic case study explores how Oregon uses strategies identified through Translation Science to achieve statewide implementation of high-fidelity recovery-oriented ACT. Method: Multiple data sources were used to evaluate this implementation process, including ACT fidelity review reports, programmatic outcome data, a national ACT taskforce survey, and focus groups with program participants. Findings: In 2013, the Oregon Health Authority funded the creation of the Oregon Center of Excellence for Assertive Community Treatment to support the implementation of ACT. It also implemented administrative rules requiring an annual re-certification process with a minimum level of fidelity to the evidence-based model. Other implementation strategies included establishing an ACT Advisory Committee, quarterly reviews of implementation and outcome data, and trainings promoting the role of peer providers and related evidence-based practices. Conclusion: High-fidelity recovery-oriented ACT services in Oregon are maintained through multiple strategies, including codifying the minimum level of ACT implementation into state administrative rule, linking fidelity benchmarks scores to Medicaid reimbursements, and funding ongoing oversight, training and technical assistance through a statewide technical assistance center. Strict adherence to the ACT model has been a key to ensuring a uniform level of high-quality care across Oregon while incorporating additional evidence-based practices without compromising the integrity of the original model. Plain language abstract: Assertive Community Treatment (ACT) is a mental health program serving individuals with the most severe mental illness in the community. While ACT is an evidence-based practice, there is more research needed to explore how ACT is implemented and maintained in different settings. In 2013, Oregon implemented ACT statewide. The Oregon Center of Excellence for ACT was created to provide training and technical assistance to ACT teams and conduct yearly fidelity reviews. Oregon is among the few states who have attached funding to yearly ACT certification, uses community sizes to determine the size of the ACT teams, and the technical assistance center not only provides training but also conducts yearly review of fidelity to the ACT model. This case study will review the steps Oregon took to implement ACT, how it continues to monitor fidelity to the model and provide training and support, and focus on recovery orientation and integrating evidence-based practices. Continued support, training, and the linking of fidelity benchmark scores to program funding are the ways that Oregon makes sure that ACT teams are successfully implementing the ACT model to fidelity with recovery-oriented care.

scholarly journals Changes in community clinicians’ attitudes and competence following a transdiagnostic Cognitive Behavioral Therapy training

2021 ◽  
Vol 2 ◽  
pp. 263348952110302
Author(s):  
Torrey A Creed ◽  
Margaret E Crane ◽  
Amber Calloway ◽  
Thomas M Olino ◽  
Philip C Kendall ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
System Level ◽  
Evidence Based ◽  
Plain Language ◽  
Evidence Based Practices ◽  
Change Models ◽  
Intensive Training ◽  
Clinician Attitudes

Background: Although the literature suggests that attitudes toward evidence-based practices (EBPs) are associated with provider use of EBPs, less is known about the association between attitudes and how competently EBPs are delivered. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Methods: Community clinicians ( N = 891) received intensive training in cognitive behavioral therapy skills followed by 6 months of consultation. Clinician attitudes were assessed using the Evidence-Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data were analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase). Results: Latent change models identified significant improvement in attitudes ( Mslatent change ⩾ 1.07, SEs ⩽ 0.19, zs ⩾ 6.85, ps < .001) and competence ( Mslatent change ⩾ 13.13, SEs ⩽ 3.53, zs ⩾ 2.30, ps < .001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop phase and across the full training ( bs ⩾ 1.58, SEs ⩽ 1.13, z ⩾ 1.89, p < .048, β ⩾ .09); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in the consultation phase ( b = 1.40, SE = 1.07, z = 1.31, p = .19, β = .08). Change in attitudes and change in competence in the training period, the workshop phase, and the consultation phase were not significantly correlated. Conclusions: Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training. Following participation in initial training workshops, other factors such as subjective norms, implementation culture, or system-level policy shifts may be more predictive of change in competence throughout consultation. Plain Language Summary Although previous research has suggested that a learner’s knowledge of evidence-based practices (EBPs) and their attitudes toward EBPs may be related, little is known about the association between a learner’s attitudes and their competence in delivering EBPs. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following training in an EBP. This study suggests that community clinicians’ initial attitudes about evidence-based mental health practices are related to how well they ultimately learn to deliver those practices. This finding suggests that future implementation efforts may benefit from directly targeting clinician attitudes prior to training, rather than relying on more broad-based training strategies.

Implementing Evidence-Based Practices in Community Treatment Programs: Initial Feasibility of a Counselor “Toolkit”

2009 ◽  
Vol 30 (3) ◽  
pp. 239-243 ◽  
Author(s):  
Deni Carise ◽  
Adam Brooks ◽  
Arthur Alterman ◽  
A. Thomas McLellan ◽  
Valerie Hoover ◽  
...  
Keyword(s):  
Community Treatment ◽  
Treatment Programs ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Community Treatment Programs

Schools and Approaches to Psychotherapy

2017 ◽  
Author(s):  
Kathleen Someah ◽  
Christopher Edwards ◽  
Larry E. Beutler
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavior Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Positive Effects ◽  
New Approaches ◽  
The Many ◽  
Sheer Number

There are many approaches to psychotherapy, commonly called “schools” or “theories.” These schools range from psychoanalytic, to variations of insight- and conflict-based approaches, through behavioral and cognitive behavioral approaches, to humanistic/existential approaches, and finally to integrative and eclectic approaches. Different and seemingly new approaches typically have been informed by older and more established ones. For instance, cognitive behavioral therapy (CBT), one of the more widely used approaches, evolved from traditional behavior therapy but has become sufficiently distinct by adding its own complex variations so as functionally to represent an approach of its own. New approaches abound both in number and in complexity. Modern clinicians have had to become increasingly widely read and creative in trying to understand the ways in which patients may be helped. The sheer number of approaches, which has climbed into the hundreds, has challenged the field to find ways of ensuring that the treatments presented are effective. The advent of Evidence Based Practices (EBP) throughout the healthcare fields has placed the responsibility on those who advocate for particular types of treatment scientifically to demonstrate their efficacy and effectiveness. While this movement has brought standards to the field and has offered some assurance that psychotherapy is usually helpful, there remains much debate about whether the many different schools produce different results from one another. The debate about how best to optimize positive effects of psychotherapy continues, and there remain many questions to be asked of psychotherapy theories and of research on these approaches.

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