scholarly journals Evaluating the Impact of Training Health Professionals to Deliver Brief Motivational and Skills-Based Interventions for Cannabis Use Disorder

2012 ◽  
Vol 2 ◽  
Author(s):  
Dion Alperstein ◽  
Jan Copeland

Background: While there is considerable evidence that brief motivational and skills-based interventions for substance use are effective, little is known regarding the transfer of knowledge from research to practice. This study aims to evaluate the effectiveness of two half-day didactic clinical training workshops for allied health workers, which did not incorporate feedback or supervision, via independent follow-up three months post training.Methods: In total, 1322 participants attended either or both of the evidence-based treatment workshops run by the National Cannabis Prevention and Information Centre. Of those participants, 495 (37%) completed an online follow-up evaluation three months later regarding their use of the newly learnt intervention(s).Results: At follow-up, 270 (54.5%) participants had an opportunity to use the skills and 144 (53.3%) of those participants reported having used the clinical skills taught in the workshop. Of those who used one of the interventions, 90 (62.5%) participants reported their clients had reduced or quit their cannabis use. Furthermore, 43 (30%) of these participants had attempted to train others in the workplace in the techniques learnt in the workshop.Conclusion: Even a half-day didactic clinical training workshop on evidence-based brief cognitive–behavioural techniques delivered to clinicians working in the field can improve knowledge and confidence among clinicians and outcomes among their clients with cannabis use related problems.

Author(s):  
N.M. Gamage ◽  
C. Darker ◽  
B.P. Smyth

Objectives: Adolescents with substance use disorders (SUDs) exhibit high rates of comorbid psychological problems. This study aimed to examine the impact of an outpatient substance use treatment programme upon the psychological wellbeing of adolescents. Methods: A prospective study was carried out examining psychological symptoms in a group of adolescents attending the Youth Drug and Alcohol (YoDA) Addiction Service in Dublin. Participants were treated with evidenced based psychological models such as cognitive behavioural therapy, motivational interviewing and systemic family therapy. The Becks Youth Inventory was utilised to assess psychological symptoms at treatment entry and repeated three months later at follow up. Results: Among 36 adolescents who were included in this study, poly-substance misuse was the norm. Almost three-quarter had a cannabis use disorder (CUD). There were significant reductions in mean subscale scores of depression (56.0 to 50.8, p = 0.003), anger (55.2 to 49.5, p < 0.001) and disruptive behaviour (61.6 to 56.5, p = 0.002) at follow up. Although there wasn’t a statistically significant reduction in mean scores for anxiety, we observed a significant proportion of participants (p = 0.008) improving and moving out of a moderate to severe symptom range when examined by category. This was also the case for self-concept (p = 0.04). Furthermore this study revealed a positive correlation between the reduction in days of cannabis use and reduction in depressive scores (Pearson correlation 0.49, p = 0.01) among those with a CUD. Conclusion: The findings indicate that substance use treatment for adolescents is associated with important psychological and behavioural improvements.


2017 ◽  
Vol 8 (2) ◽  
pp. 116 ◽  
Author(s):  
Julie Worley ◽  
Kathleen R. Delaney

Objective: To analyze science and practice surrounding nursing approaches to substance use disorders (SUDs) and make recommendations for the future.Methods: A review of literature and topics related to healthcare provider stigma, science surrounding SUDs, nursing approaches to SUDs in education and practice and evidence based treatment was conducted, analyzed and synthesized.Results: Stigma is embedded in nursing approach to SUDs, up to date information regarding SUDs is not widely disseminated or practiced in nursing.Conclusions: To reduce the impact of stigma and to bring nurses into the “turning the Tide” movement requires an understanding of how beliefs root stigma, building knowledge related to SUDs as an illness, and expansion of nurses' skill when intervening with individuals dealing with SUDs.


Author(s):  
Stephen Knoble ◽  
Anil Pandit ◽  
Bibek Koirala ◽  
Laxmi Ghimire

A representative, cross-sectional clinical skills assessment of 163 mid-level, rural-based, government health care workers was conducted in four districts of Nepal in June 2007. All Health Assistants and Auxiliary Healthcare Workers within the target districts were scored using checklists of standardized key skills in clinical encounters with model patients or clinical models. Participant scores were reported as a mean percentage in adult medicine 28(%), pediatric medicine 56(%), maternity medicine 35(%), orthopedic medicine 45(%), clinical procedures 59(%), and management 46(%). This was measured against the government’s 60(%) standard on clinical skills. There was little significant difference between categories of health workers by district of posting or years of experience. There was a minor difference in skills by level of facility - workers in higher level facilities scored better across the domains. Reasons for poor performance in clinical skills were attributed to a lack of clinical in-service training programs, training only focusing on prevention and public health, and poor on-sight supervision. Poor pre-service schooling factors included heavy theory concentration in pathophysiology and inadequate clinical exposure opportunities. Recommendations for the improvement of clinical skills and decision-making include the institution of in-service competency-based training with a high emphasis on real patient exposure. Pre-service recommendations include implementation of a national certification program and an expansion of the current government clinical training sites and clinical teacher development programs.


2020 ◽  
Vol 45 (3) ◽  
pp. 175-181
Author(s):  
Andrew G. Guzick ◽  
Sophie C. Schneider ◽  
Eric A. Storch

Abstract Despite a rapidly growing understanding of hoarding disorder (HD), there has been relatively limited systematic research into the impact of hoarding on children and adolescents. The goal of this paper is to suggest future research directions, both for children with hoarding behaviours and children living in a cluttered home. Key areas reviewed in this paper include (1) the need for prospective studies of children with hoarding behaviours and those who grow up with a parent with HD; (2) downward extensions of cognitive-behavioural models of adult HD that emphasise different information processing and behavioural biases in youth HD; (3) developmental research into the presentation of emerging HD in childhood compared with adulthood presentations of the disorder, with consideration of typical childhood development and unique motivators for childhood saving behaviours; (4) developmentally sensitive screening and assessment; and (5) the development of evidence-based treatments for this population. The paper concludes with a discussion of methodological suggestions to meet these aims.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Ladner ◽  
S D Mihailescu ◽  
D Cerasuolo

Abstract Background Rouen University Hospital implements a policy of health promotion hospital since 2016. The objective of this study was to evaluate prospectively the impact of physical activity promotion in hospital health workers (HW), using pedometers over a period of six months. Methods Physical activity was measured by electronic pedometers distributed to HW, with the aim to improve their physical activity and to measure it during six months. Online questionnaires collected at different points of follow-up, from inclusion to sixth month (a total of seven points of follow-up). Socio-demographic and characteristics on type of health work were collected as well as the number of steps and the behavior regarding their routine physical activity. Results A total of 680 HW were included in the cohort. The sex ratio M:W was 0.16. The mean age was 41.6 years (SD = 10.7). 44.0% were non-medical caregivers, 32.1% were in administrative section, 14.3% were technical workers and 9.7% were physicians or pharmacists; 53.7% of HW reported doing sport regularly. At inclusion the mean number of daily steps was 8662. The mean progression for all professional profiles between first week and sixth month was of 1082 steps daily, with difference according to position: 1319 in physicians, 1234 in non-medical caregivers, 1106 in administrative workers and 314 in technical workers. In linear regression model, the mean number of progression of daily steps was 964 in physicians, 752 in non-medical caregivers. Conclusions The study shows a significant increase in the number of daily steps measured objectively using an incentive tool, as pedometer during six months of intervention. Further researches are needed to determine if these changes are sustainable over a long period of time Key messages Despite high level of daily steps at baseline, the longitudinal study shows an increase of daily steps over a 6-month period. Such public health intervention is a relevant method to engage people in self-monitoring their physical activity.


2008 ◽  
Vol 32 (5) ◽  
pp. 183-186 ◽  
Author(s):  
David Meagher ◽  
Ananth Pullela ◽  
Marek Meisinger ◽  
Niamh Geaney ◽  
Sinead O'Brien

Aims and MethodWe studied the impact of an evidence-based multidisciplinary intervention to reduce six sub-optimal aspects of psychotropic prescribing, combined as a Prescribing Practice Quality (PPQ) score over a 5-year follow-up period in a community mental health service.ResultsSub-optimal prescribing practices were significantly reduced after 1 year and these improvements were sustained at 5-year follow-up. The PPQ scores were significantly reduced (P<0.001) in both the overall population attending at each follow-up point as well as in the ever-present population (n=163). Use of high-dose antipsychotics and thioridazine ceased entirely; use of sedative hypnotic agents was less amenable to reduction.Clinical ImplicationsMultifaceted interventions can achieve sustained improvements in prescribing practices in real-world settings.


2019 ◽  
Vol 28 (2) ◽  
pp. 104-113 ◽  
Author(s):  
Rosemary D. Meza ◽  
Nathaniel Jungbluth ◽  
Georganna Sedlar ◽  
Prerna Martin ◽  
Lucy Berliner ◽  
...  

Examining the nature and determinants of evidence-based treatment (EBT) modification is an important step toward understanding the impact of modifications and informing modification guidelines. We examined the prevalence, types, reasons for, and predictors of clinician-reported modification to cognitive behavioral therapy (CBT) for children and adolescents. Ninety-eight clinicians trained in CBT completed surveys on their intent to modify CBT, perceptions of CBT characteristics, confidence in their ability to appropriately deliver CBT in complex clinical situations, and organizational EBT implementation climate post-training. Post-consultation, clinicians self-reported the types and reasons for modifications they performed. Ninety-three percent of clinicians reported they modified CBT, primarily with fewer than half of their clients. Client needs and clinician preference or style accounted for the highest proportion of modification reasons. The number of reported modifications performed was predicted by clinician confidence in their ability to deliver CBT appropriately ( b = .90, p = .01) and their intent to modify ( b = .55, p = .01).


2012 ◽  
Vol 29 (2) ◽  
pp. 77-96 ◽  
Author(s):  
Jarrod S. Turner ◽  
David J. Leach

Behavioural Activation (BA) therapy is a stand-alone evidence-based treatment for depression and also is being applied to anxiety with promising outcomes. Essentially, BA involves structured therapy aimed at increasing the amount of activity in a person's daily life, so that he or she comes into contact with sources of positive reinforcement for clinically healthy behaviours. Originally, contemporary BA was developed as a behaviour therapy treatment condition in a study that compared BA to Cognitive Behavioural Therapy (CBT). Over time, many variants of BA have appeared in the published literature, which included techniques that might be viewed as being incompatible with the original intended treatment model and more similar to generic forms of CBT. The purpose of this article is to provide researchers and practitioners with a description of what we consider to be the distinctive and essential elements of BA therapy.


2017 ◽  
Vol 41 (S1) ◽  
pp. S136-S137
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
M. Fernández Rodríguez ◽  
D. Abejas Díez ◽  
...  

IntroductionThe association between cannabis and psychosis makes crucial the intervention on cannabis use disorder at first episodes of psychosis (FEP), especially among young population. In this group of patients, the harmful potential of cannabis is more evident by its influence on neurodevelopment. However, the nature of the association cannabis-psychosis is not clearly described. It seems to represent a mediating factor for an increased risk of psychosis in healthy and high-risk populations, determining an earlier age of onset and worsening long term outcome.ObjectivesTo assess the impact of cannabis in terms of functional and clinical prognosis in patients recruited after a FEP.Material and methodsPAFIP is an early intervention program for early stages of psychosis. One hundred and sixty-three were included, followed-up at regular intervals of six months for three years with administration of clinical and functional scales (BPRS, SAPS, SANS, CDRS, GAF and Drake). Patients were divided into three groups: (1) those non-users neither before the onset nor during follow-up (nn) PEP, (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences were observed in terms of functionality at three-year follow-up endpoint but a trend to a better-preserved functionality in the sn group. The sn group presented lower scores in scales for positive symptoms with respect to the comparison groups.ConclusionsThe interruption in cannabis use may have a beneficial effect on short-term clinical prognosis and functionality on long term.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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