Therapist predictors of treatment delivery fidelity in a community-based trial of 12-step facilitation.

Background And Aims: Therapist characteristics may be associated with variation in consistency, quality and effectiveness of treatment delivery. We examined associations between treatment fidelity and therapist education, experience, treatment orientation and perceived skills in a randomized, multi-site trial of Twelve Step Facilitation (TSF).

Methods: Raters scored audio-recorded, TSF sessions (n = 966; 97% of TSF sessions) from 32 community-based, trained therapists for adherence, competence, empathy and global session performance.

Clinician attitudes, social norms and intentions to use a computer-assisted intervention.

The National Drug Abuse Treatment Clinical Trials Network (CTN) works to bridge the gap between research and practice and tested a Web-delivered psychosocial intervention (the Therapeutic Education System, TES) in 10 community treatment centers. Computer-assisted therapies, such as Web-delivered interventions, may improve the consistency and efficiency of treatment for alcohol and drug use disorders. Prior to the start of the study, we surveyed counselors (N=96) in participating treatment centers and assessed counselor attitudes, perceived social norms and intentions to use a Web-delivered intervention.

Standardized patient walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: common challenges to protocol implementation.

Background: Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation.

Objectives: Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials.

Do students falsify information in clinical notes?

If students report information in a post-encounter note that was allegedly not obtained from the patient, they may be suspected of serious professional misconduct, ie, deliberate falsification of patient data. Over-reporting during a clinical assessment may result in accusations of cheating and even lead to failure of a high-stakes examination. Despite these serious implications, the prevalence and reasons for over-reporting are not clear.

Adolescent substance abuse treatment: Organizational change and quality of care.

Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues impacted treatment delivery. Programs report organizational change efforts with implications for future process improvement initiatives.

Medicaid reimbursement for screening and brief intervention for substance misuse.

Objectives: Effective January 2008, state Medicaid plans may reimburse for screening and brief intervention for alcohol and drug misuse. This study assessed state Medicaid activity to implement Healthcare Common Procedure Code System codes and pay for screening and brief intervention.

Methods: State and District of Columbia Medicaid representatives (N=44) participated in semistructured telephone interviews (N=37) or provided e-mail correspondence (N=7) about implementation of reimbursement codes.

Clinical perception: a study of intimate partner violence versus methamphetamine use as presenting problems.

This study draws on theory by Solomon Asch (1946, 1952) to examine how presenting with intimate partner violence versus methamphetamine use shapes characteristics of substance abuse assessment interviews. When responding to an initial open-ended question from a substance abuse counselor, the methamphetamine user and intimate partner violence survivor may elicit very different reactions from the counselor. We predicted that these differing presenting problems would initiate different trajectories for overall impression formation.

Evaluating and training substance abuse counselors: a pilot study assessing standardized patients as authentic clients.

Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients.

Implementation of evidence-based practices for treatment of alcohol and drug disorders: the role of the state authority.

The current climate of increasing performance expectations and diminishing resources, along with innovations in evidence-based practices (EBPs), creates new dilemmas for substance abuse treatment providers, policymakers, funders, and the service delivery system. This paper describes findings from baseline interviews with representatives from 49 state substance abuse authorities (SSAs). Interviews assessed efforts aimed at facilitating EBP adoption in each state and the District of Columbia.

Using a standardized patient walk-through to improve implementation of clinical trials.

This report describes a standardized patient (SP) walk-through to facilitate implementation of a clinical trial within the National Drug Abuse Treatment Clinical Trials Network (CTN). SPs are actors trained to portray a set of symptoms consistently across interactions with multiple clinicians. The Oregon/Hawaii Node of the CTN employed one SP to pilot participant screening processes in a study testing a combined pharmacological and behavioral therapy for women and men dependent on prescription opioid analgesics.