Implementing evidence-based practices in community treatment programs: initial feasibility of a counselor "toolkit"

Area of Science:

• Addiction Treatment
• Clinical Psychology
• Health Services Research

Background:

• Community substance abuse programs face challenges adopting evidence-based therapies due to limited training budgets and supervision.
• Counseling predominantly occurs in group settings, posing a barrier to implementing complex therapeutic skills.

Purpose of the Study:

• To assess the feasibility, acceptability, and sustainability of a "toolkit" approach for delivering evidence-based interventions in community substance abuse treatment.
• To evaluate the effectiveness of a "Decisional Balance" toolkit, derived from Motivational Interviewing, in a real-world clinical setting.

Main Methods:

• A feasibility trial was conducted across 6 community-based substance abuse treatment programs.
• The toolkit included a DVD, counselor guide, patient worksheets, and wallet cards for the Decisional Balance exercise.
• The study involved 26 counselors and 210 patients, assessing satisfaction and sustained use of toolkit components.

Main Results:

• High satisfaction rates were reported: 97% of patients and 100% of counselors were satisfied with the toolkit session.
• A significant majority of patients (84%) desired more sessions utilizing the toolkit.
• Sustained use was high, with 96% of counselors using toolkit components 3 months post-intervention without prompting.

Conclusions:

• A curriculum-based toolkit approach is a viable and attractive method for disseminating evidence-based therapies in community substance abuse treatment.
• This approach effectively translates complex therapeutic concepts for counselors with minimal additional training.
• The "Decisional Balance" toolkit demonstrated high acceptability and sustainability, suggesting potential for broader implementation.