Training Addiction Counselors to Implement an Evidence-Based Intervention: Strategies for Increasing Organizational and Provider Acceptance

Abstract

One barrier to widespread public access to empirically supported treatments (ESTs) is the limited availability and high cost of professionals trained to deliver them. Our earlier work from two clinical trials demonstrated that front-line addiction counselors could be trained to deliver a manualized, group-based cognitive behavioral therapy (GCBT) for depression, a prototypic example of an EST, with a high level of adherence and competence. This follow-up article provides specific recommendations for the selection and initial training of counselors, and for the structure and process of their ongoing clinical supervision. Unique challenges in working with counselors unaccustomed to traditional clinical supervision are highlighted. The recommendations are based on comprehensive feedback derived from clinician notes taken throughout the clinical trials, a focus group with counselors conducted one year following implementation, and interviews with key organization executives and administrators.

Smoking Cessation and Electronic Cigarettes in Community Mental Health Centers: Patient and Provider Perspectives

“…Despite increased emphasis on smoking intervention in the society and medical community, the introduction of the EHR in to the CMHC clinics, evidence continues to show that smoking is an especially concerning problem for people with SMI, leveraging the great opportunity offered by smokers making healthcare visits to CMHCs, these results require that we shift current practice by identifying interventions that enhance both provider practices and patient outcomes. To implement the evidence-based practice, we need not only healthcare system interventions to promote consistent use of 5As (Adsit et al 2014; Curry 2000; Lindholm et al 2010; Papadakis et al 2010) to address the barrier ‘lack of time’ but also provider training on evidence-based intervention to address the barrier ‘lack of training’ as effective quality improvement strategies (Andrews et al 2001; Bentz et al 2007; Bluestone et al 2013; Kelley et al 2001; Nicol et al 2011; Ostroff et al 2014; Schmidt et al 2012; Woo et al 2013; Ziedonis et al 2008). We should see this as a significant opportunity to reduce smoking and its harms in this high-risk, underserved population.…”

More Practice, Less Preach? The Role of Supervision Processes and Therapist Characteristics in EBP Implementation

“…Even though anecdotal examples of the critical role of coaching and supervision in EBP implementation abound within the mental health literature (Murray, Southerland, Farmer, & Bellentine, 2010; Reinke, Stormont, Webster-Stratton, Newcomer, & Herman, 2012; Woo et al, 2012), this process has not been subjected to much systematic research. An exception to this is Multisystemic Therapy (MST), one of the few scientifically supported treatments to be effectively implemented into multiple, independent service settings (Henggeler et al, 2002; Schoenwald, Sheidow, & Chapman, 2009; Schoenwald, Sheidow, & Letourneau, 2004).…”

Training Substance Use Disorder Counselors in Cognitive Behavioral Therapy for Depression: Development and Initial Exploration of an Online Training Program

“…Use of embedded videos and interactive formats can replicate elements of in-person training that have been recommended in the literature (Woo, et al, 2013).…”

“…While visible organizational support is key in encouraging adoption of EBPs (Sanders & Turner, 2005;Woo, et al, 2013), additional barriers at the individual clinician level can also hamper dissemination efforts. Like their administrative counterparts, busy practitioners also have concerns about the time and expense associated with EBP training (Lewis & Simons, 2011;Riley et al, 2007;R.…”

“…6 EBP relevance through application to actual clinical examples in training (Gunter & Whittal, 2010;Lewis & Simons, 2011;Sanders & Turner, 2005; R. E. Stewart, et al, 2012;Stirman, et al, 2004;Woo, et al, 2013).…”