Agency context and tailored training in technology transfer: A pilot evaluation of motivational interviewing training for community counselors
Agency context and tailored training in technology transfer: A pilot evaluation of motivational interviewing training for community counselors
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DOI：
10.1016/j.jsat.2009.01.003
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发表时间：
2009-09-01
影响因子：
3.9
通讯作者：
Dunn, Chris
中科院分区：
文献类型：
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作者：
Baer, John S.;Wells, Elizabeth A.;Dunn, Chris
很少有实证研究可用于指导将循证治疗转移给社区药物滥用提供者的最佳做法。为了最大限度地学习和维护新的临床技能，本研究测试了一个上下文定制的培训（CTT）模型，该模型使用标准化的患者演员在角色扮演定制机构的临床背景下，重复的实践和反馈周期，并加强组织支持。本研究报告的结果随机试点评估CTT的动机访谈（MI）。研究人员随机分配社区药物滥用治疗机构接受CTT或标准的2天MI研讨会。本研究还评估了辅导员和组织层面的变量对MI学习的影响。没有条件之间的差异，观察到收购和维护MI技能，尽管报告更高的满意度，更昂贵的上下文定制的模型。分析显示，那些辅导员更多的正规教育和较少的认可的疾病模型成瘾的MI技能的最大收益，无论培训条件。同样，个别顾问认为他们的组织更开放的变化和自治的支持较少的机构显示出更大的平均工作人员在MI技能的收益，再次，无论培训方法。机构内支持不断学习和实施管理信息系统的培训后活动对组织对变革的开放性产生了影响。这项试点研究表明，量身定制的培训方法可能不会产生更好的结果比传统的讲习班，以获取基于证据的做法，并努力提高技能的获取可以集中在学习者的特点和持续的组织支持学习。(C)2009 Elsevier Inc. All rights reserved.
Few empirical studies are available to guide best practices for transferring evidenced-based treatments to community substance abuse providers. To maximize the learning and maintenance of new clinical skills, this study tested a context-tailored training (CTT) model, which used standardized patient actors in role-plays tailored to agency clinical context, repetitive cycles of practice and feedback, and enhanced organizational support. This study reports the results of a randomized pilot evaluation of CTT for motivational interviewing (MI). Investigators randomly assigned community substance abuse treatment agencies to receive either CTT or a standard 2-day MI workshop. The study also evaluated the effects of counselor-level and organizational-level variables on the learning of MI. No between-condition differences were observed on the acquisition and maintenance of MI skills despite reported higher satisfaction with the more costly context-tailored model. Analyses revealed that those counselors with more formal education and less endorsement of a disease model of addiction made the greatest gains in MI skills, irrespective of training condition. Similarly, agencies whose individual counselors viewed their organization as being more open to change and less supportive of autonomy showed greater average staff gains in MI skills, again, irrespective of training method. Posttraining activities within agencies that supported the ongoing learning and implementation of MI mediated the effects of organizational openness to change. This pilot study suggests that tailored training methods may not produce better outcomes than traditional workshops for the acquisition of evidence-based practice, and that efforts to enhance skill acquisition can be focused on characteristics of learners and ongoing organizational support of learning. (C) 2009 Elsevier Inc. All rights reserved.