Implementing Evidence-Based Practices in Community Treatment Programs: Initial Feasibility of a Counselor "Toolkit"
Implementing Evidence-Based Practices in Community Treatment Programs: Initial Feasibility of a Counselor "Toolkit"
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DOI：
10.1080/08897070903041194
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发表时间：
2009-01-01
期刊：
影响因子：
3.5
通讯作者：
Forman, Robert
中科院分区：
文献类型：
--
作者：
Carise, Deni;Brooks, Adam;Forman, Robert
社区药物滥用治疗计划在采用“循证”治疗方法方面面临许多障碍。培训预算不足以获得复杂的技能，几乎没有可用的临床监督，几乎所有的咨询都是在小组会议中进行的。作者采用了一种在教学领域广泛使用的方法--为特定主题开发资源工具包，在这种情况下，动机访谈的循证治疗方法中经常使用决策平衡练习。这个试验工具包包括一张DVD(在分组期间电视播放以说明临床概念)、一份叠层咨询师指南(在小组期间为咨询师提供指导和谈话要点)，以及一些供患者保留关键点的工作表和钱包卡片(见表1)。一项可行性试验评估了来自6个基于社区的药物滥用治疗计划的26名咨询师和210名患者的“决策平衡”概念工具包的可接受性和可持续性。绝大多数患者(97%)和所有咨询师(100%)表示他们对工具包会议感到满意；84%的患者表示他们希望有更多像工具包会议这样的小组。几乎所有的咨询师(96%)在首次接触后3个月仍在使用该工具包的至少一个组件，没有任何提示。工具包基于课程的方法可能是一种可行和有吸引力的方法，可以将核心概念从复杂的循证治疗转化为当代社区治疗计划中的咨询师，只需最少的培训。
Community substance abuse treatment programs face many barriers to adopting "evidence-based" therapies. Training budgets are inadequate to permit acquisition of complex skills, there is little clinical supervision available, and almost all counseling is done in group sessions. The authors adopted an approach widely used in the teaching field-developing a resource "toolkit" for a specific topic, in this case, a Decisional Balance exercise often used in the evidence-based treatment approach of Motivational Interviewing. This trial toolkit was comprised of a DVD (televised during group to illustrate the clinical concept), a laminated counselor guide (to provide guidance and talking points for the counselor during group), and some worksheets and wallet cards for patients to retain key points (see Table 1). A feasibility trial assessed the acceptability, and sustainability of the "Decisional Balance" concept toolkit among 26 counselors and 210 of their patients, from 6 community-based substance abuse treatment programs. The great majority of patients (97%) and all counselors (100%) reported they were satisfied with the toolkit session; 84% of patients said they would like more groups like the toolkit session. Almost all counselors (96%) were still using at least one component of the toolkit 3 months after their initial exposure with no prompting. The toolkit curriculum-based approach may be a viable and attractive way of translating core concepts from sophisticated evidence-based therapies into use by counselors within contemporary, community-based treatment programs with minimal training.