A qualitative investigation of addiction counselors' perceptions and experiences implementing an open-access model for treating opioid use disorder.
A qualitative investigation of addiction counselors' perceptions and experiences implementing an open-access model for treating opioid use disorder.
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成瘾咨询师实施开放获取模型治疗阿片类药物使用障碍的看法和经验的定性调查。
DOI：
10.1016/j.jsat.2020.108191
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发表时间：
2021-03
影响因子：
3.9
通讯作者：
Barry DT
中科院分区：
文献类型：
--
作者：
Oberleitner LMS;Madden LM;Muthulingam D;Marcus R;Oberleitner DE;Beitel M;Gaeta M;Tamberelli JF;Barry DT
研究成瘾咨询师实施美沙酮维持治疗（MMT）开放获取模式的看法和经验，该计划迅速招募预期患者，无论其支付能力如何，并提供实时访问多种自愿治疗方案。在2006年，当治疗计划最初实施这种模式时，到2020年，在研究地点接受美沙酮维持治疗的客户人数从1，431人增加到4，500人。参与者是31名成瘾咨询师，他们受雇于一家治疗机构，该机构采用开放获取模式来扩大MMT的规模。我们研究了辅导员的看法和经验的工作程序，采用这种模式，使用个人半结构化的采访，这是一个跨学科的团队录音，转录，并系统地编码使用扎根理论。该团队审查了主题并调和了分歧（评分员一致率为98%）。我们描述了超过10%的参与者报告的主题。咨询师描述了开放获取模式对客户的优势（例如，“根据客户需求个性化”），临床医生（例如，“更少的需求”），以及社区（例如，“犯罪率下降”）。顾问们还描述了开放获取模式对临床医生的不利影响（例如，“不均匀的工作负荷”）和客户端（例如，“需要为一些客户提供更密集的服务”），以及程序级关注（例如，“缺乏结构”）。在使用开放获取框架的阿片类药物治疗项目中工作的咨询师描述了对他们自己，他们的客户和公众的多种好处;他们还概述了他们自己和客户的缺点，研究应该进一步探索和解决，以促进MMT的规模扩大。
To examine addiction counselors’ perceptions and experiences of implementing an open-access model for methadone maintenance treatment (MMT), in which the program rapidly enrolled prospective patients, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options. Between 2006, when the treatment program initially implemented this model, and 2020, the census of clients receiving methadone maintenance at the study site grew from 1,431 to 4,500. Participants were 31 addiction counselors employed at a treatment organization that implemented an open-access model to scale up MMT. We examined counselors’ perceptions and experiences of working in programs that employed this model, using individual semi-structured interviews, which an interdisciplinary team audiotaped, transcribed, and systematically coded using grounded theory. The team reviewed themes and reconciled disagreements (rater agreement was 98%). We describe themes that more than 10% of participants reported. Counselors described perceived advantages of the open-access model for clients (e.g., “individualized to client needs”), clinicians (e.g., “fewer demands”), and the community (e.g., “crime reduced”). Counselors also described perceived disadvantages of the open-access model for clinicians (e.g., “uneven workload”) and clients (e.g., “need for more intensive services for some clients”), as well as program-level concerns (e.g., “perceived lack of structure”). Counselors who work in opioid treatment programs that use an open-access framework described multiple benefits to themselves, their clients, and the public; they also outlined disadvantages for themselves and clients, which research should further explore and address to facilitate MMT scale up.
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影响因子：
3.9
作者：
Gryczynski J;Schwartz RP;Salkever DS;Mitchell SG;Jaffe JH
通讯作者：
Jaffe JH
影响因子：
3.5
作者：
Jerant, AF;von Friederichs-Fitzwater, MM;Moore, M
通讯作者：
Moore, M
影响因子：
3.6
作者：
Jackson LA;Buxton JA;Dingwell J;Dykeman M;Gahagan J;Gallant K;Karabanow J;Kirkland S;LeVangie D;Sketris I;Gossop M;Davison C
通讯作者：
Davison C
影响因子：
120.7
作者：
Bodenheimer, T;Lorig, K;Grumbach, K
通讯作者：
Grumbach, K
影响因子：
6
作者：
Madden, Lynn M.;Farnum, Scott O.;Barry, Declan T.
通讯作者：
Barry, Declan T.