TRANSFERRING DRUG ABUSE TREATMENT AND ASSESSMENT RESOURC

需要改进将新技术和研究成果转化为药物滥用治疗的一般做法的方法。该提案代表了德克萨斯基督教大学（TCU）在过去10年中开展的工作的直接延伸，该工作旨在开发和实施认知和行为干预措施，以提高客户参与度和社区治疗项目的结果。它在概念上是综合的，并侧重于(1)治疗期间客户参与和表现的测量，(2)解决客户特殊需求的干预手册，(3)基于认知的工具来改进咨询，以及(4)增加客户早期参与的行为协议。然而，将这些基于研究的创新转化为实践，需要对“组织因素和过程”进行新的研究。我们建议对动机准备、个人属性、机构资源和组织氛围进行系统评估（即由项目主管和临床工作人员进行），作为一系列技术转移研究的预测因素，这些研究将重点放在治疗项目管理和服务提供的4个维度上。通过与德克萨斯州酒精和药物滥用委员会（TCADA）及其资助的由193个药物滥用项目组成的大型全州网络的合作，计划开展一系列相互关联的研究。实施结果的后续调查将基于从工作人员收集的信息以及参与项目的客户提供的相关TCADA记录。我们的目标是：(1)基于项目领导者和员工的动机和个性属性、机构资源和组织氛围，开发一个组织变革准备的综合评估工具；(2)记录该工具在不同类型创新中的预测有效性；(3)研究组织准备随时间的变化与旨在提高动机的干预措施的关系。(4)开发和测试针对不同变革准备程度的转移策略的有效性；(5)评估不同复杂性、咨询需求和组织资源需求的创新的不同转移策略的差异有效性；(6)在采取干预措施部分或完全失败的情况下，确定所涉及的原因。

Methods for transferring new technology and research findings into the general practice of substance abuse treatment are in need of improvement. This proposal represents a direct extension of work conducted over the past 10 years at Texas Christian University (TCU) for developing and implementing cognitive and behavioral interventions that improve client engagement and outcomes in community-based treatment programs. It is conceptually integrated and focuses on (1) measurement of client engagement and performance during treatment, (2) intervention manuals that address special needs of clients, (3) a cognitive-based tool to improve counseling, and (4) a behavioral protocol for increasing early engagement of clients. Transferring these research-based innovations to practice, however, requires new studies of "organizational factors and process." We propose the development of systematic assessments (i.e., from the program director and clinical staff) of motivational readiness, personal attributes, institutional resources, and organizational climate to use as predictors in a series of technology transfer studies that will focus on 4 dimensions of treatment program management and service delivery. Through collaboration with the Texas Commission on Alcohol and Drug Abuse (TCADA) and the large state-wide network of 193 substance abuse programs it funds, a set of interrelated studies are planned. Follow-up surveys of implementation outcomes will be based on information collected from staff as well as related TCADA records from clients at participating programs. Our objectives are to (1) develop a comprehensive assessment instrument of organizational readiness for change, based on motivation and personality attributes of program leaders and staff, institutional resources, and organizational climate, (2) document the predictive validity of this instrument across different types of innovations, (3) examine changes in organizational readiness over time in relation to interventions designed to raise motivation, (4) develop and test the effectiveness of transfer strategies that address different levels of readiness for change, (5) assess the differential effectiveness of various transfer strategies for innovations that vary in complexity, counseling demands, and organizational resource requirements, and (6) in the case of partial or complete failure to adopt an intervention, identify the reasons involved.