TRANSFERRING DRUG ABUSE TREATMENT AND ASSESSMENT RESOURC

将新技术和研究成果转化为治疗药物滥用的一般做法的方法需要改进。这项建议代表了德克萨斯基督教大学(TCU)过去10年来开展的工作的直接延伸，目的是开发和实施认知和行为干预措施，以提高客户在社区治疗计划中的参与度和结果。它在概念上是集成的，重点是(1)测量客户在治疗期间的参与度和表现，(2)解决客户特殊需求的干预手册，(3)改善咨询的基于认知的工具，以及(4)增加客户早期参与度的行为规范。然而，将这些以研究为基础的创新转化为实践，需要对“组织因素和过程”进行新的研究。我们建议发展对激励准备、个人属性、机构资源和组织氛围的系统评估(即来自项目主任和临床工作人员)，作为一系列技术转移研究的预测指标，这些研究将集中在治疗计划管理和服务交付的四个维度上。通过与德克萨斯州酒精和药物滥用委员会(TCADA)及其资助的193个药物滥用项目的大型全州网络的合作，计划进行一系列相互关联的研究。对执行结果的后续调查将基于从工作人员那里收集的信息以及参与方案的客户的相关TCADA记录。我们的目标是：(1)基于项目领导和员工的动机和个性属性、机构资源和组织氛围，开发组织变革准备情况的综合评估工具；(2)记录该工具在不同类型创新中的预测有效性；(3)检查组织准备情况随时间的变化，与旨在提高动机的干预措施相关；(4)开发和测试针对不同变革准备程度的转移战略的有效性；(5)评估不同转移战略对不同复杂性、咨询需求和组织资源要求的创新的不同有效性；以及(6)在部分或完全未能采取干预措施的情况下，确定涉及的原因。

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.