Promoting Adoption of EBPs in Addiction Treatment

描述(由申请人提供)： 在成瘾服务中，科学和实际做法之间的差距是众所周知的。康涅狄格州负责精神健康和药物滥用的单一州机构--精神健康和成瘾服务部(DMHAS)已经开始利用科学为行为健康提供者提供精神健康服务。这一进程涉及在变革进程中代表多个利益攸关方的社区一级指导委员会；重新审议政策和程序以及临床实践；与专家顾问进行培训；以及加强执行持续临床监督的能力。与此同时，该机构正在发展自己的能力，不断监测护理质量，包括使用循证做法(EBPS)。目前，DMHAS缺乏必要的工具，如客户一级的工具，来监测EBPS的适当使用和相关结果。拟议的项目将：(1)测试向社区机构推出循证方案的模式，其中包括机构的投标和对变革准备情况的评估；(2)调整目前用于传播心理健康循证方案的技术转让战略，用于转让成瘾技术；以及(3)开发一种工具和程序，以良好的保真度监测正在进行的循证方案的使用，并与结果数据相联系。具体地说，DMHAS将通过特定模式治疗(动机增强疗法-认知行为疗法，MET-CBT)的信息和营销过程选择一个社区机构；协助选定的机构建立一个咨询委员会；提供MET-CBT和临床监督方面的培训；将通过标准的临床医生级别的监督观察和自我评级机制监测MET-CBT的忠诚度；并将这些评级与目标机构(n=250)和对照机构(n=250)向活跃客户提供的客户级别措施的结果进行比较，以验证客户级别的监测量表。流程评估将跟踪整个转移流程的成功和问题，并将使用成本计算来确定模型所需的资源。将通过使用行政数据来估计使用MET-CBT后结果的潜在改善。

DESCRIPTION (provided by applicant): The disparity between science and actual practice in addiction services is well established. Connecticut's Single State Agency for both mental health and substance abuse, the Department of Mental Health and Addiction Services (DMHAS), has already begun a process of using science to inform mental health services among behavioral health providers. The process involves community-level steering committees representing multiple stakeholders in the change process; reconsideration of policies and procedures as well as clinical practice; training with expert consultants; and enhancement of capacity to perform ongoing clinical supervision. Simultaneously, the agency is developing its own capacity for on going monitoring of quality of care including the use of evidence-based practices (EBPs). DMHAS currently lacks needed tools such as client-level instrumentation to monitor appropriate use of EBPs and associated outcomes. The proposed project would: (1) test a model for introduction of EBPs to community-based agencies that includes bidding by the agencies and assessment of readiness to change; (2) adapt the technology transfer strategy now used to disseminate mental health EBPs for use in transferring addictions technology; and (3) develop an instrument and process for monitoring on-going use of EBPs with good fidelity, and with linkage to outcome data. Specifically, DMHAS will select a community agency through a process of information and marketing of a particular model treatment (Motivational Enhancement Therapy - Cognitive Behavioral Therapy, MET-CBT); assist the selected agency to develop an advisory board; provide training in both MET-CBT and in clinical supervision; will monitor fidelity to MET-CBT through standard clinician-level mechanisms of supervisor observation and self-rating; and will compare these ratings with the findings of client-level measures delivered to active clients in the target agency (n=250), as well as a control agency (n=250) in order to validate a client-level monitoring scale. A process evaluation will track successes and problems with the entire transfer process, and a cost calculation will be used to establish resources needed for the model. Potential improvements in outcomes following use of MET-CBT will be estimated through use of administrative data.