Testing Therapist Training Interventions to Implement an EBT for Adolescents

描述（由申请人提供）：本项目的动力来自于提供和运输有效（即，在真实的世界实践环境中对青少年进行药物滥用治疗。母研究（DA 17487）作为该竞争性继续申请的基础，评价了南卡罗来纳州公共精神卫生和药物滥用治疗系统中636名从业者接受循证治疗（即，应急管理，CM）的青少年大麻滥用。如果有适当的机会（例如，在方便的时间和地点进行培训）和激励措施（例如，CEU学分），80%的治疗师在心理健康和药物滥用治疗系统追求的机会，在CM培训。此外，在参加CM研讨会并获得必要的资源（例如，药物检测用品、干预手册、适量的代金券资金），许多从业者试图对至少一名药物滥用青少年客户实施CM。那些没有尝试实施变革管理的从业者列举了实施的实际障碍（例如，在他们的案件中没有滥用药物的青少年），而不是理论或临床问题（例如，不喜欢手动治疗，不兼容的治疗理念）。家长的研究和其他最近的研究结果的基础上，拟议的研究评估了三个培训协议的相对有效性，越来越多的强度，在支持实施CM的从业人员治疗青少年药物滥用者在精神健康和药物滥用服务部门。与会者将包括南卡罗来纳州9个提供机构（6个在药物滥用领域，3个在精神健康治疗领域）的大约100名治疗师和主管。具体目标包括：目标1：评估三种强度不断增加的培训干预措施的相对有效性（即，工作坊与工作坊+计算机辅助培训[CAT]与工作坊+CAT+监督支持[CAT/SS]），以促进治疗师在12个月内的知识和CM的实施。目标2和3：审查两种强化培训措施的相对能力（即，CAT和CAT/SS），以维持治疗师的知识和实施CM通过12个月后，培训结束，但CM实施资源仍然存在;然后通过未来12个月后，CM资源被撤回。目的3：评估在整个研究期间，治疗师知识和实施CM的增益调节器。调节变量包括人口统计学，专业培训，组织和服务部门（药物滥用与心理健康）的措施，从从业者在基线收集。

DESCRIPTION (provided by applicant): Impetus for this project comes from several significant challenges in providing and transporting effective (i.e., evidence-based) substance abuse treatments to adolescents in real world practice settings. The parent study (DA17487), which serves as the basis for this competing continuation application, evaluated the interest of 636 practitioners in the South Carolina public mental health and drug abuse treatment systems in being trained to use an evidence-based treatment (i.e., contingency management, CM) for adolescent marijuana abuse. When provided appropriate opportunities (e.g., training at convenient times and locations) and incentives (e.g., CEU credits), 80% of therapists in both the mental health and substance abuse treatment systems pursued opportunities to be trained in CM. Moreover, after attending a CM workshop and given access to necessary resources (e.g., drug testing supplies, intervention manual, modest funding for vouchers), many of the practitioners attempted to implement CM with at least one of their substance abusing adolescent clients. Those practitioners who did not attempt to implement CM cited practical barriers to implementation (e.g., no substance abusing adolescents in their caseloads) rather than theoretical or clinical concerns (e.g., dislike of manualized treatments, incompatible treatment philosophy). Building on the results of the parent study and other recent research, the proposed study evaluates the relative effectiveness of three training protocols with increasing intensity in supporting the implementation of CM by practitioners treating adolescent substance abusers in the mental health and substance abuse service sectors. Participants will include approximately 100 therapists and supervisors across 9 provider organizations (6 in the substance abuse and 3 in the mental health treatment sector) in South Carolina. Specific aims include: Aim 1: Evaluate the relative effectiveness of three training interventions with increasing intensity (i.e., Workshop vs. Workshop + Computer Assisted Training [CAT] vs. Workshop + CAT + Supervisory Support [CAT/SS]) to promote therapist knowledge and implementation of CM over the course of 12 months. Aims 2 and 3: Examine the relative capacity of the two more intensive training interventions (i.e., CAT and CAT/SS) to sustain therapist knowledge and implementation of CM through 12 months after the training ends, but CM implementation resources remain; and then through the next 12 months after the CM resources are withdrawn. Aim 3: Evaluate moderators of gains in therapist knowledge and implementation of CM throughout the study period. Moderator variables include demographic, professional training, organizational, and service sector (substance abuse vs. mental health) measures collected from practitioners at baseline.