Multimedia Toolkits to Implement 12-Step Recovery Concepts in Group Counseling

摘要-有充分记载的挑战，在适应证据为基础的做法，以适应真实的世界， 药物滥用治疗计划。大多数实践需要比实际更多的培训和监督 用于社区治疗项目。面对教师职业中类似的问题， 教育研究者将新的复杂的课题分成几个关键要素， 利用多媒体资源（视频、音频）和预先包装的教具吸引参与者， 激发课堂讨论。会议材料被包装在一个有吸引力的，多用途的“工具包”，以帮助 教师在最少的指导或监督下准确地传递复杂的信息。我们建议 将这种方法转化为成瘾治疗领域：我们将开发，实施和测试概念 帮助药物滥用咨询师的工具包课程的忠实性、实用性和吸引力 就经验得出的12步恢复主题提供小组会议，包括寻找会议和家 小组，积极参与12步小组，解决误解和参与障碍， 他人我们将从10个住院治疗项目中随机分配80名顾问， 通常（TAU）或工具包组（TK）。TK辅导员将收到四个“工具包”-四个12步中的每一个 主题-每个包含一个简短的DVD，演员说明组的主题，以及各种易于使用的教学 艾滋病，所有包装在一个塑料包（字面意思是工具包）。这些基于证据的12步主题的内容将 基于广泛使用的手册（例如，NIAAA治疗手册、SAMHSA TIPS和项目匹配手册 和策略，已被证明可以有效地促进12步参与。辅导员成果领域 利用已被接受的计划实施结构：坚持、质量、剂量和参与者 响应能力。我们将对所有辅导员进行的四个12步小组会议进行录音和评级 干预前课程中的主题，并在1个月和6个月后再次讨论相同的主题（N=960 比较研究组之间和组内的概念保真度和一般技能， 时间辅导员还将评价工具包的可接受性和价值，并每月报告工具包的使用情况 干预后12个月。除了辅导员评估，我们将收集四个满意度 12-逐步恢复期（N= 2，400）并跟踪患者子样本（N = 400，200 TK和200 TAU/对照组），酒精问题筛查呈阳性。患者12-步骤参与（会议出席和 12-将比较研究间治疗后1个月、3个月和6个月时的逐步恢复参与情况 条件;这些数据将说明干预的最终疗效，以促进治疗后12步 参与的如果成功，这种创新的、易于使用的和具有成本效益的技术转让方法可以 帮助将基于证据的概念和信息转化为基于科学的、经过验证的临床工具， 在当代药物滥用治疗方案的资源挑战环境中。

Abstract - There are well documented challenges in adapting evidence based practices to fit the real world of substance abuse treatment programs. Most practices require more training and supervision than is practical for community-based treatment programs. Faced with a similar problem in the teaching profession, educational researchers have divided new and complex topics into key elements teachable in single sessions using multimedia resources (video, audio) and pre-packaged teaching aids to engage participants and stimulate class discussion. Session materials are packaged in an appealing, multi-use "toolkit" to assist teachers in delivering complex information accurately with minimal instruction or supervision. We propose to translate this approach to the addiction treatment field: We will develop, implement and test the conceptual fidelity, practical utility, and attractiveness of a curriculum of toolkits to help substance abuse counselors deliver group sessions on empirically derived 12-Step recovery topics including finding meetings and a home group, active participation in 12-Step groups, addressing misconceptions and barriers to participation, and others. We will randomly assign 80 counselors from 10 inpatient treatment programs to either treatment-as- usual (TAU) or the Toolkits group (TK). TK counselors will receive four "toolkits" - one on each of four 12-Step topics - each containing a brief DVD where actors illustrate the group topic, and assorted easy-to-use teaching aids, all packaged in a plastic kit (literally, a tool-kit). Content on these evidence-based 12-step topics will be based on widely used manuals e.g., NIAAA Therapy Manuals, SAMHSA TIPS and Project MATCH Manuals and strategies that have been shown to effectively promote 12-Step participation. Counselor outcome domains tap into accepted constructs of program implementation: adherence, quality, dose, and participant responsiveness. We will audiotape and rate all counselors conducting group sessions on the four 12-Step topics in our curriculum before the intervention and again, on the same topics, 1 and 6 months later (N=960 sessions) to compare concept fidelity and general skills between the study groups and within groups, over time. Counselors will also rate the toolkits' acceptability and value, and report monthly on their toolkit utilization for 12 months post-intervention. In addition to counselor assessments, we will collect satisfaction with the four 12-Step Recovery sessions (N=2,400) and track a subsample of patients (N = 400, 200 TK and 200 TAU/Control) who screen positive for alcohol problems. Patient 12-Step participation (meeting attendance and 12-Step recovery involvement) at 1-, 3- and 6-months post treatment will be compared between study conditions; these data will speak to the ultimate efficacy of the intervention to promote post-treatment 12-Step participation. If successful, this innovative, easy to use and cost effective method of technology transfer could help engineer evidence based concepts and information into science-base, validated clinical tools that will fit within the resource-challenged environment of contemporary substance abuse treatment programs.