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

摘要-在调整基于证据的实践以适应现实世界方面存在大量有案可查的挑战 药物滥用治疗计划。大多数做法需要更多的培训和监督，而不是实际操作 用于基于社区的治疗计划。在教师行业也面临着类似的问题， 教育研究人员将新的和复杂的主题划分为可在单一课程中教授的关键要素 使用多媒体资源(视频、音频)和预先打包的教具吸引参与者并 激发课堂讨论。会议材料被打包在一个吸引人的、多用途的“工具包”中，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 将这种方法翻译到成瘾治疗领域：我们将开发、实施和测试概念性 帮助药物滥用咨询师的工具包课程的保真度、实用性和吸引力 提供小组会议，讨论经验派生的12步康复主题，包括寻找会议和家庭 小组，积极参与12步小组，消除参与的误解和障碍，以及 其他。我们将从10个住院治疗项目中随机分配80名咨询师进行治疗- 通常(TAU)或工具箱组(TK)。TK辅导员将收到4个“工具包”--4个12步中的每一个 主题-每个主题包含一张简短的DVD，演员在其中说明小组主题，以及分类的易于使用的教学 艾滋病，全部包装在塑料工具箱(字面意思是工具箱)中。关于这些基于证据的12步主题的内容将是 基于广泛使用的手册，例如NIAAA治疗手册、SAMHSA提示和项目匹配手册 以及已被证明有效促进12步参与的战略。辅导员结果域 挖掘计划实施的公认结构：遵守、质量、剂量和参与者 响应性。我们将对所有进行小组会议的辅导员进行录音并对四个12步骤进行评分 干预前我们课程中的主题，以及1个月和6个月后的相同主题(N=960 会议)比较研究小组之间和小组内的概念保真度和一般技能， 时间到了。咨询师还将对工具包的可接受性和价值进行评级，并每月报告工具包的使用情况 干预后12个月。除了辅导员的评估外，我们还将收集对这四个人的满意度 12步恢复会话(N=2,400)并跟踪患者的子样本(N=400、200 TK和200 Tau/Control)，他们筛查出酒精问题呈阳性。患者12步参与(出席会议和 12步康复参与)在治疗后1、3和6个月将在以下研究中进行比较 情况；这些数据将说明促进治疗后12步干预的最终效果 参与。如果成功，这种创新、易于使用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设计成符合以下条件的基于科学的、经过验证的临床工具 在当代药物滥用治疗方案面临资源挑战的环境中。

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.