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

描述（由申请人提供）：在调整循证实践以适应物质滥用治疗计划的真实的世界方面存在有据可查的挑战。大多数做法需要更多的培训和监督比实际的社区为基础的治疗方案。面对类似的问题，在教学专业，教育研究人员已划分新的和复杂的主题，成为关键要素，可教在单一的会议使用多媒体资源（视频，音频）和预先包装的教具，以吸引参与者和刺激课堂讨论。会议材料被包装在一个有吸引力的，多用途的“工具包”，以帮助教师准确地提供复杂的信息与最少的指导或监督。我们建议将这种方法应用于成瘾治疗领域：我们将开发，实施和测试的概念保真度，实用工具，和工具包课程的吸引力，以帮助药物滥用辅导员提供经验得出的12步恢复主题，包括寻找会议和家庭组，积极参与12步组，解决误解和参与障碍，等人我们将从10个住院治疗项目中随机分配80名顾问到常规治疗组（TAU）或工具包组（TK）。TK辅导员将收到四个“工具包”--四个12步主题中的每一个--每个都包含一个简短的DVD，演员在DVD中说明小组主题，以及各种易于使用的教具，所有这些都包装在一个塑料包中（字面意思是工具包）。关于这些循证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。辅导员的结果域挖掘到接受的结构的程序执行：坚持，质量，剂量和参与者的反应。我们将录音和评级所有辅导员进行小组会议上的四个12步主题在我们的课程干预前，再次，在相同的主题，1个月和6个月后（N=960届会议），比较概念的保真度和一般技能之间的研究组和组内，随着时间的推移。辅导员还将对工具包的可接受性和价值进行评级，并每月报告干预后12个月工具包的使用情况。除了咨询师评估外，我们还将收集对四个12步恢复期的满意度（N= 2，400），并跟踪酒精问题筛查阳性的患者子样本（N = 400，200 TK和200 TAU/对照）。将在研究条件之间比较治疗后1个月、3个月和6个月的患者12步参与（会议出席和12步恢复参与）;这些数据将说明干预措施促进治疗后12步参与的最终疗效。如果成功的话，这种创新的、易于使用的、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，这些工具将适合当代药物滥用治疗计划面临资源挑战的环境。 公共卫生相关性：迫切需要将经实践证明或“循证”的做法纳入以社区为基础的药物滥用治疗方案，但这需要大量资源（时间、人员和财政），而这些资源在这种环境中往往是有限的。这个创新的项目将开发一个吸引人的，具有成本效益和易于使用的多媒体“工具包”课程，以帮助辅导员准确和全面地介绍12步康复的核心主题，在小组咨询会议上，经验证明，这种方法可以促进减少物质使用。如果成功的话，这种传播科学验证的实践的方法将推进NIAAA的使命的一个关键组成部分，即将研究结果翻译和传播到美国各地的13，371个治疗项目，每天提供近100万次门诊服务，每天治疗另外120，000人的住院/住院治疗。

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: Incorporating empirically-proven or "evidence-based" practices into community-based substance abuse treatment programs is critically needed but it requires substantial resources (time, staff and financial) that are often limited in such settings. This innovative project will develop an appealing, cost-effective and easy-to-use curriculum of multimedia "toolkits" to assist counselors in accurately and comprehensively introducing the core topics of 12-Step recovery in group counseling sessions, an approach empirically demonstrated to promote reductions in substance use. If successful, this method of disseminating scientifically-validated practices will advance a critical component in NIAAA's mission of translating and disseminating research findings to the 13,371 treatment programs throughout the US that provide almost 1 million outpatient service visits daily and treat an additional 120,000 people in residential/inpatient treatment daily.