Testing Therapist Training Interventions to Implement an EBT for Adolescents

描述(由申请者提供)：该项目的推动力来自向现实世界实践环境中的青少年提供和传输有效的(即，基于证据的)药物滥用治疗方面的几个重大挑战。家长研究(DA17487)是这项竞争性延续申请的基础，评估了南卡罗来纳州公共精神卫生和药物滥用治疗系统的636名从业人员对接受培训以使用循证治疗(即应急管理)治疗青少年大麻滥用的兴趣。当提供适当的机会(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)时，心理健康和药物滥用治疗系统中80%的治疗师都寻求接受CM培训的机会。此外，在参加了CM研讨会并获得了必要的资源(例如，药物测试用品、干预手册、适量的凭单资金)后，许多从业者试图与至少一名滥用药物的青少年客户一起实施CM。那些没有尝试实施CM的从业者列举了实施的实际障碍(例如，他们的案例中没有滥用药物的青少年)，而不是理论或临床方面的担忧(例如，不喜欢手动治疗，治疗理念不相容)。根据家长研究和其他最新研究的结果，建议的研究评估三个培训方案的相对成效，并增加培训方案的力度，以支持精神健康和药物滥用服务部门治疗青少年药物滥用者的从业者实施CM。参与者将包括南卡罗来纳州9个提供者组织(6个药物滥用组织和3个精神健康治疗部门)的约100名治疗师和监督员。具体目标包括：目标1：在12个月的过程中，评估三种培训干预措施(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])的相对有效性，以促进治疗师对CM的了解和实施。目标2和目标3：审查两种更密集的培训干预措施(即CAT和CAT/SS)在培训结束后12个月维持治疗师的知识和实施CM的相对能力，但CM实施资源仍然存在；然后在CM资源撤出后的接下来的12个月内。目标3：在整个研究期间，评估治疗师知识和CM实施情况的调节因素。调节变量包括从从业者那里收集的人口统计、专业培训、组织和服务部门(药物滥用与心理健康)指标。

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.