This application proposes to conduct """"""""implementation science"""""""" research in a 5-year project and includes 2 major research phases. In the first phase, a manualized Treatment Retention and Induction Program (TRIP) which includes sets of interactive attention-focusing activities will be adapted, adopted, and implemented by adolescent service providers. It relies on cognitive tools that utilize visual-spatial rather than traditional didactic communication approaches. TRIP will focus on increasing treatment motivation and engagement, and will be evaluated in adolescent Therapeutic Communities (TCs) using a 2-group quasi-experimental design with 600 clients in each group. Consisting of treatment elements already tested in adult and young adult samples, TRIP will address knowledge, attitudes, and behaviors related to motivation and therapeutic engagement during the initial phase of TC treatment. TRIP will be introduced into 5 programs (experimental condition) and compared with """"""""standard"""""""" orientation practices (SOP) in 5 other programs (control condition). Client- level change will be the key analytic focus and we will test hypotheses that (1) participation in TRIP, compared to SOP, will be associated with higher retention, motivation, and engagement, and (2) enhanced motivation and engagement will be associated with higher retention rates. Additional analyses will focus on differential success and change within- and between-adolescents in regards to mediating and moderating influences, and factors most likely contributing to leaving or staying in treatment. The second phase (to be conducted in the second half of the 5-year project) will examine the process of intervention implementation. A naturalistic design relying on organizational needs and functioning assessments (based on staff evaluations of the TRIP intervention training and utilization) will be launched to study implementation practices in different field settings. More specifically, a network of institution and community- based teams providing adolescent substance abuse treatment services from 6 ATTC regional networks (including 275 staff from 60 service teams) will provide information on implementation within their programs. A battery of assessments validated as effective tools for measuring structures, operations, training needs, organizational-level domains of needs and functioning, training satisfaction, and innovation utilization will be used to examine adoption and implementation processes. Analyses will focus on both institutional (i.e., juvenile justice) and community-based treatment programs and will test hypotheses that (1) greater training needs (specific to retention), higher staff functioning, and higher ratings of workshop quality will be associated with greater favorability and readiness to adopt TRIP components, and (2) favorable staff views of training, readiness to adopt, and lower perceived barriers will be associated with greater implementation progress.
Because substance use is a significant problem among youth in the U.S., and treatment providers are faced with high drop-out rates, the proposed research has the potential to impact clinical practice by increasing treatment motivation, engagement, and retention, and improving outcomes. Indeed, the adolescent population is important to the NIH and NIDA, and improving the quality of substance abuse treatment service delivery through the use of research-tested interventions will benefit public health. This application proposes to adapt treatment induction and retention tools, determine their effectiveness, and examine the process of their transfer and implementation in substance abuse treatment programs from 6 geographic regions across the U.S.
|Joe, George W; Becan, Jennifer E; Knight, Danica K et al. (2017) A structural model of treatment program and individual counselor leadership in innovation transfer. BMC Health Serv Res 17:230|
|Knight, Danica K; Joe, George W; Crawley, Rachel D et al. (2016) The Effectiveness of the Treatment Readiness and Induction Program (TRIP) for Improving During-Treatment Outcomes. J Subst Abuse Treat 62:20-7|
|Flynn, Patrick M; Brown, Barry S (2016) Matching Treatment to Rhetoric - A Challenge to Policy and Programming. J Subst Abuse Treat 64:1-2|
|Becan, Jennifer E; Knight, Danica K; Crawley, Rachel D et al. (2015) Effectiveness of the Treatment Readiness and Induction Program for increasing adolescent motivation for change. J Subst Abuse Treat 50:38-49|
|Knight, Danica K; Dansereau, Donald F; Becan, Jennifer E et al. (2015) Effectiveness of a theoretically-based judgment and decision making intervention for adolescents. J Youth Adolesc 44:1024-38|
|Crawley, Rachel D; Becan, Jennifer Edwards; Knight, Danica Kalling et al. (2015) Predictors of Physical Altercation among Adolescents in Residential Substance Abuse Treatment. Deviant Behav 36:996-1018|
|Knight, Danica K; Becan, Jennifer E; Landrum, Brittany et al. (2014) Screening and assessment tools for measuring adolescent client needs and functioning in substance abuse treatment. Subst Use Misuse 49:902-18|
|Joe, George W; Knight, Danica Kalling; Becan, Jennifer E et al. (2014) Recovery among adolescents: models for post-treatment gains in drug abuse treatments. J Subst Abuse Treat 46:362-73|
|Landrum, Brittany; Knight, Danica K; Becan, Jennifer E et al. (2014) To Stay or Not To Stay: Adolescent Client, Parent, and Counselor Perspectives on Leaving Substance Abuse Treatment Early. J Child Adolesc Subst Abuse 23:347-358|
|Dansereau, Donald F; Knight, Danica K; Flynn, Patrick M (2013) Improving Adolescent Judgment and Decision Making. Prof Psychol Res Pr 44:|
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