Emerging technology transfer research in drug abuse treatment and related fields suggests that the adoption of empirically supported treatments in community programs may be greatly facilitated with the creation of more innovative, multidimensional training systems that address the many barriers to learning that have been noted in practice settings. This proposed 4-year study, submitted in response to NIDA RFA DA-03-005, aims to develop a theory-based, multicomponent community therapist training system (CTTS) that will teach and foster competence among community drug treatment providers in the application of MDFT, a manualized, empirically-supported therapy designed for drug abusing adolescents. The proposed study will pilot test the feasibility, acceptability and impact of the CTTS in changing provider practices and client outcomes. An innovative aspect of the project is the plan to use new technologies (CD-ROM and PDA) to supplement existing training methods in order to facilitate the learning, mastery, and continued use of the manualized treatment following training. A total of 40 community therapists and 10 program directors from 10 drug abuse treatment sites, as well as 140 adolescent clients and their parents, will constitute the study sample. Using an interrupted time series design, with multiple measures pre- and post-training, we will examine changes in therapist practice patterns and client outcomes over time, in relation to training by means of the CTTS. The study has 4 aims: 1) Develop a theory-based, manual-guided training system (CTTS) with 4 basic components (workshop, treatment manual, case consultation reviews, and multimedia technology tools) for teaching community clinicians an empirically-supported family-based adolescent drug abuse therapy (MDFT); 2) Experimentally investigate therapists' satisfaction with the CTTS and its effectiveness in changing providers' practices in line with MDFT protocols; 3) Examine predictors of training outcome; and 4) Examine the impact of MDFT training on adolescent drug use and associated behavioral outcomes. In Phase I (Start-up: 6 months and Baseline: 12 months), we propose to develop the training system, conduct a pre-pilot test of the training modules and collect baseline data on clinicians' practice patterns and case outcomes. The experimental training intervention (CTTS) will be implemented with community providers in Phase 2 (Training: 6 months). We will evaluate the feasibility and acceptability of the CTTS with therapists and program directors during the Training phase and into Phase 3 (Implementation: 12 months). In the Implementation phase, training will end and providers' practices and their case outcomes will continue to be tracked to evaluate the impact of training effects after MDFT experts withdraw. During the final phase of the study (.Phase 4:12 months), investigators will analyze study results and revise the CTTS accordingly. The study has potential to reduce the research-practice gap by creating a transferable and effective training system that can be used in community agencies with existing resources to train front line providers in an effective family-based treatment for drug abusing adolescents.
