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 i nclude:
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.
