? The disparity between science and actual practice in addiction services is well established. Connecticut's Single State Agency for both mental health and substance abuse, the Department of Mental Health and Addiction Services (DMHAS), has already begun a process of using science to inform mental health services among behavioral health providers. The process involves community-level steering committees representing multiple stakeholders in the change process; reconsideration of policies and procedures as well as clinical practice; training with expert consultants; and enhancement of capacity to perform ongoing clinical supervision. Simultaneously, the agency is developing its own capacity for on going monitoring of quality of care including the use of evidence-based practices (EBPs). DMHAS currently lacks needed tools such as client-level instrumentation to monitor appropriate use of EBPs and associated outcomes. The proposed project would: (1) test a model for introduction of EBPs to community-based agencies that includes bidding by the agencies and assessment of readiness to change; (2) adapt the technology transfer strategy now used to disseminate mental health EBPs for use in transferring addictions technology; and (3) develop an instrument and process for monitoring on-going use of EBPs with good fidelity, and with linkage to outcome data. Specifically, DMHAS will select a community agency through a process of information and marketing of a particular model treatment (Motivational Enhancement Therapy - Cognitive Behavioral Therapy, MET-CBT); assist the selected agency to develop an advisory board; provide training in both MET-CBT and in clinical supervision; will monitor fidelity to MET-CBT through standard clinician-level mechanisms of supervisor observation and self-rating; and will compare these ratings with the findings of client-level measures delivered to active clients in the target agency (n=250), as well as a control agency (n=250) in order to validate a client-level monitoring scale. A process evaluation will track successes and problems with the entire transfer process, and a cost calculation will be used to establish resources needed for the model. Potential improvements in outcomes following use of MET-CBT will be estimated through use of administrative data. ? ?
| Ulaszek, Wendy R; Lin, Hsiu-Ju; Frisman, Linda K et al. (2012) Development and Initial Validation of a Client-Rated MET-CBT Adherence Measure. Subst Abuse 6:85-94 |
