This K23 award application for Bryan Hartzler, Ph.D., proposes Stage III model development for integrating empirically-supported behavioral interventions for substance users. It concentrates on a specific example of how disparate conceptual bases challenge effective integration: concurrent use of motivational interviewing (MI) and contingency management (CM) in opiate agonist treatment (OAT). This focus is congruent with NIDA initiatives for integrative treatment design (PA-07-111), community-based practice improvements (PA-07-113) and cross-disciplinary translational research (PA-07-109). Interdisciplinary training will occur in strong University of Washington academic environments, with mentorship via Department of Psychiatry and Behavioral Sciences faculty, Alcohol and Drug Abuse Institute resources, and consultation from experts in the School of Social Work, Washington State University Program of Excellence in the Addictions, University of Virginia Psychiatry and Neurobehavioral Sciences, and Evergreen Treatment Services (a CTN-affiliate OAT treatment program). Proposed mentors are Dennis Donovan and Donald Calsyn, both highly-respected clinical researchers of behavioral interventions for substance users. John Roll, Steve Lash, and David Rosengren will consult as content experts in clinical application, measurement, and training in CM and MI. Consultation in biostatistics and OAT is also proposed. Given candidate background in MI, training objectives will foster: 1) exposure to OAT policies and practices, 2) appreciation for CM principles and applications, 3) knowledge of psychometric issues in scale design/measurement, and 4) understanding the manualization of behavioral interventions. Relevant professional activities will inform developmental research, to include a set of three studies to: a) explore organizational climate/characteristics and staff background in community OAT programs, b) design and test a CM fidelity instrument, and c) evaluate impact of a CM training workshop. Attainment of training objectives, conduct of developmental research, and an iterative series of panel meetings with mentoring/consultation team will aid design of an integrative model for MI/CM training and implementation to be tested by an independent funding mechanism.
The proposed research is relevant to public health insofar as it ultimately seeks to foster more effective provision of therapeutic services to substance-using treatment-seekers in our communities.
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