Implementing EBPs in a community treatment program: Beyond instruction.

Clients in addiction treatment settings have multiple problems. Fortunately, there is a growing empirical base of interventions to address them, including motivational enhancement strategies, HIV risk reduction, relapse prevention, and numerous others. For many years, treatment programs relied on conferences to improve staff skills, often with disappointing results. Implementing evidence-based practices is far more challenging than simply transmitting information. Creating a program culture that is hospitable to innovation and new research findings is essential. It is useful to work with opinion leaders on staff to encourage receptivity and willingness to change in others who may be resistant to modifying their practices. It is also important to expose an adequate number of staff to new practices and solicit their feedback on the feasibility of bringing those practices into the program. Once there is meaningful commitment, clinicians onsite must be given information, demonstration (role-playing, videos), opportunity to practice (role-playing) with feedback from a seasoned coach, and ongoing monitoring or supervision to continue to develop solid skills. It is desirable to include mastery of designated skills in performance evaluations and provide financial and other incentives for continuing efforts to utilize evidence-based practices.

This presentation describes a number of these “key ingredients” to promoting implementation in community treatment programs, and also briefly describes three key “dissemination mechanisms:” the National Drug Abuse Treatment Clinical Trials Network, the Addiction Technology Transfer Centers, and the National Registry of Evidence-Based Programs and Practices (NREPP).