Large-scale dissemination efforts in drug abuse treatment clinics.

Contingency management (CM) interventions have demonstrated efficacy in the treatment of drug abuse. However, these interventions have not as yet become part of mainstream substance abuse treatment delivered in this country. As a precursor to dissemination and adoption, it is important to ascertain the effectiveness of CM interventions when implemented at real-world community treatment programs. Such research was undertaken within the National Drug Abuse Treatment Clinical Trials Network (CTN), where the largest study to date designed to test the effectiveness of a CM intervention in a drug-abusing population was completed (protocols CTN-0006 and CTN-0007). This chapter describes the protocol development process and study outcomes for the multisite CTN trial. It also highlights some of the barriers that need to be overcome as well as the decisions that clinicians face in designing and implementing a CM program. Further, this chapter illustrates how the issues can be resolved by striking a balance between clinical acceptability/feasibility considerations and fidelity to research-based methods previously shown to be efficacious.

In a second section of the chapter, the authors describe selected dissemination and adoption initiatives that have been undertaken following the CTN clinical trial, providing an example of how CM interventions will most likely be adopted by clinicians. Thus, the purpose of this chapter is to highlight some of the complex decisions that need to be made prior to adoption, and to illustrate several possible pathways to more widespread adoption of CM interventions by community treatment providers.

To request a copy of this item, contact ctnlib@uw.edu.

Related protocols: CTN-0006, CTN-0007