Adoption of motivational interviewing and motivational enhancement therapy following clinical trials.

The National Drug Abuse Treatment Clinical Trials Network (CTN) is designed to test drug abuse treatment interventions in multisite clinical trials and to support the translation of effective interventions into practice. This study used qualitative methods to examine adoption of motivational interviewing and motivational enhancement therapy (MI/MET) in five clinics (CTPs) in the western US where those interventions were tested (as part of protocols CTN-0004 and CTN-0005). Participants were clinic staff who were interviewed about the MI/MET study, and about whether MI/MET was adopted after the study ended. The study found that despite the fact participation in the trials created a number of conditions supportive of adoption, a range of adoption outcomes was found: full “adoption” in one clinic, “partial adoption” in one clinic, “counselor adoption” in one clinic, and “no adoption” in two clinics. These findings highlight a distinction between adoption at the organizational and counselor levels, and suggest that a range of outcomes may be observed in the field, which may have implications for state- or other mandates for adoption of evidence-based practices. Sustained implementation of evidence-based practices, in many programs, likely requires external support from county or other healthcare treatment systems, state-funded drug abuse treatment systems, or federal agencies, and support in the form of policy leadership or guidance, regulatory or funding mandates, or changes in reimbursement strategies that enable and support evidence-based practices.

Related protocols: CTN-0004, CTN-0005