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This manual for the Peer Intervention to Link Overdose Survivors to Treatment (PILOT) trial, CTN-0107, was prepared for use by peers working on the protocol. The intent of the manual is to provide materials to be used during peer training, reference materials to be used during the implementation of the clinical trial, and reference material for supervision. At the end of the study, the manual will be revised with input from participating peers and a revised manual will be developed for use in any follow-up studies.
The manual contains sections on the background of the PILOT study and intervention, what PILOT peers do in the study (engagement/re-engagement, peer coaching, transition and termination of the intervention), other things peers know and do in the PILOT study (study documentation, supervision, self-care and support, safety), and an array of tools and FAQs for peer participants.
Related protocols: CTN-0107
This manual is designed to be used as a guide for the delivery of the brief intervention (BI) and telephone booster sessions as part of the research protocol implemented in the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) protocol CTN-0047, Screening, Brief Intervention and Referral to Treatment in the Emergency Department (SMART-ED).
The BI and booster sessions are based on principles of motivational psychology and motivational interviewing style in which the interventionist attempts to mobilize in a systematic way the inherent resources for change that reside within the patient
This protocol involves one 30-minute BI session using the components in Motivational Enhancement Therapy (MET) delivered during the patient’s visit to the ED as well as the two 15-minute booster calls, which will be delivered over the phone during the one month following the baseline assessment. Ideally, the first call will be within 3 days of the patient’s discharge from the ED and the second call will be within 7 days after the first call.
The brief intervention, which will be conducted by interventionists in the emergency department, is based on motivational interviewing principles including feedback based on screening information, the FRAMES heuristic, and development of a change plan.
The goal of the first telephone booster session will be to re-engage and reinforce the change plan and support continuing efforts. The second telephone booster session will be a check-in session that reinforces positive changes and/or addresses barriers to treatment engagement.
This is an introductory training in the evidence-based clinical method of motivational interviewing (MI) and motivational enhancement therapy (MET). After orientation to the underlying spirit and principles of MI, practical exercises will help interventionists to strengthen empathy skills, recognize and elicit client change talk, and roll with resistance. The use of client assessment feedback in MET will be explained in detail; particularly as it relates to the assessments that will be conducted as part of the SMART-ED protocol.
The information in this manual was adapted from several sources, primarily Miller and Rollnick’s (2002) Motivational Interviewing: Preparing People to Change.
Related protocols: CTN-0047
This manual, developed for use by the STAGE-12 protocol, CTN-0031, was adapted from Stuart Baker’s “Twelve-Step Facilitation Therapy for Drug Abuse” (New Haven, CT: Yale Psychotherapy Research Center, 1998). STAGE-12 refers to “Stimulant Abuser Groups to Engage in 12-Step Programs,” a combined individual and group intervention targeted toward individuals who have primary or secondary diagnoses of abuse or dependence on methamphetamine, cocaine, or other stimulant drugs. The STAGE-12 intervention has been designed to be incorporated into intensive outpatient settings; however, it could equally well be incorporated into other treatment settings such residential. It could also be useful for clients with substance use disorders other than or in addition to stimulant abuse or dependence. The primary goals of STAGE-12 are to increase participants’ attendance at 12-Step meetings and to increase their active involvement in 12-Step activities. This increased attendance and engagement is thought to mediate subsequent reductions in substance use and to facilitate recovery.
The manual begins with an introductory chapter that provides a review of stimulant drugs and their effects, causes of addiction, and DSM-IV symptoms of stimulant abuse and dependence. Subsequent chapters describe the format and focus of the 3 STAGE-12 individual treatment sessions, the 5 group sessions, how clinicians are chosen and trained, and the adherence scale used to rate tapes of treatment sessions to insure that clinicians are delivering the treatment as it is intended. An extensive bibliography and list of readings and other resources are also included. These resources will provide clinicians with pertinent clinical and research literature as well as other resources related to 12-Step programs.
Related protocols: CTN-0031
This manual was developed by the National Drug Abuse Treatment Clinical Trials Network study development team for protocol CTN-0019, “Reducing HIV/STD Risk Behaviors : A Research Study for Women in Drug Abuse Treatment.” The manual was used by female counselors delivering the group intervention, “Safer Sex Skills Building (SSB)” to substance abuse treatment clients enrolled in CTN-0019. The original version of the intervention, called Project WORTH, was updated to place more emphasis on women’s negotiation skills around safer sex and safeguards against the risk of partner abuse as the potential result of assertiveness around safer sex.
The goal of this intervention is to help women change behaviors that put them at risk of becoming infected with HIV and to help them live healthy lifestyles. The intervention focuses on the importance of changing high-risk behaviors, and teaches the participants social and technical skills necessary to keep them from engaging in these high-risk behaviors. The development of interpersonal, social coping skills is a constant theme in the intervention. Skills include analyzing a risk situation; technical skills such as putting on a condom and seeking information, and social skills such as being able to refuse a request for unsafe sex and asking for help. In the five sessions, the following intervention modalities are used: information, instruction, discussion, modeling, role-playing, rehearsal and coaching, goal setting, and real-world assignments.
The download package includes a PDF version of the manual itself, a PDF version of the Participant Workbook, plus a set of PowerPoint slides for the manual’s flip charts.
Related protocols: CTN-0019
This manual was developed by the National Drug Abuse Treatment Clinical Trials Network Gender Specific HIV Prevention Intervention Protocol Development Team and used by male counselors delivering the Real Men Are Safe (REMAS) intervention to substance abuse treatment clients enrolled in NIDA CTN protocol 0018, Reducing HIV/STD Risk Behaviors: A Research Study for Men in Drug Abuse Treatment. It is a five-session group-delivered intervention package designed to help clients in substance abuse treatment reduce their HIV risk.
In the clinical trial men in substance abuse treatment were randomly assigned to attend the REMAS intervention or a single session HIV Education (HIV Ed) which served as a standardized control group representing treatment as usual for CTN community treatment programs. The trial provided compelling evidence of the effectiveness of REMAS. REMAS participants had significantly fewer unprotected sexual occasions, than HIV Ed participants, at both 3-months (effect size = .21) and 6-months (effect size = .34) (p<.0001) (Calsyn et al., 2009). This effect was heightened for REMAS completers, who attended the majority of their sessions. Men assigned to the REMAS condition reporting sex under the influence at the most recent sexual event decreased from 36.8% at baseline to 25.7% at 3 months compared to an increase from 36.9% to 38.3% in the HIV Ed condition (Calsyn et al, 2009).
REMAS materials:
- REMAS Manual** (.pdf)
- Flip charts (.ppt, for printing)
- Flip charts (.ppt, session slideshow)
- Certificate of Completion (.doc)
Related protocols: CTN-0018
This manual is a training guide for the Therapeutic Alliance intervention used in NIDA’s National Drug Abuse Treatment Clinical Trials Network (CTN) protocol #0017, “HIV and HCV Risk Reduction Interventions in Drug Detoxification and Treatment Settings.” The CTN is a cooperative research group that conducts clinical trials in community based drug treatment programs. Its mission is to join researchers and treatment providers in identifying research-based treatments which are effective in community treatment settings. Protocol CTN-0017 aims to evaluate the effectiveness of two interventions in reducing HIV and HCV risk behavior related to intravenous drug use. This manual is about one of the interventions, the Therapeutic Alliance (TA) intervention, which is designed to increase clients? entry into outpatient treatment following detox. It includes an overview of the research on Therapeutic Alliance, its goals, and a detailed session plan for clinicians to use when implementing the TA intervention in their community treatment programs.
Related protocols: CTN-0017
This 11-page document, developed as part of a training manual that drew on the results of the CTN MIEDAR protocols (CTN-0006 and -0007), provides a set of recommended guidelines with examples for community treatment programs interested in implementing the contingency management/motivational incentives program in their clinics. It includes five steps, with questions and suggestions to guide users through each one: 1) Target a Behavior (attendance at group, abstinence, etc.); 2) Pick a Reinforcer (what might your clients want as incentives?); 3) Design a Monitoring System; 4) Design an Incentive Delivery Schedule (fishbowl method, raffle tickets, etc.); and 5) Ensure Consistent Application. The guide also includes a worksheet to help clinicians design their incentive program, and ends with a page of tips that can help with troubleshooting down the line.
Related protocols: CTN-0006, CTN-0007
This is the Counseling and Education (C&E) Intervention Training Manual for protocol CTN-0017, “HIV and HCV Risk Reduction in Detoxification Settings.” This training manual is for CTN-0017 interventionists and supervisors, and is intended as a training tool and a quick reference guide for delivering the CTN-0017 protocol. It provides step-by-step instructions on how to conduct all aspects of the CTN-0017 C&E intervention and provides guidelines and templates for the development of Standard Operating Procedures (SOPs) for aspects of the protocol that will be specific to a particular site.
This manual is a revised, updated version of the 1993 NIDA HIV Counseling and Education Intervention Model. It has been tailored to fit the CTN-0017 C&E intervention and to include HCV counseling and education in the intervention. The manual includes implementation requirements, intervention guidelines, scripts for interventionists, cue cards for sessions one and two, guidelines and outlines for C&E intervention SOPs, and more.
Related protocols: CTN-0017
This manual was used in CTN Protocol CTN-0016. The feedback system in this manual is designed to help individual clinicians and clinical teams monitor attendance and two factors believed to contribute to attendance: therapeutic alliance and treatment satisfaction. Additionally, this system provides an objective, supportive and hopefully enjoyable way for clinicians and supervisors to work together to improve patient care. The Patient Feedback system is composed of four main components: feedback surveys, feedback reports, feedback newsletters, and team meetings, all of which are detailed in the manual. The Patient Feedback Survey instrument can be downloaded separately.
Related protocols: CTN-0016
Brief Strategic Family Therapy (BSFT) is a brief intervention used to treat adolescent drug use that occurs with other problem behaviors. These co-occurring problem behaviors include conduct problems at home and at school, oppositional behavior, delinquency, associating with antisocial peers, aggressive and violent behavior, and risky sexual behavior.
BSFT is based on three basic principles: that BSFT is a family systems approach; that the patterns of interaction in the family influence the behavior of each family member; and that interventions should be planned that carefully target and provide practical ways to change those patterns of interaction. This manual introduces counselors to concepts that are needed to understand the family as a vital context within which adolescent drug abuse occurs. It also describes strategies for creating a therapeutic relationship with families, assessing and diagnosing maladaptive patterns of family interaction, and changing patterns of family interaction from maladaptive to adaptive.
Related protocols: CTN-0014
This book can be purchased on the Guilford Press website. It is not available through the CTN Dissemination Library.
This book describes Seeking Safety, a present-focused therapy intended to help people attain safety from both PTSD and substance abuse. This treatment was designed for flexible use. It has been conducted in group and individual format; for women, men, and mixed-gender; using all topics or just a subset of topics; in a variety of settings (e.g., outpatient, inpatient, residential); and for both substance abuse and dependence. It has also been used with people who have a trauma history, but do not meet criteria for PTSD. The key principles of Seeking Safety are: 1) Safety as the overarching goal (working on both PTSD and substance abuse at the same time); 2) Integrated treatment (for both PTSD and substance abuse); 3) A focus on ideals to counteract the loss of ideals in both PTSD and substance abuse; 4) Four content areas: cognitive, behavioral, interpersonal, and case management; and 5) Attention to clinical processes (helping clinicians work on countertransference, self-care, and other issues).
Seeking Safety is one of two manualized interventions for women that was used in CTN protocol NIDA-CTN-0015, “Women’s Treatment for Trauma and Substance Use Disorders” (the other intervention was “Women’s Health Education”). The protocol used the following 12 of Seeking Safety’s 25 sessions or “topics”: 1) Introduction to Treatment; 2) Safety; 3) PTSD: Taking Back Your Power; 4) Detaching from Emotional Pain: 5) Grounding; When Substances Control You; 6) Taking Good Care of Yourself; 7) Compassion; 8) Red and Green Flags; Honesty; 9) Integrating the Split Self; 10) Creating Meaning; 11) Setting Boundaries in Relationships; and 12) Healing from Anger.
More information about the Seeking Safety program, including instructions on how to purchase a copy of the manual, a training calendar, a video training series, full-text articles about developing or implementing the program, and an assessment instrument designed to evaluate a clinician’s use of the treatment can be found at the Seeking Safety web site: http://www.seekingsafety.org. The manual provides both client handouts and guidance for clinicians.
Related protocols: CTN-0015
Women’s Health Education (WHE) is a nonspecific short-term manualized treatment that features sessions focusing on such topics as understanding the female body, human sexual behavior, pregnancy and childbirth, sexually transmitted diseases, HIV, and AIDS. It uses minilectures, videos, story telling, text readings, and discussion techniques to provide this health information. A revised version of this manual, edited by Gloria M. Miele, PhD, and Lisa R. Cohen, PhD, was used in the National Drug Abuse Treatment Clinical Trials Network protocol CTN-0015, “Women’s Treatment for Trauma and Substance Use Disorders.” This intervention was compared in CTN-0015 to “Seeking Safety,” a substance abuse treatment designed specifically for women with trauma. Findings indicated that both interventions significantly reduced PTSD symptoms over the course of one year follow-up.
This collection of documents includes the WHE manual and workbook, information/tips for facilitators, a list of session materials, and activity cards.
Related protocols: CTN-0015