Building a bonfire that remains stoked: sustainment of a contingency management intervention developed through collaborative design

Substance Abuse Treatment, Prevention, and Policy

Bryan Hartzler¹ 

[1] Alcohol & Drug Abuse Institute, University of Washington, 1107 NE 45th Street, Suite 120, Seattle 98105-4631, WA, USA

关键词: Behavior therapy dissemination;    Collaborative design;    Contingency management;   

Others  :  1223359
DOI  :  10.1186/s13011-015-0027-0

 received in 2015-05-12, accepted in 2015-07-24,  发布年份 2015

【 摘 要 】

Background

Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. The adaptability of contingency management renders it an exemplary therapy to model this collaborative design process.

Methods

At conclusion of an implementation/effectiveness hybrid trial conducted at an opiate treatment program, a group elicitation interview was conducted with the setting’s five managerial staff to cull qualitative impressions of a collaboratively-designed contingency management intervention after 90 days of provisional implementation in the setting. Two independent raters reviewed the audio-recording and conducted a phenomenological narrative analysis, extracting themes and selecting excerpts to correspond with innovation attributes (i.e., relative advantage, compatibility, complexity, trialability, observability) of a well-known implementation science framework.

Results

This qualitative analysis suggested the intervention was regarded as: 1) cost-effective and clinically useful relative to prior practices, 2) a strong fit with existing service structure and staffing resources, 3) procedurally uncomplicated, with staff consistently implementing it as intended, 4) providing site-specific data to sufficiently inform decisions about its sustainment, and 5) offering palpable benefits to staff-patient interactions.

Conclusions

The current work complements prior reports of positive implementation outcomes and intervention effectiveness for the parent trial, mapping qualitative managerial accounts of this contingency management intervention to a set of attributes thought to influence the speed and effectiveness with which an innovative practice is disseminated. Findings support the incorporation of collaborative design processes in future efforts to transport contingency management to the addiction treatment community.

【 授权许可】

   
2015 Hartzler.

【 参考文献 】

• [1]Higgins ST, Silverman K, Heil SH. Contingency management in substance abuse treatment. Guilford, New York; 2008.
• [2]Lussier JP, Heil SH, Mongeon JA, Badger GJ, Higgins ST. A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction. 2006; 101:192-203.
• [3]Prendergast M, Podus D, Finney JW, Greenwell L, Roll JM. Contingency management for treatment of substance use disorders: a meta-analysis. Addiction. 2006; 101:1546-1560.
• [4]Benishek LA, Dugosh KL, Kirby KC, Matejkowski J, Clements NT, Seymour BL, Festinger DS. Prize-based contingency management for the treatment of substance abusers: a meta-analysis. Addiction. 2014; 109:1426-1436.
• [5]Petry NM, Martin B. Low-cost contingency management for treating cocaine- and opioid-abusing methadone patients. J. Consult. Clin. Psychol. 2002; 70:398-405.
• [6]Petry NM, Peirce J, Stitzer ML, Blaine J, Roll JM, Cohen A, Li R. Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: a national drug abuse treatment clinical trials network study. Arch. Gen. Psychiatry. 2005; 62:1148-1156.
• [7]Peirce J, Petry NM, Stitzer ML, Blaine J, Kellogg S, Satterfield F, Kolodner K. Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: A National Drug Abuse Treatment Clinical Trials Network Study. Arch. Gen. Psychiatry. 2006; 63:201-208.
• [8]Hartzler B, Rabun C. Community treatment adoption of contingency management: a conceptual profile of U.S. clinics based on innovativeness of executive staff. Int J Drug Policy. 2013; 24(4):333-341.
• [9]Ritter A, Cameron J. Australian clinician attitudes towards contingency management: comparing down under with America. Drug Alcohol Depend. 2007; 87:312-315.
• [10]Kirby KC, Benishek LA, Dugosh KL, Kerwin ME. Substance abuse treatment providers’ beliefs and objections regarding contingency management: implications for dissemination. Drug Alcohol Depend. 2006; 85:19-27.
• [11]Roman PM, Abraham AJ, Rothrauff TC, Knudsen HK. A longitudinal study of organizational formation, innovation adoption, and dissemination activities within the National Drug Abuse Treatment Clinical Trials Network. J. Subst. Abuse Treat. 2010; 38 Supplement 1:S44-S52.
• [12]Tuten M, Svikis DS, Keyser-Marcus L, O'Grady KE, Jones HE. Lessons learned from a randomized trial of fixed and escalating contingency management schedules in opioid-dependent pregnant women. A J Drug Alcohol Abuse. 2012; 38(4):286-292.
• [13]Walker R, Rosvall T, Field CA, Allen S, McDonald D, Salim Z, Adinoff B. Disseminating contingency management to increase attendance in two community substance abuse treatment centers: lessons learned. J. Subst. Abuse Treat. 2010; 39(3):202-209.
• [14]Rogers EM. Diffusion of innovations. Vol. 5. The Free Press, New York; 2003.
• [15]Rogers EM. Diffusion of drug abuse prevention programs: Spontaneous diffusion, agenda setting, and reinvention. In: Reviewing the behavioral science knowledge base on technology transfer, NIDA Research Monograph 155. Backer TE, David SL, Saucy G, editors. National Institute on Drug Abuse, Rockville, MD; 1995: p.90-105.
• [16]Petry NM. Contingency Management for substance abuse treatment: a guide to implementing this evidence-based practice. Routledge, New York; 2012.
• [17]Hartzler B, Lash SJ, Roll JM. Contingency management in substance abuse treatment: a structured review of the evidence for its transportability. Drug Alcohol Depend. 2012; 122(1–2):1-10.
• [18]Tenkasi RV, Mohrman SA. Technology transfer as collaborative learning, NIDA Research Monograph 155. In: Reviewing the behavioral science knowledge base on technology transfer. Backer TE, David SL, Saucy G, editors. National Institute on Drug Abuse, Rockville, MD; 1995: p.147-168.
• [19]Hartzler B, Jackson TR, Jones BE, Beadnell B, Calsyn DA. Disseminating contingency management: impacts of staff training and implementation at an opiate treatment program. J Subst Abuse Treat. 2014;46:429–38.
• [20]Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med. Care. 2012; 50(3):217-226.
• [21]Lehman WEK, Greener JM, Simpson DD. Assessing organizational readiness for change. J. Subst. Abuse Treat. 2002; 22:197-209.
• [22]Greener JM, Joe GW, Simpson DD, Rowan-Szal GA, Lehman WEK. Influence of organizational functioning on client engagement in treatment. J Subst Abuse Treat. 2007;33(2):139–47.
• [23]Hartzler B, Rabun C. Training addiction professionals in empirically-supported treatments: perspectives from the treatment community. Subst. Abus. 2014; 35(1):30-36.
• [24]Petry NM, Alessi SM, Ledgerwood DM, Sierra S. Psychometric properties of the contingency management competence scale. Drug Alcohol Depend. 2010;109(1):167–74.
• [25]Aarons GA, Hurlburt M, McCue Horwitz S. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011; 38(1):4-23.
• [26]Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am. J. Public Health. 1999; 89(9):1322-1327.
• [27]Bernard HS, Ryan GW. Analyzing qualitative data: systematic approaches. Sage Publications, Inc, Los Angelos, CA; 2010.
• [28]Brownson RC, Colditz GA, Proctor E. Dissemination and implemenation research in health: translating science to practice. Oxford University Press, New York, NY; 2012.
• [29]Hartzler B, Donovan DM, Tillotson C, Mongoue-Tchokote S, Doyle S, McCarty D. A multi-level approach to predicting community addiction treatment attitudes about contingency management. J Subst Abuse Treat. 2012;42(2):213–21.
• [30]Fuller BE, Rieckmann T, Nunes EV, Miller M, Arfken C, Edmundson E, McCarty D. Organizational Readiness for Change and opinions toward treatment innovations. J Subst Abuse Treat. 2007;33(2):183–92.
• [31]Garner B, Hunter BD, Modisette KC, Ihnes PC, Godley SH. Treatment staff turnover in organizations implementing evidence-based practices: turnover rates and their association with client outcomes. J Subst Abuse Treat. 2012;42(2):134–42.
• [32]Eby LT, Burk H, Maher CP. How serious of a problem is staff turnover in substance abuse treatment? A longitudinal study of actual turnover. J. Subst. Abuse Treat. 2010; 39(3):264-271.
• [33]Garner B, Hunter BD, Godley SH, Godley MD. Training and retaining staff to competently deliver an evidence-based practice: the role of staff attributes and perceptions of organizational functioning. J Subst Abuse Treat. 2012;42:191–200.
• [34]Carpenter KM, Cheng WY, Smith JL, Brooks AC, Amrhein PC, Wain RM, Nunes EV. “Old dogs” and new skills: how clinician characteristics relate to motivational interviewing skills before, during, and after training. J Consult Clin Psychol. 2012;80(4):560–73.
• [35]Martino S, Canning-Ball M, Carroll KM, Rounsaville B. A criterion-based stepwise approach for training counselors in motivational interviewing. J Subst Abuse Treat. 2011;40:357–65.
• [36]Kellogg SH, Burns M, Coleman P, Stitzer ML, Wale, JB, Kreek, MJ. Something of value: the introduction of contingency management interventions into the New York City Health and Hospital Addiction Treatment Service. J Subst Abuse Treat. 2005;28:57–65.
• [37]Wiltsey Stirman S, Kimberly J, Cook N, Calloway A, Castro F, Charns M. The sustainability of new programs and innovations: a review of the empirical literature and recommendation for future research. Implement Sci. 2012;7:17.
• [38]Squires DD, Gumbley SJ, Storti SA. Training substance abuse treatment organizations to adopt evidence-based practices: the addiction transfer center of New England science-to-service laboratory. J. Subst. Abuse Treat. 2008; 34:293-301.
• [39]Carroll KM, Onken LS. Behavioral therapies for drug abuse. Am J Psychiatry. 2005; 162:1452-60.
• [40]Rounsaville BJ, Carroll KM, Onken LS. A stage model of behavioral therapies research: getting started and moving on from stage I. Clin Psychol: Sci Pract. 2001; 8(2):133-142.
• [41]Carroll KM. Treatment integrity and dissemination: rethinking fidelity via the stage model. Clin Psychol Sci Pract. 2013; 20:99-106.
• [42]Kendall PC, Beidas RS. Smoothing the trail for dissemination of evidence-based practices for youth: flexibility within fidelity. Prof Psychol Res Pract. 2007; 38(1):13-20.
• [43]Damschroder LJ, Hagedorn H. A guiding framework and approache for implementation research in substance use disorders treatment. Psychol. Addict. Behav. 2011; 25(2):194-206.
• [44]Fixsen D, Naoom S, Blase KA, Friedman RM, Wallace F. Implementation research: a synthesis of the literature, T.N.I.R.N. Louis de la Pate Florida Mental Health Institute, Editor. Tampa, FL: University of South Florida; 2005.
• [45]Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons GA, Bunger A, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65–76.