 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Roy M. Gabriel, PhD, RMC Research Corporation, 522 S.W. Fifth Avenue, Suite 1407, Portland, OR 97204, 503-223-8248, roy_gabriel@rmccorp.com and Eldon Edmundson, PhD, Department of Public Health and Preventive Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, CB669, Portland, OR 97201.
The National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have devoted considerable attention to enhancing the connection between science and practice in substance abuse prevention and treatment. For the past three years, the Center for Substance Abuse Treatment (CSAT) within SAMHSA has one funded one multi-site initiative to identify effective strategies for adopting and sustaining science-based practices. The “Practice Improvement Collaborative” has conducted studies at the local, regional, and state level, to identify key ingredients leading to community-based treatment agencies successfully adopting a variety of science-based practices. Motivational Enhancement Therapy (MET), a counselor interviewing technique designed to break down denial and internal barriers to participating in treatment, is the science-based practice highlighted in this presentation.
Two years of study of the implementation of MET in two local treatment agencies in Portland Oregon, has crystallized distinct sets of external (systemic) and internal (organizational) factors that strongly influenced the adoption of science-based practices. Interestingly, neither of these relate to individual counselor skills, which are often the sole target of these improvement initiatives. Examples of key systemic influences are instability of public funding and habitual turnover in the agency workforce. Organizational influences include ambivalence in the commitment to change and the process used to communicate this commitment through all levels of affected staff in the agency.
The authors assert that, without attention to key systemic and organizational influences, the most detailed and science-based efforts at skill improvement will not be successfully adopted by community-based treatment agencies.
Learning Objectives:
Keywords: Evidence Based Practice, Organizational Change
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.