219019 Modifications of evidence-based practices in community-based addiction treatment organizations: A qualitative research study

Monday, November 8, 2010 : 9:24 AM - 9:42 AM

Lena Lundgren, PhD , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Maryann Amodeo, PhD, MSW , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Alexander Cohen, MSW , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Amanda Horowitz, MSW, MPH , Network Health Alliance, Commonwealth Care Alliance, Watertown, MA
Deborah Chassler, MSW , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Objective: This qualitative study funded by the Robert Wood Johnson, Substance Abuse Policy Research Program examined implementation of evidence-based practices (EBPs) in 100 community-based addiction treatment organizations (CBOs) nationwide. The study explored (1) the extent to which EBPs were modified, (2) whether modifications were seen as positive or negative, and; (3) standards used for modifications.

Methods: Data from 100 semi-structured phone interviews with project directors from a random sample of 100 CBOs funded by Center for Substance Abuse Treatment, 2005-2007 were analyzed using qualitative methods.

Findings: The 100 projects implemented 182 different EBPs. Of these 48% were modified. Consistent themes included: 1) modifications were seen as improving the EBP, 2) the most common modifications included adding/deleting sessions or changing the order of sessions; 3) some descriptions suggested major EBP modifications, where fidelity was compromised; 4) most respondents perceived the modifications as minor; 5) primary reason for modifications included EBP not being responsive to specific needs of client group. Implications: The addiction treatment field lacks clear directives on the extent to which EBP modifications can be made without affecting the fidelity of a treatment intervention. Addiction treatment researchers need to test and create standards for EBP modifications. Without such standards, federally funded EBP implementation efforts may result in less than ideal outcomes.

Learning Objectives: 1. Understand organizational perspectives on the how and why of substance abuse treatment modifications to EBPs. 2. Discuss significance of maintaining EBP fidelity for treatment outcomes. 3. Identify policy guidelines for modifying EBPs in CBO addiction treatment.

Learning Areas:
Implementation of health education strategies, interventions and programs
Public health administration or related administration
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
1) Describe organizational perspectives on the how and why of substance abuse treatment modifications to EBPs. 2) Discuss significance of maintaining EBP fidelity for treatment outcomes. 3) Identify policy guidelines for modifying EBPs in CBO addiction treatment.

Keywords: Substance Abuse Treatment, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have been an integral part of this study throughout our research design, data collection, and data analysis efforts, in addition to providing substance abuse treatment in a community-based agency
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.