Diffusion of research in practice in Substance Abuse Treatment: A knowledge adoption study of gender sensitive treatment Deborah Rugs, Ph.D. Holly Hills, Ph.D. Roger Peters, Ph.D. University of South Florida Louis de la Parte Florida Mental Health Institute Department of Mental Health Law and Policy

Tampa PIC This CSAT/SAMHSA funded project seeks to “bridge the gap” between researchers, treatment providers, criminal justice professionals, policy makers, and consumers to improve service delivery to persons with substance use disorders involved the criminal justice system. Funded Collaborative Partners include: FMHI/USF, DACCO, Inc., ACTS, Inc., Operation PAR, Inc., FADAA, and the Hillsborough County Sheriff’s Office

Project Partners Stakeholders n Treatment Providers n Researchers n Policymakers n Consumers Liaison Groups n Education/Training n Community Support Services n Self-Help, Faith Community

n Recruit stakeholders n Establish formal organization n Conduct needs assessment n Develop locally defined practice/research agenda n Develop stakeholder-endorsed implementation plan Phase I: PIC Development

Phase II: PIC Implementation n Infrastructure Support n Network Enhancement n Implement Knowledge Adoption Studies

Knowledge Adoption (KA) Study Approach KA Study foci identified through Community Needs Assessment Gender-Sensitive Treatment (GST) Co-Occurring Disorders Treatment (CDT) n KA Study Goal: Test the effectiveness of implementing evidence-based clinical protocol identified in Pilot Study, through use of an Opinion Leader network

Dissemination Method: Use of Opinion Leaders  Opinion Leaders are identified by peer counselors as respected for their knowledge in a particular topic area  Opinion Leaders are trained in the use of an evidence-based treatment curriculum  Opinion Leaders then train their peer counselors and supervise the application of the curriculum  Changes in counselor behaviors and attitudes are measured to determine the effectiveness of the Opinion Leader model

Training & Consultation Activities: GST 1. Foundations training – 4 hours for Opinion Leaders and program counselors 2. Opinion Leader training – 1.5 days 3. Treatment counselor training conducted by Opinion Leaders –How to implement treatment protocol –For GST, up to four 2-hour sessions to cover all 25 topics 4. Group /Individual supervision – once a week –Conducted by Opinion Leaders for treatment counselors 5. Ongoing supervision provided to Opinion Leaders –Conducted by Site Coordinators / Project staff –GST: Brown Bag Luncheons

Trained Counselors N=30 Study Design: GST Experimental Group Tampa N=42 Comparison Group Orlando N=55 Opinion Leaders N=9 Counselors N=33 Counselors N=55

Model Interventions n Seeking Safety (Najavits, 2001) n Concurrent Treatment of PTSD and Cocaine Dependence (Brady et al., 2001) n Substance Dependence PTSD Therapy (Triffleman et al., 1999) n Triad Women’s Project (C. Clark, PI) n Trauma Recovery and Empowerment (TREM) (Harris, 1998)

Seeking Safety (Najavits, 2002) n Structured interventions in manual format n Organized around 25 trauma-related topics n Integrates trauma & substance abuse n For more information: Seeking Safety: A Treatment Manual for PTSD and Substance Abuse (Guilford Press, 2002) n

Where would you go for information about treating a female client with a history of trauma and substance abuse? How Helpful? (1) Not at all to (10) Extremely

Where would you go for information about treating a female client with a history of trauma and substance abuse problems? How Often? (1) Never (2) Monthly (3) Weekly (4) Daily

Number of Clients in Seeking Safety Groups (405 Total Groups) Average = 7.25 Clients per Group

Opinion Leaders’ Impressions of How Well the Modules Were Received?

GST Counselor (N=38) Feedback on OL Process at Post

Counselor (N=38) Difficulties with Implementing the Seeking Safety Groups %N Changing the Daily Schedule40%15 Preparing for the Groups29%11 Removing other Clinical Material from the Schedule 26%10 Participating in Training11%4 Participating in Supervision11%4

GST: Did Change Occur?

GST: What Parts of the Manual will you be Using? Tampa vs. Orlando at post.001 signif

Staff Attrition from Post Implementation to Follow Up