1. Addiction treatment workforce: Counselor credentials, training and innovation
J. Aaron Johnson, Ph.D.
Lori J. Ducharme, Ph.D.
Sarah Henderson, M.A.
Center for Research on Behavioral Health and Human Services Delivery
The University of Georgia
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

2. Professionalization of Addiction Treatment Workforce
Traditionally addiction treatment counselors were recovering addicts, often graduates of program in which they were employed
Numerous factors led to professionalization of workforce
Today, nearly half have Master’s degrees
More than half are either certified and/or licensed as addictions counselors
Significant differences in level of professionalization in publicly funded and privately funded programs
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

3. Professionalization and Evidence-based Practice
Addiction treatment traditionally based on the 12-step model. Research suggests adherence to 12-step model may impede innovation.
Many new techniques, including FDA approval of several pharmacotherapies, have recently emerged.
Educating and training clinical staff on new techniques may remove barriers to innovation by changing attitudes.
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

4. Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976
Research Question
To what extent are there differences between publicly and privately funded centers in regards to counselor credentials and training?
What impact does counselor credentials and training have on perceived effectiveness and acceptability of selected new treatment techniques?
What are the implications for adoption of new treatment techniques?
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

5. Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976
Data and Methods
The National Treatment Center Study
Nationally representative samples of publicly and privately funded addiction treatment programs (N=763)
Counselor data via mail questionnaire from counselors employed in these programs (N=2296)
Counselor Response rate = 61%
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

6. Counselor Demographics
Public Centers
Private Centers
Gender (% Female)
63.9%**
57.6%
Race
- White
81.9%
- Black
22.4%**
10.5%
- Hispanic
8.1%**
3.4%
Average Age
44.4 Yrs**
46.4 Yrs
In Recovery
48.9%
47.7%
Salary (% > $40K)
8.9%**
24.3%
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

7. Counselor Credentials and Training
Public Centers
Private Centers
Education(% MA or Higher)
37.9%**
47.7%
Ave. Annual In-service Training (Hours)
23.9*
20.6
Ave. Annual External Training (Hours)
35.9*
32.0
Certified (%)
53.4%*
58.6%
Licensed (%)
24.2%
27.0%
Experience (Yrs in Field)
8.3Yrs**
10.3Yrs
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

8. Specific Training on Select Evidence-based Practice (Scale = 1 to 7)
Public Centers
Private Centers
Buprenorphine
1.85**
2.18
Naltrexone
2.09**
2.72
SSRIs
2.65**
3.32
Motivational Enhancement Therapy
3.43
3.26
Motivational Incentives
2.37**
1.94
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

9. Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976
Relationship b/w Training and Perceived Effectiveness/ Acceptability of Therapies (Bivariate Regression Coefficients)
Perceived Effectiveness of Technique
Perceived Acceptability of Technique
Buprenorphine
.599**
.369**
Naltrexone
.567**
.344**
SSRIs
.667**
.425**
Motivational Enhancement Therapy
.494**
.311**
Motivational Incentives
.568**
.366**
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

10. Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976
Relationship b/w Education and Perceived Effectiveness/ Acceptability of Therapies (Bivariate Regression Coefficients)
Perceived Effectiveness of Technique
Perceived Acceptability of Technique
Buprenorphine
.074*
.283**
Naltrexone
.127**
.293**
SSRIs
.600**
.481**
Motivational Enhancement Therapy
.068
.191**
Motivational Incentives
-.063
.095**
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

11. Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976
Conclusions
Significant differences b/w counselors employed in public and private treatment programs.
Public Centers
Demographics - more racially diverse, employ higher proportion of females, have significantly lower salaries
Credentials – lower % with MA or certification, fewer years of experience in field
Training – more training hours, but less training on pharmacotherapies
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976

12. Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976
Conclusions (cont.)
Both training on specific techniques and overall levels of education shown to increase perceptions of effectiveness and acceptability for new techniques, particularly pharmacotherapies.
Significant differences in education levels and training in public centers could make it more difficult to move research into practice in these settings.
Funded by NIDA Grants: R01-DA13110, R01-DA14482, R01-DA14976