Journal of Substance Abuse Treatment 2017;72:126-133. [doi: 10.1016/j.jsat.2015.11.010]
Bryan Hartzler, PhD, Blair Beadnell, PhD, Dennis M. Donovan, PhD (all from the University of Washington, PN Node).
In the context of a contingency management (CM) implementation/effectiveness hybrid trial, the post-training implementation domains of direct-care clinicians affiliated with one of the community treatment programs in the Pacific Northwest Node of the NIDA Clinical Trials Network (N=19) were examined in relation to a targeted clinical outcome of subsequently CM-exposed clients. Clinicians' CM skillfulness, a behavioral measure of their capability to skillfully deliver the intended CM intervention, was found to be a robust and specific predictor of their subsequent client outcomes. Analyses also revealed CM skillfulness to: (1) fully mediate an association between a general therapeutic effectiveness and client outcome; (2) partially mediate an association of in-training exposure to CM and client outcomes; and (3) be composed of six component clinical practice behaviors that each contributed meaningfully to this behavior fidelity index.
Conclusions: Study findings offer preliminary evidence of the predictive validity of post-training CM skillfulness for subsequent client outcomes. This suggests an apparent value in providing skills-focused training in CM, and perhaps other empirically-supported behavior therapies. Skills-focused training does not necessarily preclude trainer use of didactic and discussion elements in CM training curricula, presumably for purposes of enhancing clinician knowledge of core operant conditions principles and practices, as well as to dispel myths and misconceptions that deter adoption readiness. However, current findings provide preliminary evidence to suggest such passive learning strategies are insufficient if the goal of behavior therapy training is to prepare a workforce to effectively implement a new approach. (Article (Peer-Reviewed), PDF, English, 2016)
Keywords: Adoption of interventions | Behavior therapy | Contingency Management (CM) | CTN platform/ancillary study | Evidence-based treatment | Training | Journal of Substance Abuse Treatment (journal)
Document No: 1248, PMID: 26733276, PMCID: PMC4882285 (available 1/1/2018).
Submitted by Dennis M. Donovan, PhD, PN Node.