National Drug Abuse Treatment

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What is Usual about "Treatment-As-Usual"? Data from Two Multisite Effectiveness Trials.

Journal of Substance Abuse Treatment 2008;35(4):369-379. [DOI: 10.1016/j.jsat.2008.01.003].

Elizabeth J. Santa Ana, PhD (Connecticut Veterans Affairs Healthcare Center, Yale University, NE Node), Steve Martino, PhD (Connecticut Veterans Affairs Healthcare Center, Yale University, NE Node), Samuel A. Ball, PhD (Yale Community School of Medicine, NE Node), Charla Nich (Connecticut VA Healthcare Center, Yale University, NE Node), Tami L. Frankforter (Connecticut VA Healthcare Center, Yale University, NE Node), Kathleen M. Carroll, PhD (Connecticut VA Healthcare Center, Yale University, NE Node).

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Despite increased emphasis on broadening the implementation of empirically supported therapies (ESTs) to improve standard clinical practice and patient outcomes, objective descriptions of what actually constitutes standard practice in community-based drug abuse treatment do not exist. In this article, the authors present data from independent ratings of 379 audiotapes drawn from the "treatment-as-usual" arm of two multisite effectiveness trials in the National Drug Abuse Treatment Clinical Trials Network (protocols NIDA-CTN-0004, "Motivational Enhancement Treatment to Improve Treatment Engagement and Outcome in Subjects Seeking Treatment for Substance Abuse," and NIDA-CTN-0005, "Motivational Interviewing (MI) to Improve Treatment Engagement and Outcome in Subjects Seeking Treatment for Substance Abuse"). As expected, the most frequently occurring strategies involved assessing the participant's substance use and social functioning, asking open-ended questions, discussing problems and feedback, and giving advice and direction. However, a number of interventions associated with ESTs were very rarely implemented in these early sessions. These data suggest missed opportunities for optimally engaging patients in the early stages of treatment and enhancing substance use outcomes and only moderate success to date of efforts to bridge the gap between research and practice. (Article (Peer-Reviewed), PDF, English, 2007)

Keywords: Behavior therapy | Community health services | CTN platform/ancillary study | Evidence-based treatment | Motivational Enhancement Therapy (MET) | Motivational interviewing (MI) | Journal of Substance Abuse Treatment (journal)

Document No: 266

Submitted by CTN Dissemination Librarians, 3/17/2008.

AUTHORS SEARCH LINK
Ball, Samuel A. search mail
Carroll, Kathleen M. search mail
Frankforter, Tami L. search mail
Martino, Steve search mail
Nich, Charla search mail
Santa Ana, Elizabeth J. search mail
PROTOCOLS
NIDA-CTN-0004 search www
NIDA-CTN-0005 search www
NODES & CTPs
New England (Lead - both) search
  Connecticut Renaissance, Inc. search www
  LMG Programs, Inc. search www
Delaware Valley search www
  Northeast Treatment Center search www
  Rehab After Work search www
Mid-Atlantic search www
  Chesterfield Community Service Board Substance Abuse Service search www
  ARS Pantops Clinic search www
Oregon/Hawaii search www
  ADAPT, Inc. search www
  ChangePoint, Inc. search www
  Willamette Family Treatment Services search www
Pacific Region search www
  Haight-Ashbury Free Clinic search
  Tarzana Treatment Center search www

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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