Transcript Evidence Based Practices - Rhonda G Patrick, LCSW, MPA

Gaps in Substance Use Treatment
Presented by:
Rhonda G. Patrick, LCSW, MPA
Amy C. Traylor, MSW, Ph.D.
Evidence based practice…
 What is it?
 What is it not?
 Not only for
clinical practice
Steps of evidence based
practice
 Convert the need for information into an answerable question.
 Track down the best clinical evidence to answer that question.
 Critically appraise the evidence.
 Integrate your appraisal with your expertise and the client’s
values.
 Evaluate the effectiveness of the process.
Integration is key…
 What does the
literature say?
 What do I bring?
 What about my
client?
Evidence Based Practices
 Why EBP?
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Concerns related to cost and effectiveness of substance
abuse treatment.
Delineation of a rational approach to allocation of scarce
resources.
Mitigation against a system in which treatment practices
are based solely on practice wisdom.
Finding the “best” available treatment or policy that
reduces the harm and costs of substance abuse.
Research & Knowledge
What do we know?
What don’t we
know?
Bridging the Gap: Community
 Characterize the local community
 Understand community factors
 Develop community research partners
 Utilize a community participatory research framework
Bridging the Gap: Service Delivery
 Test the effectiveness of community-based therapeutic
approaches that take advantage of natural supports (religious
organizations) and of those that bring evidence-based
treatments to non-clinical environments (e.g., academic
community-partnerships).
 Evaluate and test collaborative research partnerships with
community members that identify new and innovative
approaches to drug abuse treatment services.
 Test community-level interventions that facilitate recovery and
reintegration of drug users within their communities.
Bridging the Gap: Linkages
 Generate information that can be used to develop and
test a workable model of community-based delivery in
communities, including research that identifies
untapped, informal community-based resources.
 Develop and evaluate best practices that focus on the
integration of social, health and drug abuse services
and that can optimize treatment outcomes for service
users.
Bridging the Gap: Other Issues
 Speaking a Common Language
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How we define the problem
How we define the outcome
How we define the measurement
 Documenting Effectiveness
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Informal Publications
Formal Publications
 Increasing Funding for Research and Services
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Making Addiction a Priority
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Economic Costs
Social Costs
Evidence Based Substance Use
Treatment: Where do we find them?
 National Registry of Evidence-Based Programs and
Practices
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Created in 2007
Lists SAMSHA Model Treatment Programs
Defines EBP as “approaches to prevention or treatment
based in theory and have undergone scientific evaluation.”
Submissions are “reviewed” by experts with doctoral
degrees, evaluation research experience, and clinical
experience.
Many more prevention/intervention programs.
Searchable by target population needs
Evidence Based Substance Use
Treatment: Where do we find them?
 Agency for Healthcare Research and Quality
 National Guidelines Clearinghouse
 Search by topic area.
 Can compare multiple guidelines across variety of
criteria and classifications.
 Can download information to PDA’s.
 Rigorous selection and review process
Evidence Based Substance Use
Treatment: Where do we find them?
 Co-Occurring Disorder Center for Excellence
 Created in 2003 to foster infusion and adoption of
evidence and consensus based treatment and program
innovation into clinical and organization practice.
 Intended for the co-occurring disorder service system
 Provides descriptions of interventions
 Describes intervention implementation
 References related to EBPs
Evidence Based Substance Use
Treatment: Where do we find them?
 Technology Transfer Centers
 14 regionally-based addiction technology transfer
centers
 Bridging the gap between science and practice
 Addiction Science Made Easy Program
 Intended for addiction treatment professionals
 Provides descriptions of interventions
 Describes intervention implementation
 References related to EBPs
Evidence Based Substance Use
Treatment: Where do we find them?
 National Drug Abuse Treatment Clinical Trials
Network
 Conducting studies of behavioral, pharmacological, and
integrated behavioral and pharmacological treatment
interventions of therapeutic effect in rigorous, multi-site clinical
trials to determine effectiveness across a broad range of
community-based treatment settings and diversified patient
populations; and
 Ensuring the transfer of research results to physicians, clinicians,
providers, and patients.
 Regional “Nodes”
 Service providers attached to various regional nodes