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The objectives of the current study were to characterize (a) peer specialist interest in enrolling in/returning to higher education and perceived barriers, (b) perceptions of the local availability of higher education/continuing education programming, and (c) perceived barriers to the advancement of the peer workforce. Method: We utilized both close-ended and open-ended items from a large, collaboratively developed national survey of peer specialists. Analytic methods included both descriptive and basic inferential statistics (N ϭ 801) and qualitative coding and analysis (subsample N ϭ 451). Results: High levels of interest in higher education were found, with nearly 80% of participants reporting that they would enroll/return to college were it feasible. Analysis of open-ended responses regarding perceived barriers to career advancement revealed 5 major themes: financing and administrative policies; perceived public discrimination and devaluation of the peer specialist role by coworkers and agency leadership; lack of opportunities and mechanisms for advancement; the simultaneous need for advanced education and the inaccessibility of college or graduate degrees; and individual level barriers, including internalized stigma and derailed work histories due to disability. Conclusions and Implications for Practice: As the peer workforce continues to grow, it is critical that the field grapple with fundamental questions as to how to best support the development and advancement of the peer workforce. Our findings underscore persistent workplace challenges and perceived barriers to advancement, insights which may help the field develop strategies for improving development supports. Impact and ImplicationsThe research reported in this article found high levels of peer specialist interest in returning to higher education to advance professional skills, while simultaneously documenting significant perceived barriers to advancement, spanning organization-level challenges, state and federal policy, and higher education infrastructure. Moving forward, we suggest that the mental health field consider policies and practices that would better enable the mobility and advancement of peer providers.

Table of contentsIntroduction to the 3rd Biennial Conference of the Society for Implementation Research Collaboration: advancing efficient methodologies through team science and community partnershipsCara Lewis, Doyanne Darnell, Suzanne Kerns, Maria Monroe-DeVita, Sara J. Landes, Aaron R. Lyon, Cameo Stanick, Shannon Dorsey, Jill Locke, Brigid Marriott, Ajeng Puspitasari, Caitlin Dorsey, Karin Hendricks, Andria Pierson, Phil Fizur, Katherine A. ComtoisA1: A behavioral economic perspective on adoption, implementation, and sustainment of evidence-based interventionsLawrence A. PalinkasA2: Towards making scale up of evidence-based practices in child welfare systems more efficient and affordablePatricia ChamberlainA3: Mixed method examination of strategic leadership for evidence-based practice implementationGregory A. Aarons, Amy E. Green, Mark. G. Ehrhart, Elise M. Trott, Cathleen E. WillgingA4: Implementing practice change in Federally Qualified Health Centers: Learning from leaders’ experiencesMaria E. Fernandez, Nicholas H. Woolf, Shuting (Lily) Liang, Natalia I. Heredia, Michelle Kegler, Betsy Risendal, Andrea Dwyer, Vicki Young, Dayna Campbell, Michelle Carvalho, Yvonne Kellar-GuentherA3: Mixed method examination of strategic leadership for evidence-based practice implementationGregory A. Aarons, Amy E. Green, Mark. G. Ehrhart, Elise M. Trott, Cathleen E. WillgingA4: Implementing practice change in Federally Qualified Health Centers: Learning from leaders’ experiencesMaria E. Fernandez, Nicholas H. Woolf, Shuting (Lily) Liang, Natalia I. Heredia, Michelle Kegler, Betsy Risendal, Andrea Dwyer, Vicki Young, Dayna Campbell, Michelle Carvalho, Yvonne Kellar-GuentherA5: Efficient synthesis: Using qualitative comparative analysis and the Consolidated Framework for Implementation Research across diverse studiesLaura J. Damschroder, Julie C. LoweryA6: Establishing a veterans engagement group to empower patients and inform Veterans Affairs (VA) health services researchSarah S. Ono, Kathleen F. Carlson, Erika K. Cottrell, Maya E. O’Neil, Travis L. LovejoyA7: Building patient-practitioner partnerships in community oncology settings to implement behavioral interventions for anxious and depressed cancer survivorsJoanna J. Arch, Jill L. MitchellA8: Tailoring a Cognitive Behavioral Therapy implementation protocol using mixed methods, conjoint analysis, and implementation teamsCara C. Lewis, Brigid R. Marriott, Kelli ScottA9: Wraparound Structured Assessment and Review (WrapSTAR): An efficient, yet comprehensive approach to Wraparound implementation evaluationJennifer Schurer Coldiron, Eric J. Bruns, Alyssa N. HookA10: Improving the efficiency of standardized patient assessment of clinician fidelity: A comparison of automated actor-based and manual clinician-based ratingsBenjamin C. Graham, Katelin JordanA11: Measuring fidelity on the cheapRochelle F. Hanson, Angela Moreland, Benjamin E. Saunders, Heidi S. ResnickA12: Leveraging routine clinical materials to assess fidelity to an evidence-based psychotherapyShannon Wiltsey Sti...

Objectives Alcohol Behavioral Couple Therapy (ABCT) is an efficacious treatment for alcohol use disorders. Coding treatment integrity can shed light on the active ingredients of ABCT, but there are no published studies of treatment integrity instruments for ABCT. The present study describes the development and initial reliability of the Treatment Integrity Rating System – Couples Version (C-TIRS) for ABCT. Methods The C-TIRS was used to rate 284 first- and mid-treatment ABCT sessions of 188 couples in four randomized clinical trials. Results Average inter-rater reliability for distinguishing ratings between C-TIRS items was fair-to-good for quantity items (intraclass correlation [ICC] = 0.64) and poor-to-fair for quality items (ICC = 0.41). Five C-TIRS subscales were defined a priori to measure treatment components involving cognitive-behavioral therapy, spouse involvement, couple therapy, common therapeutic factors, and overall adherence to the treatment protocol and had adequate internal reliability (α = 0.74–0.89). Inter-rater reliability was fair to good on seven of ten scales but poor on three scales (ICC range = 0.17–0.72). Conclusions The C-TIRS was designed to provide information about quantity and quality of the delivery of ABCT components; however, further refinement of the C-TIRS is warranted before it should be used in frontline practice. Clinical implications and recommendations for future research are discussed.

Background:The Approach and Avoidance of Alcohol questionnaire (AAAQ) was developed as a measure of craving to assess both desires to consume and desires to avoid consuming alcohol. Although the measure has been used in a variety of populations to predict future alcohol use behavior, the factor structures observed varies based on sample type (e.g., clinical versus college samples) and may be overly long for use in repeated measure designs. The current article describes the development of a brief version of the AAAQ for use in clinical populations.Methods: Using existing data sets of individuals in treatment for alcohol use disorder, exploratory analyses (e.g. exploratory factor analysis and item response theory) were conducted using an inpatient sample (N=298) at a substance abuse treatment facility. Confirmatory analyses (e.g., confirmatory factor analysis and multiple regression) were conducted using an inpatient detoxification sample (N=175) and a longitudinal outpatient treatment sample (N=53). Results:The brief AAAQ had comparable internal consistency, explained a similar amount of variance in alcohol consumption and related problems, and exhibited superior model fit as compared to the original measure.

In this research, we integrate attachment theory and dyadic methodology to examine how attachment anxiety and avoidance might interact with marital conflict to influence alcohol consumption, drinking motives, and alcohol-related problems in a sample of 280 married and cohabiting couples over 3 years. Both husband and wife attachment anxiety were related to higher levels of own drinking to cope and alcohol-related problems. Additionally, both husband and wife reports of marital conflict were associated with own alcohol-related problems. For wives, significant interactions between anxiety and marital conflict suggested that anxiety was more strongly associated with alcohol consumption, coping, and problems at higher levels of conflict. For husbands, significant interactions between avoidance and conflict indicated that avoidance was more strongly associated with coping and problems at lower levels of conflict. This research suggests two main patterns of attachment and alcohol use, both exacerbated by marital conflict and different for husbands and wives.