The evaluation of treatment services and systems for substance use disorders

Abstract

Scientific research and program evaluation have not played a major role in shaping the development of treatment services and systems in most countries. This has led to disparities in the development, management and monitoring of national treatment systems. In the evaluation of treatment for substance use disorders, the evaluation practitioner will usually be working at one of five levels: single case, treatment activity, treatment service, treatment agency or treatment system. One of the major barriers to undertaking internal program evaluation is the belief that it is a complicated research process best left to those with specific research training. Program managers and staff can plan and initiate an evaluation process for their program if they have access to research expertise when needed for certain parts of the process. There are seven main components of an evaluation process that can be planned and implemented: need assessment; evaluation planning, process evaluation, cost analysis, client satisfaction evaluation, outcome evaluation and economic evaluation. However, evaluation is more than the techniques and technology required to implement these types of activities. It also involves the routine questioning of current practice even if the feedback may be less positive than anticipated. A healthy culture for evaluation is one in which feedback loops are woven into the fabric of the treatment service or system. There are many barriers to evaluation in substance abuse services but these barriers can be overcome with careful planning and commitment to the delivery of evidence-based services.

Evaluation of Flexible and Integrative Psychiatric Treatment Models in Germany—A Mixed-Method Patient and Staff-Oriented Exploratory Study

“…To give a second example, flexible types of care (C3) often initially caused confusion for both staff and patients, but, after full implementation, lead to greater satisfaction as they allow for more need-adapted forms of treatment. The general finding that concrete experience of new treatment structures or processes enhances their evaluations had been described elsewhere (39). Moreover, the association was robust in our study, as demonstrated by the large concordance of significances (quantitative assessments) with levels of saturation (qualitative assessments; see also sections Concordant and Discordant Results and Discussion of Components).…”

Curso de prevenção ao uso de drogas: Descrição e avaliação de satisfação

“…Considerando o cenário de ampla utilização das metodologias de ensino à distância, avaliar se tal postura é seguida por bons resultados quanto ao processo de construção do conhecimento faz-se necessário, uma vez que investimentos em políticas públicas devem ser avaliados para estudo sobre a eficácia dos métodos utilizados (Mota, Costa, Ronzani, Colugnati, & Rush, 2014). Rush (2003) propõe componentes que devem ser analisados em um processo de avaliação de programas na área de álcool e outras drogas. Dentre estes componentes estão: avaliação de necessidades, planejamento da avaliação, avaliação de processo, avaliação de custos, satisfação de usuários, avaliação de resultados e avaliação econômica.…”

Evaluating the Complex: Alternative Models and Measures for Evaluating Collaboration among Substance use Services with Mental Health, Primary Care and other Services and Sectors

“…Given so many options for designing and implementing more integrated, collaborative systems of substance use services, and with so many potential outcomes to aim for, planners, administrators and evalua- (Rush & Ogborne, 1991;Julian, 1997;Rush, 2004).…”