Direct Care Workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs

Abstract

Objective-Individuals with direct care responsibilities in 348 drug abuse treatment units were surveyed to obtain a description of the workforce and to assess support for evidence-based therapies.Methods-Surveys were distributed to 112 programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN). Descriptive analyses characterized the workforce. Analyses of covariance tested the effects of job category (counselors, medical staff, managersupervisors, and support staff) on opinions about evidence-based practices and controlled for the effects of education, modality (outpatient or residential), race, and gender.Results-Women made up two-thirds of the CTN workforce. One-third of the workforce had a master's or doctoral degree. Responses from 1,757 counselors, 908 support staff, 522 managerssupervisors, and 511 medical staff (71% of eligible participants) suggested that the variables that most consistently influenced responses were job category (19 of 22 items) and education (20 of 22 items). Managers-supervisors were the most supportive of evidence-based therapies, and support staff were the least supportive. Generally, individuals with graduate degrees had more positive opinions about evidence-based therapies. Support for using medications and contingency management was modest across job categories. Conclusions-The relatively traditional beliefs of support staff could inhibit the introduction of evidence-based practices. Programs initiating changes in therapeutic approaches may benefit from including all employees in change efforts.The National Drug Abuse Treatment Clinical Trials Network (CTN) began in 1999 with support from the National Institute on Drug Abuse. Research centers (currently 17) partner with five or more local alcohol and drug treatment centers (currently almost 150 distinct corporations) to conduct multisite clinical trials that test behavioral, pharmacological, and integrated behavioral and pharmacological treatment interventions in treatment programs with heterogeneous patient populations (1). Successful trials generate evidence of effectiveness and may promote the dissemination and adoption of science-based behavioral and pharmaceutical therapies. The first trials assessed buprenorphine detoxification (2,3), motivational interviewing and motivational enhancement therapy (4), and low-cost incentives for use with patients in methadone and outpatient programs (5,6). Initial results documented the feasibility of collaboration with community drug abuse treatment centers and provided a foundation for expansion and growth.Bridging the gap between practice and research, however, requires more than conducting clinical trials in community settings. Individuals who work in the treatment programs are essential to the introduction, adoption, and sustainability of science-based practices. Unfortunately, there is little current information on the workforce that provides treatment services for substance use disorders and on workers' opinions about the use of evidencebased therapies....

Substance Abuse Treatment Counselors and Tobacco Use: A Comparison of Comprehensive and Indoor-Only Workplace Smoking Bans

“…Second, we studied one type of health care organization, so future research should examine other health care settings and other industries. While our response rate was similar or higher than some other studies of counselors (Duraisingam, Pidd, & Roche, 2009;Forman, Bovasso, & Woody, 2001;Gallon, Gabriel, & Knudsen, 2003;Joe, Broome, Simpson, & Rowan-Szal, 2007), it was lower than the 70% response rate achieved in a large study of counselors working in the National Drug Abuse Treatment Clinical Trials Network (McCarty et al, 2007). We cannot address the extent to which non response at the level of individual counselors may bias our results, which is a limitation of this research.…”

Treatment programs in the National Drug Abuse Treatment Clinical Trials Network

“…Results from the Workforce Survey are presented elsewhere (McCarty et al, 2007). While the study was in the field, the CTN expanded to include three additional research centers and their …”

“…The protocol also surveyed the clinic's workforce to assess their characteristics and their attitudes and beliefs about specific drug abuse treatments. This report summarizes data from the Organizational and Treatment Unit Surveys.Results from the Workforce Survey are presented elsewhere (McCarty et al, 2007). While the study was in the field, the CTN expanded to include three additional research centers and their …”

Organizational Readiness for Change and opinions toward treatment innovations

“…Complete details on the data collection methods for the Organizational, Treatment Unit and Workforce Surveys are presented elsewhere (McCarty et al, 2006a). A protocol coordinator helped each of the regional networks to distribute materials to the treatment programs, facilitate participation, and monitor response rates.…”