Implementing Outside the Box: Community-Based Social Service Provider Experiences With Using an Alcohol Screening and Intervention

Abstract

Objective The aim of this study is better understand perceptions of front-line social service workers who are not addiction specialists, but have to address addiction-related issues during their standard services. Method Six social service organizations implemented a validated alcohol assessment and brief education intervention. After a 3-month trial implementation period, a convenience sample of 64 front-line providers participated in six focus groups to examine barriers and facilitators to the implementation of an alcohol screening and brief intervention. Results Three themes emerged: (1) usefulness of the intervention, (2) intervention being an appropriate fit with the agency and client population, and (3) worker commitment and proper utilization during the implementation process. Conclusions A cross-cutting theme that emerged was the context in which the intervention was implemented, as this was central to each of the three primary themes identified from the focus groups (i.e., the usefulness and appropriateness of the intervention and the implementation process overall). Practitioner buy-in concerns also indicate the need for better addiction service training opportunities for those without addiction-specific educational backgrounds. Future research should assess whether targeted trainings increase addiction screening and education in social services settings.

Adapting, Implementing, and Maintaining a Group Cognitive Behavioral Therapy Program at an Inpatient Addiction Treatment Facility

“…This finding is supported by extant literature that yields similar results within facilities that treat SUDs 21,41,42 as well as gaps in wider mental health and psychiatric training and education. [7][8][9][10][11] It should be noted that some participants had more prior experience with group CBT manuals than others before leading groups, either at the current or past facilities, which led to a deeper understanding of CBT principles. Nevertheless, the lack of training caused difficulties adapting the needs and requirements of the manual.…”

“…[3][4][5][6] It is suggested that one of the greatest contributors to this low level of uptake is the lack of proper training and education among healthcare professionals to administer EBP within healthcare facilities. 5,[7][8][9][10][11][12] Therefore, implementation alone is simply not enough to ensure that new practices are being adequately adopted into routine care. 13 Consequently, dynamic, multi-pronged, multi-stakeholder implementation strategies are necessary to enhance adaptation and sustainment of a certain innovation.…”

“…9,15,16 This field faces the aforementioned barriers of training and education of healthcare professionals to a heightened degree. 9,11,17,18 Further, little information exists about how well various facilities manage the uptake and dissemination involved in implementation science, resulting in many known barriers but little documented information about the processes for identifying and overcoming said barriers. 4 The current study is additionally necessary due to the high morbidity and mortality among those with substance use disorders (SUDs).…”