Integration of treatment innovation planning and implementation: Strategic process models and organizational challenges.

Abstract

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A 2-phase procedural approach is therefore presented based on the integration of TCU models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings.

Introduction to the special issue on organizational dynamics within substance abuse treatment: A complex human activity system

“…Thus, assessment of individual client needs is critical not only for diagnosis and treatment planning but also for designing and implementing program change initiatives (Joe, Broome, Rowan-Szal, & Simpson, 2002;Lehman, Simpson, Knight, & Flynn, 2011). Titus, Smith, Dennis, Ives, Twanow, and White (2011) studied the influence of training and certification on the quality of assessment data obtained by interviewers, finding that staff who attained certification and had more experience administering the assessment collected higher quality assessment data than those with certification and less experience.…”

Implementing Tobacco Education and Cessation Services at a Large Community Mental Health Center: Lessons Learned

“…Without appropriate implementation, tobacco-free initiatives may have little to no effect on consumers' smoking cessation (El-Guebaly et al, 2002). Successfully implementing complex, evidence-based interventions requires the consideration of an organization's unique social and environmental factors while utilizing effective tools for implementing, assessing, and sustaining change at system and practitioner levels (Lehman, Simpson, Knight, & Flynn, 2011). Community Healthlink, a large community mental health center that values change and flexibility, enacted such an intervention using an organizational to system-level change approach called Addressing Tobacco Through Organizational Change (ATTOC), developed and implemented by .…”

Readiness and barriers to adopt evidence-based practices for substance abuse treatment in Mexico

“…Challenges still remain and are being studied in the US. [14][15][16][17][18] It is important to understand the challenges for adoption of EBPs in substance abuse treatment in Mexico as the network evolves.…”