TY - JOUR
T1 - Implementation of a Brief Treatment Counseling Toolkit in Federally Qualified Healthcare Centers
T2 - Patient and Clinician Utilization and Satisfaction
AU - Brooks, Adam C.
AU - Chambers, Jaclyn E.
AU - Lauby, Jennifer
AU - Byrne, Elizabeth
AU - Carpenedo, Carolyn M.
AU - Benishek, Lois A.
AU - Medvin, Rachel
AU - Metzger, David S.
AU - Kirby, Kimberly C.
N1 - Funding Information:
This research was made possible by a Commonwealth Universal Research Enhancement Program grant awarded by the Pennsylvania Department of Health (SAP No. 4100055578 ). These funding sources were not involved in the study’s conceptualization, data analysis/interpretation, or manuscript writing. The authors wish to acknowledge the Directors of the three participating primary care centers, Patricia Gerrity, Anne Kelly, and Donna Torrisi, along with the Behavioral Health Counselors who provided support and were responsible for implementing the interventions. The authors also acknowledge Mary Milnamow and Michelle Henry who organized and conducted many of the staff and patient interviews. Finally, the authors acknowledge the contribution of the research technicians who assisted in implementing the project at the primary care sites: Roxana Arango, Meredith Asch, Emily Ball, Christina Cruz, Nicolas Joseph, and Tameka Williams. This study describes the SBIRT + Toolkit ™ , which is the property of the Treatment Research Institute. TRI may market this Toolkit, and currently distributes other Toolkit products. TRI is a non-profit research organization, and all proceeds are returned to the core mission of treatment research. While many of the co-authors are employees of TRI, we do not benefit financially from the sale of its products.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Introduction: The need to integrate behavioral health care within medical settings is widely recognized, and integrative care approaches are associated with improved outcomes for a range of disorders. As substance use treatment integration efforts expand within primary care settings, training behavioral health providers in evidence-based brief treatment models that are cost-effective and easily fit within the medical flow is essential. Methods: Guided by principles drawn from Diffusion of Innovations theory (Rogers, 2003) and the Consolidated Framework of Implementation Research (Damschroder et al., 2009), we adapted elements of Motivational Enhancement Therapy, cognitive-behavioral therapy, and 12-step facilitation into a brief counseling toolkit. The toolkit is a menu driven assortment of 35 separate structured clinical interventions that each include client takeaway resources to reinforce brief clinical contacts. We then implemented this toolkit in the context of a randomized clinical trial in three Federally Qualified Healthcare Centers. Behavioral Health Consultants (BHCs) used a pre-screening model wherein 10,935 patients received a brief initial screener, and 2011 received more in-depth substance use screening. Six hundred patients were assigned to either a single session brief intervention or an expanded brief treatment encompassing up to five additional sessions. We conducted structured interviews with patients, medical providers, and BHCs to obtain feedback on toolkit implementation. Results: On average, patients assigned to brief treatment attended 3.29 sessions. Fifty eight percent of patients reported using most or all of the educational materials provided to them. Patients assigned to brief treatment reported that the BHC sessions were somewhat more helpful than did patients assigned to a single session brief intervention (p= .072). BHCs generally reported that the addition of the toolkit was helpful to their work in delivering screening and brief treatment. Discussion: This work is significant because it provides support to clinicians in delivering evidence-based brief interventions and has been formatted into presentation styles that can be presented flexibly depending on patient need.
AB - Introduction: The need to integrate behavioral health care within medical settings is widely recognized, and integrative care approaches are associated with improved outcomes for a range of disorders. As substance use treatment integration efforts expand within primary care settings, training behavioral health providers in evidence-based brief treatment models that are cost-effective and easily fit within the medical flow is essential. Methods: Guided by principles drawn from Diffusion of Innovations theory (Rogers, 2003) and the Consolidated Framework of Implementation Research (Damschroder et al., 2009), we adapted elements of Motivational Enhancement Therapy, cognitive-behavioral therapy, and 12-step facilitation into a brief counseling toolkit. The toolkit is a menu driven assortment of 35 separate structured clinical interventions that each include client takeaway resources to reinforce brief clinical contacts. We then implemented this toolkit in the context of a randomized clinical trial in three Federally Qualified Healthcare Centers. Behavioral Health Consultants (BHCs) used a pre-screening model wherein 10,935 patients received a brief initial screener, and 2011 received more in-depth substance use screening. Six hundred patients were assigned to either a single session brief intervention or an expanded brief treatment encompassing up to five additional sessions. We conducted structured interviews with patients, medical providers, and BHCs to obtain feedback on toolkit implementation. Results: On average, patients assigned to brief treatment attended 3.29 sessions. Fifty eight percent of patients reported using most or all of the educational materials provided to them. Patients assigned to brief treatment reported that the BHC sessions were somewhat more helpful than did patients assigned to a single session brief intervention (p= .072). BHCs generally reported that the addition of the toolkit was helpful to their work in delivering screening and brief treatment. Discussion: This work is significant because it provides support to clinicians in delivering evidence-based brief interventions and has been formatted into presentation styles that can be presented flexibly depending on patient need.
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U2 - 10.1016/j.jsat.2015.08.005
DO - 10.1016/j.jsat.2015.08.005
M3 - Article
C2 - 26508714
AN - SCOPUS:84952637186
VL - 60
SP - 70
EP - 80
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
SN - 0740-5472
ER -