Our recent series of innovative randomized trials evaluating the efficacy of various strategies for training clinicians to use evidence based therapies in alcohol and drug abuse has indicated that while both in-person workshop and computer-assisted training can impart the skills necessary to deliver Twelve Step Facilitation, they are by no means sufficient in establishing competence. Rather, they are an essential first step in providing therapists with initial exposure to basic skills and strategies; to assure that clinicians implement this and other evidence based therapies consistently, effectively, and with adequate fidelity to manual guidelines, ongoing supervision and feedback via monitoring of clinicians' implementation of TSF are essential. However, there are no existing tools available for use by clinical supervisors to guide performance monitoring and feedback in clinicians' implementation of TSF. The overall aim of this Phase I SBIR is to develop a prototype TSF Supervisors Toolkit and to conduct a pilot feasibility study to evaluate the effectiveness of the Toolkit on the ability of clinical supervisors in community-based addiction treatment settings to accurately evaluate clinicians' fidelity (e.g., adherence and competence) in delivering TSF. If successful, Phase I would provide preliminary evidence that the TSF Supervision Toolkit is feasible and effective in training clinical supervisors to accurately assess clinicians' fidelity and skill in TSF. Specific aims are as follows: 1. Develop a prototype of the TSF Supervisors Toolkit and supervisor workshop. If the Phase I project is successful, these materials will become the basis of a more comprehensive, interactive CD-Rom based version of the Toolkit for a Phase II application, which would be evaluated in a randomized trial of the impact of ongoing structured supervision on the ability of clinicians to conduct TSF effectively. 2. Conduct a randomized pilot trial evaluating the impact of the prototype CBT Supervision Toolkit and workshop on clinical supervisors' ability to evaluate clinicians' fidelity in delivering TSF. We will randomize 30 clinical supervisors recruited from community based clinics in New England to two groups: one group will receive the prototype TSF Supervision Toolkit and training via a workshop; the other will receive no formal training. The primary outcome measure will be condition by time differences in the supervisors' accuracy in completing the adherence/competence ratings (in comparison to a master set of expert ratings). We hypothesize that those assigned to the prototype Toolkit and workshop will have greater increases in the accuracy of their adherence and competence ratings compared to those who receive no training.
Public Health Relevance: The overall aim of this Phase I SBIR is to develop a prototype TSF Supervisor's Toolkit and to conduct a pilot feasibility study to evaluate the effectiveness of the Toolkit on the ability of clinical supervisors in community- based addiction treatment settings to accurately evaluate clinicians' fidelity (e.g., adherence and competence) in delivering TSF and to provide effective clinical supervision and coaching to clinicians in TSF. Supervision and feedback via monitoring of clinicians' application of TSF is essential to assure that clinicians implement TSF (and other evidenced based therapies) consistently, effectively and with sufficient fidelity to manual guidelines. If successful, Phase I would provide preliminary evidence that the TSF Supervision Toolkit is feasible and effective in training clinical supervisors to accurately assess clinicians' fidelity and skill in TSF.
Public Health Relevance Statement: PROJECT NARRATIVE The overall aim of this Phase I SBIR is to develop a prototype TSF Supervisor's Toolkit and to conduct a pilot feasibility study to evaluate the effectiveness of the Toolkit on the ability of clinical supervisors in community- based addiction treatment settings to accurately evaluate clinicians' fidelity (e.g., adherence and competence) in delivering TSF and to provide effective clinical supervision and coaching to clinicians in TSF. Supervision and feedback via monitoring of clinicians' application of TSF is essential to assure that clinicians implement TSF (and other evidenced based therapies) consistently, effectively and with sufficient fidelity to manual guidelines. If successful, Phase I would provide preliminary evidence that the TSF Supervision Toolkit is feasible and effective in training clinical supervisors to accurately assess clinicians' fidelity and skill in TSF.
NIH Spending Category: Alcoholism; Behavioral and Social Science; Bioengineering; Brain Disorders; Clinical Research; Clinical Trials; Comparative Effectiveness Research; Substance Abuse
Project Terms: Address; Adherence; Adherence (attribute); Alcohols; Behavior Conditioning Therapy; Behavior Modification; Behavior Therapy; Behavior Treatment; Behavior or Life Style Modifications; Behavioral Conditioning Therapy; Behavioral Modification; Behavioral Therapy; Behavioral Treatment; CD-I; CDI; Chemical Class, Alcohol; Classification; Clinic; Clinical; Communities; Compact Disc-Interactive; Compact Disk Interactive; Competence; Computer Assisted; Conditioning Therapy; Controlled Clinical Trials, Randomized; Development; Drug abuse; Educational process of instructing; Educational workshop; Effectiveness; Evaluation; Evidence based practice; Exposure to; Feasibility Studies; Feedback; Guidelines; Individual; Interactive CD; Life Style Modification; Manuals; Measures; Medical; Modeling; Monitor; Multimedia; Multimedium; NIAAA; NIH; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; National Institutes of Health (U.S.); New England; Northeastern United States; On-Line Systems; Online Systems; Outcome; Outcome Measure; Performance; Persons; Phase; Play; Population; Procedures; Productivity; Programs (PT); Programs [Publication Type]; Qualifying; RFP; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Reading; Recruitment Activity; Request for Proposals; Role; SBIR; SBIRS (R43/44); Sampling; Self Assessment; Self Assessment (Psychology); Series; Small Business Innovation Research; Small Business Innovation Research Grant; Structure; Supervision; System; System, LOINC Axis 4; Systematics; Teaching; Time; Training; Training Programs; United States National Institutes of Health; Videotape; Work; Workshop; abuse of drugs; abuses drugs; addiction; base; behavior intervention; behavioral intervention; clinical practice; comparative efficacy; computer aided; cost; cost effectiveness; evidence base; innovate; innovation; innovative; motivational enhancement therapy; motivational interview; online computer; pilot trial; primary outcome; programs; prototype; public health relevance; randomisation; randomization; randomized trial; randomly assigned; recruit; response; skills; social role; tool; trial comparing; web based
