SECTION
ON TREATMENT SYSTEMS
Director: Deni Carise, Ph.D.
Selected
Projects: Policy Development
Performance
Based Purchasing in the Delaware Substance Abuse Treatment System:
Deni Carise, Ph.D.
A performance based purchasing system for substance abuse treatment services
was developed by the State of Delaware with assistance from TRI investigators.
Team members helped State officials and treatment providers introduce
a performance-based contracting system rewarding providers able to increase
capacity utilization and rates of retention in treatment. Read
evaluation study. (See follow-up project under Research and Evaluation,
below.)
Reducing Paperwork
Burdens of Outpatient Treatment Providers in Delaware:
Deni Carise, Ph.D.
As part of a NIDA-funded grant to expand Delaware’s performance
monitoring/contracting procedures over four phases (see study description
under Research & Evaluation, below) TRI completed a systematic evaluation
of the multiple data collection demands placed upon state-funded outpatient
treatment providers. TRI’s recommendations were adopted and resulted
in decreases in paperwork burden at admission, during ongoing treatment
and at discharge. Read
study or view Research
Brief.
Selected
Projects: Research and Evaluation
Concurrent
Recovery Monitoring in Delaware: Deni Carise, Ph.D.
In this NIDA R21 Exploratory Grant, Dr. Carise is collaborating with Delaware
agency staff and outpatient treatment providers to extend the performance-based
contracting system already in place. During the two-year pilot project
the team: 1) completed a systematic evaluation of the “paperwork
burden” in each treatment program with the goal of removing unnecessary
and burdensome requirements and consolidating others; 2) selected a small
number of additional performance indicators for regular collection within
the existing outpatient performance monitoring/contracting system; 3)
will pilot test the data collection, recording and reporting procedures
for these additional CRM measures to assess their feasibility and their
usefulness to the treatment programs; and 4) will use the results of this
work to submit further proposals to evaluate evidence-based practices
and to further develop the statewide CRM system.
Betty
Ford: Focused Continuing Care; Deni Carise, Ph.D.
An existing extended care model, “Focused Continuing Care”
or “FCC” has been standardized to simplify training and improve
client engagement. The frequency of post-discharge telephone contact was
increased with more emphasis on follow-up contact rates. Other changes
engage clients and their families in the recovery process by providing
graphic reports illustrating clinical progress and “next steps”
toward recovery. Development of a data collection/reporting infrastructure
allowing Betty Ford counselors to assess results of future FCC changes
is underway.
Computer
Assisted System for Patient Assessment and Referral (CASPAR): Bucks, Delaware
and Montgomery Counties: Deni Carise, Ph.D.
This NIDA-funded study is a replication of a previous study in Philadelphia
that found that with brief training on CASPAR, 1) counselors developed
treatment plans that were better matched to patient needs; 2) patients
received more and better matched services, and 3) patients stayed in treatment
longer and were more likely to complete the full course of treatment.
The five-year study, now in itss second year, seeks to enroll 20 treatment
programs, at least 40 counselors and 400 patients into the two Phases
of the study. More
on CASPAR.
In Phase I, approximately 40 counselors drawn from all adult, abstinence-oriented
outpatient treatment programs will be trained to administer the ASI. TRI
will review ASIs and completed treatment plans for five clients from each
recruited counselor. In Phase II, counselors will receive either a three-hour
CASPAR training or a three-hour ASI Booster Training. TRI will follow
all clients from Phases I and II at 2, 4, 8 and 12 weeks post admission
using the Treatment Services Review to measure the number and types of
services received. At six months post admission, TRI will administer the
ASI and TSR, along with the Helping Alliance Questionnaire, saliva drug
screen, and breathalyzer. Data from clients will be compared between counselor
groups to assess replication of previous study findings and to assess
the effects of CASPAR training compared to ASI training only.
Computer
Assisted System for Patient Assessment and Referral (CASPAR): South Jersey:
Deni Carise, Ph.D.
A replication study similar in methodology to the Bucks, Montgomery and
Delaware Counties study is funded by NIAAA to evaluate the CASPAR training
and resource guide in South Jersey, with primarily alcohol dependent clients.
Group
Drug Counseling Toolkits: Deni Carise, Ph.D.
This NIDA-funded study is evaluating the feasibility, acceptability
and impact of a “Toolkit” designed to assist counselors to
conduct group therapy sessions using motivational interviewing techniques
with minimal prior training. The “Toolkit” is a plastic clipboard
containing 1) a laminated Clinician’s Guide with prompts; 2) a five
minute DVD played at the beginning of the group as orientation; 3) patient
worksheets for listing “good things” and “not so good
things” about recovery; and 4) wallet cards for patients to record
reminders about their recovery process. Up to 30 counselors will be recruited
from six programs in Philadelphia and asked to conduct one Toolkit-informed
group session with brief advance training. They will also be invited to
conduct additional sessions on a voluntary basis over a three-month period
with no additional training. Survey feedback collected from patients and
clinicians will evaluate patient satisfaction, increases in readiness
to change, and clinician acceptance and ability to administer the technique
with proficiency.
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