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The Process of Innovation: Best Practices A “How-To” Guide.

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Presentation on theme: "The Process of Innovation: Best Practices A “How-To” Guide."— Presentation transcript:

1 The Process of Innovation: Best Practices A “How-To” Guide

2 A Note to Viewers The following slides were gathered and/or prepared for the ADAA Management Conference, October 2004, for a workshop on The Process of Innovation. These slides should give you an orientation about how to approach change within your organization and promote a best practice. Page 1

3 A Note to Viewers There are many ways to learn, which this workshop promotes. Regardless of the following approaches, rigor and thoroughness is recommended for planning. You can then leaving as little to chance as possible but encourage collaboration, initiative and creativity from your staff. 1) The Workbook approach: You will notice references to the Change Book created by ATTC. 2) The Iowa Consortium: Dr. Cohen has created checklists that can be used to assist the process. These were adapted from a report “Evidence-Based Practices”: An Implementation Guide for Community Based Substance Abuse Treatment Agencies” by the IOWA Consortium for Substance Abuse Research and Evaluation. 3) Dwayne Simpson and the TCU group model: Slides are included with accompanying notes that depict a visual approach to planning. You will find among the web site references on the last slides a link to this group. You can then use some very helpful assessment tools for evaluating your agencies readiness for change and program needs. Peter R. Cohen MD, Medical Director, ADAA, October 25, 2004 Page 2

4 The Process of Innovation Participants Will Be Able To  Identify a number of current evidence- based practices  Apply a method for assessing their program’s readiness for adopting evidence-based practices  Apply the steps for organizational change for implementing evidence-based practices

5 Our Step-Wise Approach  Choose a case  Assess the Institution and Patient’s Needs  Choose an EVP  Assess the Readiness for Change  Choose a Model for Change  Carry out the Ten Steps  Evaluate Your Change

6 Ten Steps of Effective Change Initiatives 1. Identify the problem 2. Organize a team 3. Identify an outcome 4. Assess your organization 5. Assess your audience From the Change Book (www.nattc.org, 2002 )

7 6. Identify the approach 7. Design action & maintenance plans 8. Implement the plans 9. Evaluate your plans 10. Revise your plans Ten Steps of Effective Change Initiatives

8 Organizational Readiness for Change (ORC) Resources Offices/Staffing Offices/Staffing Training Training Equipment Equipment Organizational Dynamics Staff: Growth Growth Efficacy Efficacy Influence Influence Adaptability Adaptability Orientation Orientation Climate: Mission Mission Cohesion Cohesion Autonomy Autonomy Communication Communication Stress Stress Change Change Motivation Program Needs Program Needs Training Needs Training Needs Pressures Pressures Program variations ?

9 ProgramImprove-mentProgramImprove-ment Stages of Transfer 1-Exposure (Training) (Training) Lecture Lecture Self Study Self Study Workshop Workshop Consultant Consultant1-Exposure (Training) (Training) Lecture Lecture Self Study Self Study Workshop Workshop Consultant Consultant Program Change Model ProgramChangeProgramChange Services Services Process Process Mgmt Mgmt InstitutionalSupportsInstitutionalSupports Monitoring Monitoring Feedback Feedback Rewards Rewards Organizational Dynamics Satisfaction Satisfaction Ease of use Ease of use Values fit Values fit Institutional & Personal Readiness StaffStaff 2-Adoption (Leadership decision) 2-Adoption 4-Practice (Routine use) 4-Practice 3-Implementation (Exploratory use) 3-Implementation ResourcesResourcesMotivationMotivation Climate for Change StaffAttributesStaffAttributes Reception & Utility Reception Time & Place From Simpson, 2002 (JSAT)

10 Program Staff & Patients 6-9 Mos AfterORC/CEST & PTN WorkshopPlans Workshop Planning & Evaluation Design A B C D ProgramStaff 3-4 Mos AfterFollow-upEvaluation B D C A 3-4 Mos BeforeProgram Staff & Patients ORC/CEST Workshop Sessions: Workshop Sessions: Psychosocial Skills Psychosocial Skills Induction Strategies Induction Strategies Cognitive (Mapping) Cognitive (Mapping) Assessments Assessments 6 Mos BeforeProgramStaff PTN

11 11 An Evidence-Based Treatment Model for Improving Practice D. Dwayne Simpson and Colleagues Texas Christian University

12 Summary PowerPoint Presentations WHAT’S NEW ABOUT IBR STAFF PROJECTS NEWSLETTERS PUBLICATIONS PRESENTATIONS MANUALS FORMS OTHER LINKS Search Contents Site map IBR HOME PAGE SITE GUIDES: IBRIBR Institute of Behavioral Research at Texas Christian University The IBR specializes in the study of drug abuse treatment – including new interventions, therapeutic process, and outcomes. DATOSDATOS TCU Resource Collections: National Treatment Evaluations Correctional Treatment Evaluations Treatment Process Counseling Manuals Cognitive Interventions Technology Transfer Client/Treatment Assessments Spotlight…_______________ New studies on “transferring research to practice” were recently published in a special issue of Journal of Substance Abuse Treatment The latest Research Roundup Newsletter is out, focusing on IBR technology transfer research Handouts from presentations available Core Forms & Research Summaries available Publication Abstracts available New Activities…___________ The IBR Website is redesigned to streamline access and highlight integrated sets of materials – manuals, forms, findings – in specialized Resource Collections

13 Elements of a Treatment Process Model SufficientRetentionSufficientRetention ? PatientFactorsPatientFactors Psychological Functioning, Motivation, & Problem Severity Cognitive and behavioral components with therapeutic impact Posttreatment DrugUseDrugUse CrimeCrime SocialRelationsSocialRelations Detox OP-DF TC/Res OP-MM

14 TCU Treatment Process Model SufficientRetentionSufficientRetention Posttreatment DrugUseDrugUse CrimeCrime SocialRelationsSocialRelations PatientAttributes at Intake PatientAttributes Motiv Simpson, 2001 (Addiction) EarlyEngagementEarlyRecovery ProgramParticipationProgramParticipation TherapeuticRelationshipTherapeuticRelationship BehavioralChangeBehavioralChange Psycho-SocialChangePsycho-SocialChange Engagement

15 Adequate Stay in Tx Posttreatment DrugUseDrugUse CrimeCrime SocialRelationsSocialRelations Program Participation Therapeutic Relationship Behavioral Change Cognitive Change Patient Readiness for Tx “Sequence” of Recovery Stages Targeted Interventions Get Focused!!

16 Simpson, 2001 (Addiction) SufficientRetentionSufficientRetention EarlyEngagementEarlyRecovery Posttreatment DrugUseDrugUse CrimeCrime SocialRelationsSocialRelations ProgramParticipationProgramParticipation TherapeuticRelationshipTherapeuticRelationship BehavioralChangeBehavioralChange Psycho-SocialChangePsycho-SocialChange PatientAttributes at Intake PatientAttributes Motiv Interventions Should Maintain This Process

17 Sufficient Retention Early Engagement Early Recovery Posttreatment Drug Use Crime Social Relations Program Participation Therapeutic Relationship Behavioral Change Psycho-Social Change Patient Attributes at Intake Motiv Induction to Treatment (Motivational Enhancement) Simpson & Joe, 1993 (Pt); Blankenship et al., 1999 (PJ); Sia, Dansereau, & Czuchry, 2000 (JSAT) Problem Recognition Desire for Help Readiness for Treatment

18 Sufficient Retention Early Engagement Early Recovery Posttreatment Drug Use Crime Social Relations Program Participation Therapeutic Relationship Behavioral Change Psycho-Social Change Patient Attributes at Intake Motiv Counseling Enhancements (Cognitive “Mapping”) Dansereau et al., 1993 (JCP), 1995 (PAB); Joe et al., 1997 (JNMD); Pitre et al., 1998 (JSAT)

19 Sufficient Retention Early Engagement Early Recovery Posttreatment Drug Use Crime Social Relations Program Participation Therapeutic Relationship Behavioral Change Psycho-Social Change Patient Attributes at Intake Motiv Contingency Management (Token Rewards) Rowan-Szal et al., 1994 (JSAT); 1997 (JMA); Griffith, Rowan-Szal et al., 2000 (DAD)

20 Sufficient Retention Early Engagement Early Recovery Posttreatment Drug Use Crime Social Relations Program Participation Therapeutic Relationship Behavioral Change Psycho-Social Change Patient Attributes at Intake Motiv Specialized Interventions (Skills-Based Counseling Manuals) Specialized Interventions (Skills-Based Counseling Manuals) Bartholomew et al., 1994 (JPD); 2000 (JSAT); Hiller et al., 1996 (SUM) Supportive Networks

21 SufficientRetentionSufficientRetention EarlyEngagementEarlyRecovery Posttreatment DrugUseDrugUse CrimeCrime SocialRelationsSocialRelations ProgramParticipationProgramParticipation TherapeuticRelationshipTherapeuticRelationship BehavioralChangeBehavioralChange Psycho-SocialChangePsycho-SocialChange PatientAttributes at Intake PatientAttributes Motiv Evidence-Based Treatment Model EnhancedCounseling BehavioralStrategies Social Skills Training Family & Friends SupportiveNetworksSupportiveNetworks Induction Personal Health Services Social Support Services ProgramCharacteristicsProgramCharacteristicsStaffAttributes & Skills StaffAttributes Simpson, 2001 (Addiction)

22 Summary  Defined evidence-based practice  Considered barriers to adoption  Noted counselor endorsements and recommendations for manuals  Described an evidence-based practice model  Discussed how manuals fit within that model

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34 Sources of Evidence-Based Information on the Web  Managed Care samhsa.gov/mcnew samhsa.gov/mcnew  Dual Disorders dartmouth.edu/~psychrc dartmouth.edu/~psychrc  Stimulant Treatment matrixcenter.com matrixcenter.com  Drug Abuse Treatment ibr.tcu.edu ibr.tcu.edu

35 Sources of Evidence-Based Information on the Web  Drug Abuse Treatment nida.nih.gov nida.nih.gov  Alcoholism Treatment niaaa.nih.gov niaaa.nih.gov  Addiction Medicine asam.org asam.org  HIV/AIDS cdc.gov/idu/ cdc.gov/idu/

36 Sources of Evidence-Based Information on the Web  Prevention unr.edu/westcapt unr.edu/westcapt  Technology Transfer nattc.org nattc.org  Addiction Science utexas.edu/research/asrec utexas.edu/research/asrec


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