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RESEARCH OVERVIEW Traci Rieckmann, Ph.D. OREGON HEALTH AND SCIENCES UNIVERSITY DOUG NOVINS, M.D., UNIVERSITY OF COLORADO DENVER LAURIE MOORE, M.P.H. UNIVERSITY.

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Presentation on theme: "RESEARCH OVERVIEW Traci Rieckmann, Ph.D. OREGON HEALTH AND SCIENCES UNIVERSITY DOUG NOVINS, M.D., UNIVERSITY OF COLORADO DENVER LAURIE MOORE, M.P.H. UNIVERSITY."— Presentation transcript:

1 RESEARCH OVERVIEW Traci Rieckmann, Ph.D. OREGON HEALTH AND SCIENCES UNIVERSITY DOUG NOVINS, M.D., UNIVERSITY OF COLORADO DENVER LAURIE MOORE, M.P.H. UNIVERSITY OF COLORADO DENVER NIDA Roundtable Meeting on Evidence-Based Treatments for Substance Abuse in Indian Country Frank Big Bear

2 Role of the Provider  Counselors/providers play significant role  quality of care  patient satisfaction and outcomes  implementation of new practices.  Provider support varies depending on intervention, counselor education level, and experience.  Adoption of new therapies requires marketing of interventions, supervision, exposure to the innovative, practice, and monitoring for adherence (Abraham, et al., 2009; Santisteban, Vega, & Suarez-Morales, 2006; Knudsen, et al., 2007).

3 The Current Workforce  Counseling workforce is estimated to include approximately 200,000 individuals (SAMHSA, 2013; Libretto et al, 2004).  Workforce analysis suggests majority of treatment professionals are Caucasian, middle- aged, and more often female than male (SAMHSA, 2013; Abraham, Ducharme, & Roman, 2009; Mulvey et al., 2003; Libretto et al., 2004).  Counseling workforce is projected to increase 20-24% by 2018 (SAMHSA, 2013).

4 Workforce Studies  Characteristics individual  Training  Credentials/competencies  Attitudes and experiences  Toward EBPs  Administration and leadership  Intentions to use innovation  Results often vary across:  Treatment Setting (funding sources: Public, private)  Time frame

5 Workforce Studies NIDA CTNNTCS SAMHSA (2013) Gender Male38%38.7%28.8% Female62%61.3%71.2% Race/Ethnicity White63%70.2%55.8% African American20%18.7%27.9% Hispanic/Latino12%11.1% (or “Other”)11.1% AI/AN0.7% Education Master’s or Doctorate42%42.5%50-55% Certification/License44% State 18% National 59.4% Certified; 32.9% Licensed 45-72% Credentialed

6 Transitions and Growth  Annual turnover rate is cited as being anywhere between 18% and 50% (Rothrauff et al., 2011; Eby, et al., 2010; Johnson et al., 2002; McNulty et al., 2007; Mclellan et al., 2003).  Projected growth across disciplines:  Substance Abuse & Behavioral Disorders Counselors21%  Mental Health Counselors24%  Mental Health & Substance Abuse Social Workers 20%  Psychologists 11% To date, no national study has focused on the characteristics of counselors working in AI/AN treatment programs.

7  DATA ANALYSIS METHODS  Sample (n=192)  Analytic methods used  Descriptive analyses by program location (rural/urban) were completed on all variables that described either respondent, staff, or program characteristics;  Variables with p-values <=0.25 in a univariate regression with program location (rural/urban) were entered into logistic regression models that follow

8 TABLE 1a: Characteristics of Staff of 192 Substance Abuse Programs by Program Location Characteristic Total respondents (N=192) Urban Programs (n=50) Rural Programs (n=142) N%n%n% 51% or more of staff are AI/AN Staff with master’s or doctoral degree Tribal language spoken by one or more staff % or more of staff in recovery Staff years of experience in program (mean, std dev) 5.6 (3.5)4.5 (2.7)6.0 (3.7)

9 TABLE 1b: Characteristics of Staff of 192 Substance Abuse Programs Participating in the Evidence-Based Practices Survey, by Program Location Characteristic Total respondents (N=192) Urban Programs (n=50) Rural Programs (n=142) n%n%n% 51% or more of staff are certified addictions counselors % or more of staff are certified mental health counselors % or more of staff are licensed counseling professionals* * Licensed addictions counselor, licensed clinical social worker, licensed clinical psychologist, physician, etc.

10 TABLE 1c: Characteristics of Staff of 192 Substance Abuse Programs Participating in the Evidence-Based Practices Survey, by Program Location Characteristic Total respondents (N=192) Urban Programs (n=50) Rural Programs (n=142) n%n%n% Traditional healers on staff Veterans/Nat’l Guard members on staff LGBT on staff Disciplines represented on staff Addictions Mental health Social work Education Nursing Medicine/psychiatry

11 TABLE 2a: Program Characteristics of 192 Substance Abuse Programs Participating in the Evidence-Based Practices Survey, by Program Location Characteristic Total respondents (N=192) Urban Programs (n=50) Rural Programs (n=142) n%n%n% Struggle to recruit / retain staff Collect treatment outcome data Utilize outside evaluator Utilize strategic planning to improve services

12 TABLE 2b: Program Characteristics of 192 Substance Abuse Programs Participating in the Evidence-Based Practices Survey, by Program Location Characteristic Total respondents (N=192) Urban Programs (n=50) Rural Programs (n=142) n%n%n% Consider the use of EBPs as part of strategic planning process Formal method used to assess motivation for change Program participated in research/program evaluation study

13 Table 3a. Logistic regression model predicting rural program location with staff characteristics as predictors. B-coefficientOdds ratio 95% Wald confidence limitsP-value Nursing discipline on staff Traditional healing consultants on staff

14 Staffing Characteristics Programs in rural locations are LESS likely to  Have nurses on staff  Have traditional healing consultants on staff

15 Table 3b. Logistic regression model predicting rural program location with program characteristics as predictors. B- coefficient Odds ratio 95% Wald confidence limits P-value Program struggles to recruit / retain staff AA – open group recovery services offered Equine therapy offered Medication therapies offered Pipe ceremonies offered Cultural activities offered Religious services offered Meditation services offered

16 Program Characteristics  Struggle to recruit and retain staff  Offer AA-open group recovery services  Offer equine therapy  Offer religious and meditation services  Offer medication therapies  Offer pipe ceremonies and cultural activities Rural programs are MORE likely toRural programs are LESS likely to

17 Table 3c. Logistic regression model predicting rural program location with program assessment characteristics as predictors. B- coefficient Odds ratio 95% Wald confidence limits P-value Program collects data on treatment outcomes Program uses an outside evaluator Program participated in research or program evaluation study

18 Program Assessment  Collect data on treatment outcomes  Use an outside evaluator  Participate in research or program evaluation Rural programs are MORE likely toRural programs are LESS likely to


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