1. presented by John G. Gardin II, Ph.D. Director of Behavioral Health & Research, ADAPT Clinical Assistance Professor, OHSU Medical School

2. Why CRA? Solid research base, with and without contingency management Amenable to blending with other skill modules 12-Step friendly Cost effectiveness Learner-friendly

3. ADAPT, Inc. Founded in 1969; incorporated in 1971 ≈ 150 employees with 80 clinical staff 9 offices in 3 rural counties Outpatient and Intensive Outpatient SUD for adolescents, adults (specialty services for women) Outpatient MH for adolescents and adults Residential SUD (CD) for adolescents, adults (specialty for women with infants) FQHC

5. Training and Implementation All-agency 2-day Training (Jun 2006) Individual Program Training (Jan-Jun 2007) Master’s Clinicians Training (Sep 2007 – present) Skills Training – Programs (Sep 2008 - present) Audiotape reviews (Sep 2009 - present)

6. Outcomes Qualitative Staff cohesiveness Programmatic identity Programmatic consistency Inter-programmatic consistency Choose your roll-out carefully Choose your expert carefully Pick Change Leaders early Be persistent and consistent