Implementing and Sustaining Evidence-Based Drug Treatment in Criminal Justice Settings

1. 1 Implementing and Sustaining Evidence-Based Drug Treatment in Criminal Justice Settings Conference Overview, Orientation, and Logistics Steven Belenko, Ph.D. Harry K. Wexler, Ph.D. Center on Evidence-based Interventions for Crime and Addiction (CEICA) Conference Philadelphia, PA December 6-7, 2006

2. 2 Conference Funding: National Institute on Drug Abuse National Institute on Alcohol Abuse and Alcoholism Bureau of Justice Assistance, Office of Justice Programs Center for Substance Abuse Treatment CEICA Funding: Robert Wood Johnson Foundation National Institute of Corrections Acknowledgments

3. 3 Welcome Conference Overview Evidence-based Practice CEICA Criminal Justice Context EBP Challenges Conference Logistics, Consensus & Next Steps Overview of Presentation

4. 4 Conference Overview What are evidence based practices (EBP)? Framing critical issues in substance abuse treatment for criminal justice populations Challenges of identifying, implementing, and sustaining evidence-based practices Perspectives: practitioners, researchers, policy makers, and recovering persons

5. 5 Conference Overview Goal: consensus on issues/challenges & actions to foster interventions that improve offender outcomes (recovery & crime reduction) CEICA ongoing efforts to clarify EBP issues and to support the dissemination, implementation, and sustaining of EBP Multiple federal agencies support and participation

6. 6 What is Evidence Based Practice? High quality evaluation design and methodology (best is randomized clinical trials), replication by other researchers, and availability of a manual �Evidence-based practice is the integration of best research evidence with clinical expertise and patient values � Patient values refers to the unique preferences, concerns, and expectations that each patient brings to the clinical encounter� (Institute of Medicine, 2001) �Evidence-based practices are interventions for which there is consistent scientific evidence showing that they improve client outcomes.� (Drake et. al., 2001)

7. 7 Efficacy; evidence that a treatment has beneficial effects when delivered under carefully controlled conditions designed for experimentation; the investigator exerts considerable control over sample selection, delivery of the intervention, and settings Effectiveness; evidence that a treatment has beneficial effects when delivered to heterogeneous clinically referred samples treated in clinical settings by clinicians vs. researchers Sustainability; continuance of intervention over time after study completion. Clinical staff decides the program is effective and better than available alternative approaches. Usually requires commitment of local resources after original external funding (e.g., federal) is completed. Efficacy, Effectiveness, & Sustainability

8. 8 Levels of Evidence Participant and Program Staff Observations Qualitative information Focus Groups Expert Panels Key Informant Activities Process Evaluations Quasi-experimental Single Site Experimental Replications and Multisite Random Clinical Trials Multivariate Longitudinal Research

9. 9  Center on Evidence-based Interventions for Crime and Addiction

10. 10 To understand, inform, and facilitate the utilization of evidence based practices (EBP), with the aim of improving substance abuse treatment outcomes for criminal justice-involved clients CEICA Mission

11. 11 Conduct EBP needs assessments with collaborating practitioner organizations Conduct targeted systematic reviews of the scientific evidence Develop and evaluate dissemination and training strategies to maximize use of EBP Work with government partners to identify research/training/dissemination gaps Overview of CEICA Aims

12. 12 Gerald Melnick, Ph.D., National Development & Research Institutes, Inc John Norcross, Ph.D., University of Scranton Roger Peters, Ph.D., University of South Florida Laurie Robinson, University of Pennsylvania Faye Taxman, Ph.D., Virginia Commonwealth University Terry Wilkins, Friends Research Institute Senior TRI Advisors: A. Thomas McLellan, Ph.D. Mady Chalk, Ph.D. Douglas Marlowe, J.D., Ph.D.