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Saturday May 17, 2013 Cheryl A. Branch, MS, Community Trainer, UCLA-ISAP PSATTC

Knowledge Application Programs (KAPS) in Faith-based Reentry Community Substance Abuse Treatment Settings. Saturday May 17, 2013 Cheryl A. Branch, MS, Community Trainer, UCLA-ISAP PSATTC 2012-2013 Faith-based Education & Training Series. Faith-based Organizations.

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Saturday May 17, 2013 Cheryl A. Branch, MS, Community Trainer, UCLA-ISAP PSATTC

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  1. Knowledge Application Programs (KAPS) in Faith-based Reentry Community Substance Abuse Treatment Settings Saturday May 17, 2013 Cheryl A. Branch, MS, Community Trainer, UCLA-ISAP PSATTC 2012-2013 Faith-based Education & Training Series

  2. Faith-based Organizations • The next generation of prison ministries is here. In response to the call for national action to reduce alcohol & drug abuse health disparities LAM congregations developed a plan to promote EBPs in small to mid size AOD treatment and counseling providers in South LA and partnered with UCLA PSATTC. • Knowledge Application Programs (KAPs) are an opportunity for FBOs to participate and practice EBPs

  3. Bridging The Gap • In California, publicly funded addiction services are impacted by increasingly a need to understand Prisoner Reentry

  4. Realignment Sentencing Created New Populations in California Current offense violent/serious/ sex-related Parole State prison PRCS (Post-release Community Supervision) Current offense is not violent/serious/ sex-related, but prior offense(s) was Jail only County Sentence (Local Prison Term) (1170(h) Neither current offense nor prior offense was violent/serious/sex-related Jail + Mandatory Supervision Mandatory Supervision only

  5. The Landscape for Addressing the Alcohol and Drug Treatment and Health Care Needs of the Reentry Population Has Changed • Recession of 2008 had a major impact on counties’ health care safety nets

  6. ???? So, how do you decide what to do?

  7. Prison and Parole Tend to Have a Number of Chronic Health Conditions ^Indicates differences between Prison vs. Parole statistically significant at .05 level.

  8. PRCS and Local Custody Tend to Be Physically Healthier Than Prison/Parole Populations *Indicates differences between Parole vs. PRCS statistically significant. State vs. Local also significant.

  9. There Is More Serious Mental Illness Among the Parole Population ^Indicates differences between Prison vs. Parole statistically significant at .05 level.

  10. County Clients Tend to Have More Treatment Needs with Respect to Drug Abuse/Dependence *Indicates differences between Parole vs. PRCS statistically significant. All State vs. Local differences also significant.

  11. Understanding the ‘New Normal’ in FB Reentry Community Treatment Settings • In the new ones, the infrastructure will have to include internal systems that: • support performance monitoring systems • assess impact of fidelity vs. adaptation on outcomes of treatment provider • use of both KAP and non-KAP products, and provide input to the scientific community regarding new research priorities and service gaps for the substance abuse treatment field. 

  12. Solutions

  13. Knowledge Application Program (KAP) • SAMHSA's Knowledge Application Program (KAP) provides substance abuse treatment professionals (i.e. Faith-based Counselors, Prevention Specialists) with publications, online education, and other resources that contain information on best treatment practices. • www.kap.samhsa.gov • You can access these resources online and no- cost! • Some materials available for non-English speaking populations

  14. Knowledge Application Programs (KAPS) • The KAP approach integrates science-based health communications, social marketing, and knowledge transfer activities into an evidence-based dissemination practice which includes: • Developing a culturally competent Knowledge Transfer Model based on proven dissemination principles and practices • Developing products and processes to present research findings, best practices, and promising practices to the field • Using partnerships with organizations as an effective service practice and as a strategy in creating effective distribution channels. • LAM is practicing the KAP approach to community education and professional development for faith-based clergy and laity addiction counselors

  15. SAMHSA Center for Mental Health Services - Knowledge Application Program (CMHS/KAP) - Dedicated to supporting product development and dissemination through providing innovative use of media and marketing that will advance the adoption of evidenced -based and promising practices in servicing persons with mental illnesses and/or substance use disorders.

  16. Different Types of KAPs • SAMHSA Protocol (TIP) Series • SAMHSA Technical Assistance Publications (TAPs) • Periodicals • ATTC’s • Local quarterly LAC SAPC training • Local ONTRACK Program Resources (state)

  17. How Are Evidence-Based Practices Documented? Gold Standard • Multiple randomized clinical trials Second Tier • Consensus reviews of available science Third Tier • Expert opinion based on clinical observation

  18. Process Benchmarking In Action • How do they do it? • The identification of “best practices?”

  19. In Plain Terms, Please • It’s about: • Critical Thinking, • Standardized Approaches • Collective Work Teams • Lots of Reading and Writing • Disciplined Procedures & Systems • Follow the Plan—all the time • Balancing idea each client is different and the same • It is not your program’s daily schedule

  20. Evidence-Based Practices for Alcohol Treatment • Brief intervention • Social skills training • Motivational enhancement • Community reinforcement • Behavioral contracting

  21. Scientifically-Based Approaches to Addiction Treatment • Cognitive–behavioral interventions • Community reinforcement • Motivational enhancement therapy • 12-step facilitation • Contingency management • Pharmacological therapies • Systems treatment

  22. What Does All This Mean? • We have an opportunity to improve treatment services. • There are effective and cost-efficient treatments available for alcohol and drug dependence. • Need solutions for Changing Environment in local agencies (i.e. SAPC, DMH, DPSS, Probation, LAUSD, Courts)

  23. In Summary

  24. 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

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

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

  27. Sources of Evidence-Based Information on the Web • Prevention • unr.edu/westcapt • Technology Transfer • nattc.org • Addiction Science • utexas.edu/research/asrec • http://gainscenter.samhsa.gov/topical_resources/ebps.asp • http://www.nrepp.samhsa.gov/Learnlanding.aspx • http://store.samhsa.gov/list/series?name=Evidence-Based-Practices-KITs

  28. An Evidence-Based Treatment Model for Improving Practice1

  29. Group/Individual Counseling Urine Monitoring Core Treatment Abstinence Based Case Management Intake Assessment Pharmaco-therapy Continuing Care Treatment Plans Self-Help (AA/NA) Core Components of Comprehensive Services Medical Financial Mental Health Housing & Transportation Vocational Child Care Educational Family Legal AIDS / HIV Risks

  30. Elements of a Treatment Process Model Detox Patient Factors ? OP-DF Sufficient Retention Drug Use PsychologicalFunctioning, Motivation, & ProblemSeverity TC/Res Crime Social Relations OP-MM Post-treatment Cognitive and behavioralcomponents with therapeutic impact

  31. Motiv Patient Attributes at Intake TCU Treatment Process Model Early Engagement Early Recovery Program Participation Behavioral Change Sufficient Retention Drug Use Crime Therapeutic Relationship Psycho-Social Change Social Relations Posttreatment Engagement Simpson, 2001 (Addiction)

  32. Drug Use Crime Social Relations Posttreatment “Sequence” of Recovery Stages Patient Readiness for Tx Program Participation Behavioral Change AdequateStay in Tx Therapeutic Relationship Cognitive Change Targeted Interventions Get Focused!!

  33. Interventions Should Maintain This Process Motiv Patient Attributes at Intake Early Engagement Early Recovery Program Participation Behavioral Change Sufficient Retention Drug Use Crime Therapeutic Relationship Psycho-Social Change Social Relations Posttreatment

  34. Early Engagement Early Recovery Motiv Patient Attributes at Intake Program Participation Behavioral Change Sufficient Retention Drug Use Crime Therapeutic Relationship Psycho-Social Change Social Relations Posttreatment Induction to Treatment(Motivational Enhancement) ProblemRecognition Desirefor Help Readinessfor Treatment

  35. Early Engagement Early Recovery Motiv Patient Attributes at Intake Program Participation Behavioral Change Sufficient Retention Drug Use Crime Therapeutic Relationship Psycho-Social Change Social Relations Posttreatment Counseling Enhancements(Cognitive “Mapping”)

  36. Early Engagement Early Recovery Motiv Patient Attributes at Intake Program Participation Behavioral Change Sufficient Retention Drug Use Crime Therapeutic Relationship Psycho-Social Change Social Relations Posttreatment Contingency Management(Token Rewards)

  37. Early Engagement Early Recovery Motiv Patient Attributes at Intake Program Participation Behavioral Change Sufficient Retention Drug Use Crime Therapeutic Relationship Psycho-Social Change Social Relations Posttreatment Specialized Interventions (Skills-Based Counseling Manuals) Supportive Networks

  38. Motiv Patient Attributes at Intake Program Characteristics Staff Attributes & Skills Evidence-Based Treatment Model Behavioral Strategies Induction Family & Friends Personal Health Services Supportive Networks Early Engagement Early Recovery Program Participation Behavioral Change Sufficient Retention Drug Use Crime Therapeutic Relationship Psycho-Social Change Social Relations Posttreatment Enhanced Counseling Social Skills Training Social Support Services Simpson, 2001 (Addiction)

  39. How to Order KAPs To order publications, contact SAMHSA at http://store.samhsa.gov or 1-877-SAMHSA-7 (1-877-726-4727) (English and Español) or call 800-487-4889 (TDD hearing impaired) and ask for an information specialist

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