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National Frontier and Rural ATTC
National Addiction Workforce Work-GroupDecember 10, 2012
Serve as the national subject expert and key resource to PROMOTE the awareness
and implementation of telehealth technologies
PREPARE pre-service addiction treatment and allied health students on using
telehealth technologies by developing and disseminating academic curricula for
infusion into existing courses;
Create addiction treatment telehealth competencies and develop policy
recommendations for national license portability to encourage the addiction treatment and recovery workforce to ADOPT the use of telehealth services;
Use state-of-the-art culturally-relevant training and technical assistance activities
to help the frontier/rural addiction treatment and recovery workforce IMPLEMENT telehealth services.
Definitions
Telehealth ‘refers to the use of telecommunications and information technologies to provide access to health information and services across a geographical distance.’
Telemedicine –’Use of medical information exchanged from one site to another via electronic communications to improve patients’ health status’
Telehealth is not about technology itself but is a bridge to relationship with the patient in order to
provide care. Shore, 2012
Definitions
• Synchronous communications- Telephone counseling• Asynchronous Communications-
email or web-based programs• Some web-based programs include
both type of communications
National Addiction Workforce Group
Purpose: To assist/advise NFAR staff on issues relating to frontier/rural addiction treatment workforce- retention, recruitment, and training.
National Addiction Workforce Group
Membership: NASADADSAASATTCsWorkforce researchersRural/frontier treatment providersState Treatment Providers Associations
National Addiction Workforce Group
Commitment:
First Year 4 meetings
NASADAD Survey
• In 2009, Addiction treatment providers in 16 states reported offering treatment services using telehealth (16 states out of the 37 states that responded to the survey) • 25 states reported providing
mental health treatment services using telehealth
Brief Review of Research
Telehealth Research
• 141 Randomized Control Trials–148 telemedicine interventions with
nearly 37,000 patients–108 of the trials were favorable toward
telemedicine intervention–38 trials showed no statistical differences
CBT4CBT is a computer-based version of cognitive behavioral therapy
(CBT) used in conjunction with standard clinical care for current substance users. Six modules and
follow up assignments focus on key concepts in substance use, including
cravings, problem solving and decision making skills.
TES is an interactive, web-based program theoretically grounded in the
evidence-based Community Reinforcement Approach (CRA) to
behavior therapy
Theoretical Approach: Community Reinforcement Approach (CRA) behavior therapy; contingency management (CM)
Target Substance: Poly-substance use
Mōtiv8 is a web based contingency management program for smoking cessation using a home
monitoring system
Subjects log onto a website and use video recording software to record and submit videos of breath carbon monoxide (CO) samples. The Mōtiv8 application uses a
web-based interface for collecting data, automating immediate voucher (incentive) delivery, and some versions of the application include a group support
forum.
MES is a computer-based brief intervention with the goal of facilitating
self-change, treatment engagement, and/or motivation to change via a single
intervention session.Theoretical Approach:
Motivational interventionTarget Substance: Multiple substances,
poly-substance use
cMET/CBT/CM is a computer-delivered intervention for cannabis
use disorders, incorporating features of three evidence-based treatments: cognitive behavioral therapy (CBT), motivational enhancement therapy
(MET), and contingency management (CM). Nine sessions presented over 12 weeks offer computer-assisted
instruction
MyStudentBody is an interactive, web-based brief intervention for alcohol use
in college student populations
Theoretical Approach: Screening and Brief intervention
Target Substance: Alcohol
McClure, Acquanta, Harding, & Stitzer In Press
• Surveyed 8 urban clinics in Baltimore (266 patients)• Client’s Access to:–Mobile Phone- 91%– Text Messaging- 79%– Internet/Email/Computer 39-45%
Training Substance Abuse Clinicians in Motivational Interviewing Using Live
Supervision via TeleconferencingTeleconferencing supervision (TCS)
was developed to provide remote, live supervision for training MI
TCS shows promise for promoting new counseling behaviors following
participation in workshop training. Smith, et al., 2012 Journal of Consulting and Clinical Psychology;80(3):450-464
Needs AssessmentGoals
Determine the •use of telehealth by treatment providers, especially those in frontier/rural areas•regulations/issues regarding telehealth •interest in/use of telehealth recovery support services •use of telehealth in providing clinical supervision to addiction treatment clinical staff
Target populations• SSAs and/or NTNs • State credentialing boards • Recovery community programs• Clinical Supervisors from all 10 regions
Methodology
Collect quantitative and qualitative data regarding•use of telehealth in providing addiction treatment services, clinical supervision, and recovery support •interest among treatment provider administrators in offering telehealth from a business practice perspective•training/TA needs