Beth A. Rutkowski

Improving client engagement and retention in treatment: The Los Angeles County experience

This article discusses a two-phase demonstration project focused on the implementation of the Network for the Improvement of Addiction Treatment model of process improvement among substance abuse treatment providers in Los Angeles County, California. A total of 30 Change Teams from 12 county-contracted treatment agencies planned and executed one or more rapid-cycle change projects to reduce wait time to treatment, reduce no-shows to scheduled appointments, increase admissions, or improve continuation in treatment. The findings and lessons learned illustrate the importance of a concrete and straightforward methodology and consistent peer-to-peer interaction provided in a learning collaborative environment. In addition, both ongoing technical assistance and coaching are essential for successful implementation of this innovative, low-cost, evidence-based process improvement strategy.

The Rise in Treatment Admissions for Methamphetamine Use in Los Angeles County from 2001 through 2005

Abstract Drug use trends for people entering county-funded treatment programs from 2001 through 2005 were investigated. The sample was drawn from outpatient counseling, residential treatment, and day care habilitative programs. Findings center on the rising number of admissions to treatment programs for primary methamphetamine (MA) use, with a focus on participant gender, age, and race/ethnicity. Additional participant characteristics, such as referral source, employment, housing, and health status were also briefly explored. This investi gation found that the percentage of admissions to treatment programs for primary MA use has substantially increased in Los Angeles County each year from 2001 through 2005. The groups most affected were young people of Asian, Latino, Native American, and White descent. Additionally, it was determined that women were more likely to enter treatment for primary MA use (relative to other drugs) than were males. National implications of these findings, their limitations, and directions for future research are discussed.

California Substance Abuse Research Consortium, September 2005: update on recent methamphetamine trends in four California regions.

Abstract California Substance Abuse Research Consortium (SARC) meetings have become a mainstay in supporting the exchange of new alcohol and other drug information on research to policy and other initiatives throughout the state. A cornerstone of SARC is a discussion of regional substance abuse patterns and trends. This article provides readers with a brief overview of recently released methamphetamine statistics, as well as a more detailed review of the methamphetamine information presented during the substance abuse epidemiology portion of the September 2005 meeting, as presented for Kern County, Los Angeles County, San Diego County, the San Francisco Bay Area, and the state of California.

Editors' Introduction: The Evidence for Integrated Care—Substance Use Disorders, Mental Health and Primary Care: California Substance Abuse Research Consortium (SARC) Meetings, 2011

The California Substance Abuse Research Consortium (SARC) has, for nearly 30 years, documented (1) California’s developing and evolving substance abuse trends; (2) critical research efforts within the state conducted to raise awareness of and increase knowledge about local and regional substance abuse problems; and (3) relevant policy decisions and initiatives. The SARC meeting series offers an opportunity for professionals from a variety of disciplines to come together in a face-to-face setting to discuss the latest promising prevention and treatment strategies, emerging and continued criminal justice and social service partnerships, and other relevant substance use disorder-related topics. SARC is sponsored by the California Department of Alcohol and Drug Programs (ADP) and the Pacific Southwest Addiction

“I've been NIATxed”: Participants' Experience with Process Improvement

Abstract Process improvement strategies provide industries with a method for improving outcomes and performance at a low cost and with minimal training. In Los Angeles County, two process improvement projects were implemented as a way to improve access to, and engagement and retention in, alcohol and other drug abuse treatment. A qualitative evaluation was completed after the Phase II pilot project to assess how the providers felt about the project, what worked, what did not work, what was learned, and the degree to which process improvements changed program operations. Semistructured interviews were conducted with 33 individuals, representing every level of staff participation in the project. Overall, comments indicated a positive experience for staff, administrators, and clients. Providers noted the relative ease of implementation and how quickly changes resulted in impressive improvements. Challenging issues included resistant staff or a lack of additional resources to pay for the project; however, most noted that these issues were resolved. Interview participants also requested more training on data collection and a reduction in the frequency of the project conference calls. This study gives support to the idea of process improvement being a tool that dramatically improves services to consumers of addiction treatment services.

Using ECHO Clinics to Promote Capacity Building in Clinical Supervision

INTRODUCTION Project Extension for Community Healthcare Outcomes (ECHO™) is a hub-and-spoke knowledge-sharing network, led by expert teams who use multipoint videoconferencing to conduct virtual clinics with community providers in order to improve the quality of care. For this project, members of the Addiction Technology Transfer Center network applied this model in order to enhance workforce capacity to deliver clinical supervision for the treatment of substance use disorders. METHODS Clinical supervisors (n=66) employed in substance use disorder treatment programs were recruited to participate in this pilot study. The virtual ECHO clinic consisted of 12 total sessions, each lasting 1 hour and comprising a 15-minute mini-lecture on a clinical supervision topic and a 45-minute case presentation and review. All data were collected and analyzed between September 2016 and June 2017. RESULTS Forty-eight staff attended at least one ECHO session (mean=6.38) and results are presented for 20 staff who completed the follow-up survey. Participants were highly satisfied with the overall intervention, organization of the clinic and the facilitation of Hub experts, relevance of the technical assistance to their work, and with the impact of the intervention on their effectiveness as a supervisor. Results also indicate that there were significant self-reported improvements in clinical supervision self-efficacy following participation in the ECHO clinic. CONCLUSIONS Results from this pilot study suggest that ECHO virtual clinics are feasible to implement for the purpose of workforce development, are well liked by participants, and can enhance clinical supervision self-efficacy among participants. Further research should explore the impact of self-efficacy on the effective implementation of clinical supervision practices. SUPPLEMENT INFORMATION This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

Editors' introduction: Identifying and assessing promising practices for criminal justice clients--California Substance Abuse Research Consortium (SARC) meetings, 2010.

Abstract Although some practices clearly have stronger supporting evidence than others, a single authoritative list of evidence-based practices (EBPs) that can be applied in the treatment of criminal justice clients does not exist. Nationally, use of EBPs is low, and such practices are generally only implemented under certain circumstances. To clarify these issues, experts from around the nation were invited to California for two research-to-policy meetings focused on EBP identification and implementation. Their presentations and the resulting series of articles in this special theme issue describe the current state of EBP research for criminal justice clients. To advance the field beyond the compilation of EBP lists, which can only represent a partial solution at best, next steps should include a greater focus on quality of implementation, intensity of quality assurance and monitoring, and training for underlying skills and principles.