National Frontier and Rural ATTC National Addiction Workforce Work-Group December 10, 2012
Serve as the national subject expert andkey resource to PROMOTE the awareness and implementation of telehealth technologies
PREPARE pre-service addiction treatment and allied health students on usingtelehealth technologies by developing and disseminating academic curricula for infusion into existing courses;
Create addiction treatment telehealth competencies and develop policyrecommendations for national licenseportability to encourage the addictiontreatment and recovery workforce toADOPT the use of telehealth services;
Use state-of-the-art culturally-relevanttraining and technical assistance activities to help the frontier/rural addiction treatment and recovery workforce IMPLEMENT telehealth services.
DefinitionsTelehealth ‘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 abridge 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 GroupPurpose: To assist/advise NFAR staff on issues relating to frontier/rural addiction treatment workforce- retention, recruitment, and training.
National Addiction Workforce GroupCommitment: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
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 behavioraltherapy (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, includingcravings, problem solving and decision making skills.
TES is an interactive, web-basedprogram theoretically grounded in the evidence-based Community Reinforcement Approach (CRA) to behavior therapy Theoretical Approach: CommunityReinforcement Approach (CRA) behaviortherapy; 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 recordingsoftware to record and submit videos of breath carbonmonoxide (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 briefintervention with the goal of facilitating self-change, treatment engagement,and/or motivation to change via a single intervention session. Theoretical Approach: Motivational intervention Target Substance: Multiple substances, poly-substance use
cMET/CBT/CM is a computer- delivered intervention for cannabisuse 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 Assessment GoalsDetermine the•use of telehealth by treatment providers,especially those in frontier/rural areas•regulations/issues regarding telehealth•interest in/use of telehealth recovery supportservices•use of telehealth in providing clinical supervisionto addiction treatment clinical staff
MethodologyTarget populations • SSAs and/or NTNs • State credentialing boards • Recovery community programs • Clinical Supervisors from all 10 regions
Collect quantitative and qualitative data regarding•use of telehealth in providing addiction treatmentservices, clinical supervision, and recovery support•interest among treatment provider administratorsin offering telehealth from a business practiceperspective•training/TA needs