So far we have developed general knowledge about the biological, psychological, and social contributors to substance use disorders. We have come to appreciate these disorders as developmental disorders, and we are able to cite evidence that supports what we believe are the risk and protective factors associated with the onset of substance use disorders. As practitioners, an appreciation of these etiologies is essential, since they guide us in the creation and application of evidence-based treatment and prevention practices. We also have learned about the principles of evidence-based practice and are building capacity in the skills essential to the identification of valid and useful evidence for practice.
In this lesson, we begin to consider established and innovative approaches for the prevention and treatment of substance use and substance use disorders. This lesson is designed to provide a basic introduction to the philosophies underpinning current approaches to the prevention and treatment of substance use disorders. We also will examine the macro (ideological) context, mezzo (agency/organizational) culture, and individual counselor characteristics associated with the acceptance and implementation of evidence-based practice (EBP) in the prevention and treatment of substance use disorders.
Readings and discussions pertaining to the theories that have influenced the development of current programs, services, and practices; and recommendations for ongoing development will explain the challenges and rewards faced by many members of Canada’s substance abuse workforce. Special consideration is given to the concept of a continuum of care for addiction treatment that addresses the changing needs of clients as they transition through stages of recovery. We also will continue to develop our evidence-based decision making (EBDM) competency by applying EBDM skills to our investigation of long-standing and innovative practices.
A central question in this lesson is: Are the treatment modalities used in practice consistent with our knowledge and understanding of the causes of substance use disorders?
Lesson 7 addresses the following topics:
- Knowledge to practice: Congruence of etiology and treatment perspectives
- Knowledge to practice: Implementing evidence-based knowledge to practice
- Knowledge to practice: The counselor’s role
After you complete this lesson, you should be able to:
- Assess contrasting theories of substance use disorders for their utility in prevention and treatment.
- Evaluate the knowledge-to-practice gap in the field of problematic substance use.
- Explain the various factors (barriers) that have been responsible for our current knowledge-to-practice gap (i.e., how the natural diffusion process of practice change has created a large gap).
- Develop recommendations for closing the knowledge-to practice gap in the treatment and prevention of problematic substance use.
- Identify your role in closing the knowledge-to-practice gap in your workplace.
Arria, A. M ., & McLellan, A. T. (2012). Evolution of concept—but not action—in addiction treatment. Substance Use Misuse, 47, 1041–1048.
Available Through TRU Library
Amodeo, M., Lundgren, L., Fernanda-Beltrame, C., Chassler, D., Cohen, A., & D’Ippolito, M. (2013). Facilitating factors in implementing four evidence-based practices: Reports from addiction treatment staff. Substance Use and Misuse, 48, 600–611.
Cunningham, J. A., & McCambridge, J. (2011). Is alcohol dependence best viewed as a chronic relapsing disorder? Addiction, 107, 6–12.
Garner, B. (2009). Research on the diffusion of evidence-based treatment within substance abuse treatment: A systematic review. Journal of Substance Abuse Treatment, 36, 376–399.
Glasner-Edwards, S., & Rawson, R. (2010). Evidence-based practices in addiction treatment: Review and recommendations for public policy. Health Policy, 97(2-3), 93–104.
Miller, W. R., Sorensen, J. L., Selzer, J. A., Brigham, G. S. (2006). Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. Journal Substance Abuse Treatment, 31, 25–39.
Smith, B. (2013). Substance use treatment counselors’ attitudes toward evidence-based practice: The importance of organizational context. Substance Use and Misuse, 48, 379–390.
HBO Addiction Series: Treatment. Available at: http://www.hbo.com/addiction/treatment/index.html?current=2
Following is a checklist of the learning activities you will be completing in Lesson 7. You may find it useful for planning your work.
☐ Activity 1: Do treatment methods match etiology knowledge?
☐ Activity 2: Implementing new practices—Is your agency well suited to do this?
☐ Activity 3: Facilitating factors in implementing evidence-based practice—Your role