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Bartholomew, N. G., Rowan-Szal, G. A., Chatham, L. R., Nucatola, D. C., & Simpson, D. D. (2002). Sexual abuse among women entering methadone treatment. Journal of Psychoactive Drugs, 34(4), 347-354.

Abstract: Women who enter drug abuse treatment programs are likely to report histories of sexual abuse that may impact psychosocial functioning, retention, and outcomes. This study investigates differences at admission between women with and without sexual abuse histories who entered an outpatient methadone treatment program in Texas. In a sample of 137 women, 39% reported prior sexual abuse. Findings show that women with sexual abuse histories were more likely also to have experienced physical and emotional abuse, to report poorer family-of-origin relationships, and to report more drug-related problems. These clients also reported more depression, anxiety, thoughts of suicide, trouble concentrating, and trouble controlling violent behavior. Results are discussed in terms of the need for adequate assessment of abuse history at intake and the need for targeted outcome studies to better define the impact of past abuse on treatment participation and outcome. [Keywords: Methadone; psychosocial functioning; sexual abuse; women]

Bennett, J. B., & Lehman, W. E. K. (2002).  Supervisor tolerance-responsiveness to substance abuse and workplace prevention training: Use of a cognitive mapping tool.  Health Education Research, 17(1), 27-42.

Abstract:  Supervisor tolerance-responsiveness, referring to the attitudes and behaviors associated with either ignoring or taking proactive steps with troubled employees, was investigated in two studies. The studies were conducted to help examine, understand and improve supervisor responsiveness to employee substance abuse. Study 1 examined supervisor response to and tolerance of coworker substance use and ways of interfacing with the Employee Assistance Program (EAP) in two workplaces (n = 244 and 107). These surveys suggested that engaging supervisors in a dialogue about tolerance might improve their willingness to use the EAP. Study 2 was a randomized control field experiment that assessed a team-oriented training. This training adopted a cognitive mapping technique to help improve supervisor responsiveness. Supervisors receiving this training (n = 29) were more likely to improve on several dimensions of responsiveness (e.g. likely to contact the EAP) than were supervisors who received a more didactic, informational training (n = 23) or a no-training control group (n = 17). Trained supervisors also showed increases in their own help-seeking behavior. Procedures and maps from the mapping activity (two-stage conversational mapping) are described. Overall, results indicate that while supervisor tolerance of coworker substance use inhibits EAP utilization, it may be possible to address this tolerance using team-oriented prevention training in the work-site.

Broome, K. M., Simpson, D. D., & Joe, G. W. (2002). The role of social support following short-term inpatient treatment.  The American Journal on Addictions, 11, 57-65.

Abstract:  The intensive, time-limited short-term inpatient modality treatment for substance abuse appears to have positive outcomes despite its brevity. This study examined patient characteristics and posttreatment experiences to understand who is likely to benefit from this treatment and under what circumstances. Our sample included 748 patients in 12 short-term inpatient programs. Twenty-two percent of patients used cocaine at least weekly in the 1-year follow-up period, and an additional 9% drank frequently (compared with pretreatment rates of 69% and 15%, respectively). Overall, patients' social support networks following treatment were more important factors than the pre- or during-treatment variables examined.

Brown, B. S., & Flynn, P. M. (2002).  The federal role in drug abuse technology transfer: A history and perspective.  Journal of Substance Abuse Treatment, 22(4), 245-257.

Abstract:  The past 30 years have seen a focus on substance abuse research in association with the creation of federal agencies specifically mandated to guide that effort. While research has been well supported and largely productive, there has been increasing concern with the slow pace of adoption of the findings from that research. The history of those efforts suggests a long-standing concern with knowledge development, and a continuing reliance on print media to achieve knowledge application. Nonetheless, evidence from other human service fields, and increasingly from the substance abuse field, indicates interpersonal strategies are dramatically more effective in achieving the individual and organizational behavior change needed to achieve technology transfer. Argument is made that the federal government remains the best, if not the only resource for promoting technology transfer. A paradigm is described to further federal efforts in this area, and structural elements suggested for the achievement of technology transfer goals. [Keywords: Technology transfer; NIDA; drug abuse treatment; organizational change; research utilization]

Dansereau, D. F., & Dees, S. M. (2002).  Mapping training:  The transfer of a cognitive technology for improving counseling.  Journal of Substance Abuse Treatment, 22(4), 219-230.

Abstract:  To provide information that will reduce the gap between research and practice, the transfer of a complex drug abuse counseling technology is examined.  This technology, cognitive mapping, is a graphic tool shown to effectively facilitate communication and problem solving in group and individual counseling sessions.  Unlike some techniques, mapping requires substantial counselor time, effort, and expertise to learn and to use.  This article briefly describes the development and evolution of mapping and supporting research. It then focuses on our efforts to develop mapping training that will facilitate use of this evidence-based technique in drug abuse treatment.  Major training and transfer pitfalls are noted, and strategies for successful training are recommended.  [Keywords: Mapping; cognitive tools; counselor training; drug abuse treatment]

Hiller, M. L., Knight, K., Leukefeld, C., & Simpson, D. D. (2002).  Motivation as a predictor of therapeutic engagement in mandated residential substance abuse treatment.  Criminal Justice and Behavior, 29(1), 56-75.

Abstract:  Studies of community-based substance abuse treatment indicate that motivation for treatment is critical for retaining clients in the program and for their becoming therapeutically engaged in the recovery process. Relatively little work, however, has examined the effect of motivation on therapeutic engagement in criminal justice settings. Baseline and during-treatment data were collected prospectively from 419 probationers remanded to a 6-month modified therapeutic community. Findings showed that desire for help and treatment readiness were associated with indicators of therapeutic engagement even after statistically controlling for additional factors that could have confounded these relationships. Targeted readiness and induction interventions are therefore recommended for offenders with low motivation who are remanded to treatment in correctional settings.

Hiller, M. L., Knight, K., Rao, S. R., & Simpson, D. D.  (2002).  Assessing and evaluating mandated correctional substance-abuse treatment.  In C. G. Leukefeld, F. Tims, & D. Farabee (Eds.), Treatment of drug offenders:  Policies and issues (pp. 41-56).  New York:  Springer.

Summary:  Research has shown that intensive rehabilitation services provided to offenders in correctional settings can reduce criminality and drug use following incarceration; however, comparatively little is known about the impact of therapeutic communities when used within the context of correctional supervision in the community.  This chapter provides a broad description of the baseline and during treatment assessments that are used with probationers in a “real-world” treatment setting.  Special emphasis is placed on describing the data collection instruments as well as on their potential for narrowing the feedback loop between stakeholders, program staff, and probationers to help improve selection, classification, and the treatment process.  It begins with a functional assessment of the risks and needs the offenders present at treatment intake (including classification of drug dependence problems), followed by an examination of the short-term impact of the TC on improvements in psychosocial functioning and treatment motivation.  Finally, results from a series of analyses are presented that examine the characteristics of clients who drop out of treatment prematurely.

Joe, G. W., Broome, K. M., Rowan-Szal, G. A., & Simpson, D. D. (2002).  Measuring patient attributes and engagement in treatment.  Journal of Substance Abuse Treatment, 22(4), 183-196.

Abstract:  Brief but comprehensive instruments measuring patient motivation, psychosocial functioning, treatment process, social network support, and services received are needed for monitoring drug abuse treatment delivery and patient progress.  Combining this information across patients within a program also provides useful indicators about institutional composition and functioning.  Consequently, the same assessment tools can be used to identify areas where treatment protocols need to be changed, and to monitor improvements following such changes.  The Texas Christian University (TCU) Client Evaluation of Self and Treatment (CEST) is a 144-item self-rating instrument that includes 16 scales measuring patient functioning and treatment perceptions.  Psychometric properties (including reliability and construct validity) of the scales are examined in this article, based on patient samples drawn from 87 programs that participated in a series of staff training workshops.  Acceptable reliabilities (.70 or above) were generally reported, and construct validity was also demonstrated (although the confirmatory factor analyses suggested some item pools could represent more than one factor).  Prediction analyses were conducted using selected scales from each measurement domain to illustrate their sensitivity to treatment program contexts.  [Keywords: Psychosocial functioning; organizational assessment; patient monitoring; program monitoring; reliability; validity]

Knight, K., Simpson, D. D., & Hiller, M. L.  (2002).  Screening and referral for substance-abuse treatment in the criminal justice system.  In C. G. Leukefeld, F. Tims, & D. Farabee (Eds.), Treatment of drug offenders:  Policies and issues (pp. 259-272).  New York:  Springer.

Summary:  The U.S. adult prison and jail inmate population is near the two million mark, with drug-involved offenders comprising the majority of the incarcerated population.  By providing therapeutic intervention, criminal justice agencies have a unique opportunity to identify and rehabilitate drug-involved offenders who are likely, if untreated, to return to a personally and socially destructive pattern of drug use and criminal activity following release from prison.  Since it is neither possible nor necessary to provide services (particularly intensive residential treatment) to every drug-involved offender, referral decisions must be made regarding whether an offender’s drug-related problems are serious enough to warrant treatment.  This chapter describes an objective screening and referral protocol based on the TCU Drug Screen that can serve to provide a consistent means of identifying drug-involved offenders most likely to benefit from limited treatment resources.  The chapter also addresses come of the important factors that correctional agencies should consider when developing a system of screening and referral.

Lehman, W. E. K., & Bennett, J. B.  Job risk and employee substance use: The influence of personal background and work environment factors.  American Journal of Drug and Alcohol Abuse, 28(2), 263-286.

Abstract:  Previous studies have noted that employees who work in jobs with physical risk report more substance use than employees working in non-risky jobs. This study examined the extent to which this relationship could be explained by personal background, specifically general deviance or psychosocial functioning, or work characteristics, including job stressors, organizational bonding, or work group drinking climate. Results from two worksites (ns = 943, 923) indicated that the relationship of job risk and alcohol problems could be fully explained by personal characteristics, particularly deviant behavior styles. Interaction effects were also found. Employees with more deviance indicators were particularly susceptible to recent drug use and problem drinking when they worked in drinking climates or exposed to coworker drinking. These results suggest the joint influence of personal and job factors and support prevention programs that target the workplace social environment.

Lehman, W. E. K., Greener, J. M., & Simpson, D. D. (2002).  Assessing organizational readiness for change.  Journal of Substance Abuse Treatment, 22(4), 197-209.

Abstract:  A comprehensive assessment of organizational functioning and readiness for change (ORC) was developed based on a conceptual model and previous findings on transferring research to practice.  It focuses on motivation and personality attributes of program leaders and staff, institutional resources, and organizational climate as an important first step in understanding organizational factors related to implementing new technologies into a program.  This article describes the rationale and structure of the ORC and shows it has acceptable psychometric properties.  Results of surveys of over 500 treatment personnel from more than 100 treatment units support its construct validity on the basis of agreement between management and staff on several ORC dimensions, relationships between staff organizational climate dimensions and patient engagement in treatment, and associations of agency resources and climate with organizational stability.  Overall, these results indicate the ORC can contribute to the study of organizational change and technology transfer by identifying functional barriers involved.  [Keywords: Organizational behavior; technology transfer; readiness for change; drug treatment programs; psychometrics]

Simpson, D. D. (2002).  A conceptual framework for transferring research to practice.  Journal of Substance Abuse Treatment, 22(4), 171-182.

Abstract:  Systematic evaluations of efforts to transfer research-based interventions and procedures into general practice at community drug treatment programs have been limited.  However, practical experiences as well as results from studies of technology transfer and organizational behavior in related fields provide a basis for proposing a heuristic model of key factors that influence this process.  The successful completion of four stages of activity typically involved in program change (exposure, adoption, implementation, and practice of new interventions) appears to be influenced by several organizational considerations (e.g., institutional readiness for change, resources, and climate) as well as staff attributes.  Assessment instruments for measuring organizational functioning (based on ratings aggregated for staff and patients in a program) are introduced, along with preliminary evidence for their validity.  A better conceptual understanding of the process of program change and common barriers that may be encountered is needed for effectively transferring research to practice.  [Keywords: Drug abuse treatment; technology transfer; organizational behavior; assessments; modeling]

Simpson, D. D., Joe, G. W., & Broome, K. M. (2002). A national 5-year follow-up of treatment outcomes for cocaine dependence.  Archives of General Psychiatry, 59, 538-544.

Abstract:  Background: Long-term (5-year) outcomes of community treatment for cocaine dependence were examined in relation to problem severity at treatment entry and treatment exposure throughout the follow-up period.  Methods: Interviews were conducted at 1 and 5 years after treatment for 708 subjects (from 45 programs in 8 cities) who met DSM-III-R criteria for cocaine dependence when admitted to treatment in 1991-1993.  Primary outcome measures included cocaine use and arrests.  Self-reported cocaine use showed high overall agreement with urine (79% agreement) and hair (80% agreement) toxicology analyses.   Results: Weekly cocaine use was reported by 25% of the sample at 5 years, slightly higher than the 21% at 1 year.  Similarly, 26% had cocaine detected in urine specimens at follow-up and 18% reported having been arrested.  Poorer long-term outcomes were related to higher problem severity at treatment admission and low treatment exposure.  Conclusions: The large decreases in cocaine use 1 year after treatment discharge were sustained during the 5-year follow-up.  Severity of drug and psychosocial problems at intake was predictive of long-term outcomes and outcomes improved in direct relation to level of treatment exposure.

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